杭州浙大迪迅生物基因工程有限公司

原标题：过敏原组分分析是诊断和治疗职业性过敏的一种手段
要点
　　目前已鉴定出400多种职业致敏剂，但其中只有少数被进行在分子水平上的特征描述。
天然胶乳(NRL)过敏是利用重组主要变应原改善sIgE测定的一个很好的范例。
面包师哮喘患者的IgE 致敏情况显示出很大的个体间差异。
对于面包师哮喘的诊断，基于提取的诊断仍然是推荐的。
增加职业过敏原的知识，并在临床实践中实施和评估标准化的工具是必要的
概述
　　我们正处于“分子变应学”的时代，大量临床相关的变应原分子可用于改善体外变应原试验和变应原检测方法的性能。本文综述了职业性变应原的特征及其在职业性变态反应的体外诊断和变应原检测中的应用。
超过400种职业性致敏剂被鉴定为“呼吸敏化剂”，但目前只有有限数量的过敏原在分子水平上被鉴定并能以天然或重组过敏原的形式用于常规诊断。但有一个例外，即来自巴西橡胶树的天然胶乳(NRL)仍然是重要的职业性过敏原来源。
对15个天然橡胶乳胶（NRL）变应原的表征导致了对NRL材料中过敏原含量测定方法的发展和针对特异性IgE抗体测定的组分诊断(component- resolution diagnosis, CRD)的出现。使用重组或天然过敏原的微阵列芯片或单点检测是诊断NRL过敏的可靠工具。
此外，NRL过敏是一种利用稳定的重组主要变应原rHev b5扩增NRL提取物制剂改进基于提取物的特异性IgE测定的优良模式。尽管人们做了很多努力来确定与职业相关的小麦过敏原对面包师哮喘的影响，但结果却非常多样化。面包师哮喘是最常见的职业性哮喘。
面包师傅的小麦致敏谱表现出较大的个体差异，没有一种小麦过敏原能被认为是主要过敏原。对于面包师哮喘的诊断，全麦提取物仍然是特异性IgE测定的最佳选择。但是单一的小麦过敏原可能有助于区分小麦引起的食物过敏、草花粉过敏和面包师哮喘。对于工作场所相关的过敏原，如咖啡、木材、大豆、海鲜和霉菌等，过敏原虽被表征，但很少有可用的，其与职业致敏途径的相关性有待进一步研究验证。
延伸阅读
Molecular Immunology                              
Allergen component analysis as a tool in the diagnosis and management of occupational allergy
https://doi.org/10.1016/j.molimm.2018.03.013
Highlights
More than 400 occupational sensitizers are identified, but only a limited number of them are characterized on the molecular level.
Natural rubber latex (NRL) allergy is an excellent model for improving sIgE measurement with recombinant major allergen.
IgE-sensitization profile in patients with baker’s asthma showed great inter-individual variation.
For diagnosis of baker’s asthma extract-based diagnostic is still recommended.
Increasing the knowledge of occupational allergens and implement and evaluate standardized tools in clinical practice is necessary.
Abstract
We are now in the epoch of “molecular allergology” and numerous clinically relevant allergenic molecules are available improving the performance of in vitro allergen tests and allergen detection methods. This review is focusing on characterized occupational allergens and their implementation into the in vitro diagnosis for occupational allergy and in allergen detection methods.
More than 400 occupational agents are identified and documented as being ‘respiratory sensitizers’, but currently only a limited number of them are characterized on the molecular level and available for routine diagnosis as native or recombinant allergens. One exception, however, is natural rubber latex (NRL) from Hevea brasiliensis still remaining an important occupational allergen source.
Characterization of 15 NRL allergens led to the development of assays for the determination of allergen content of NRL materials and the implementation of component-resolved diagnosis (CRD) for specific IgE antibody measurement. Microarray or singleplex using recombinant or native allergens are reliable tools for NRL allergy diagnosis.
In addition, NRL allergy is an excellent model for improving extract-based specific IgE measurement by amplification of NRL extract preparation with stable recombinant major allergen rHev b 5. Despite the many efforts to characterize the occupationally relevant wheat allergens for baker’s asthma, the most frequently occurring forms of occupational asthma, the results are highly diverse.
Wheat sensitization profiles of bakers showed great interindividual variability and no wheat allergen could be classified as the major allergen. For diagnosis of baker’s asthma, a whole wheat extract is still the best option for specific IgE determination. But single wheat allergens might help to discriminate between wheat-induced food allergy, grass pollen allergy and baker’s asthma. For workplace-related allergens like coffee, wood, soybean, seafood and moulds allergens are characterized and few of them are available, but their relevance for occupational sensitization routes should be verified in the further studies.
Author:
MonikaRaulf
　　创建过敏性疾病的科研、科普知识交流平台，为过敏患者提供专业诊断、治疗、预防的共享平台。