烟曲霉致敏的呼吸道疾病患者对其他真菌致敏的sIgE水平及相关性分析  

Correlations among serum specific IgE levels against several fugal species in patients with aspergillus fumigatus induced asthma or allergic bronchopulmonary aspergillosis

作　　者：胡海圣 罗文婷[1] 吴世权[1] 韦妮莉[1] 梁雪清[1] 孙宝清[1] 

机构地区：[1]广州医科大学附属第一医院 国家呼吸疾病临床医学研究中心变态反应科,510120

出　　处：《国际呼吸杂志》2016年第10期721-725,共5页International Journal of Respiration

基　　金：基金项目：广东省省级科技计划项目（20138090500129）;呼吸疾病国家重点实验室开放课题（2014SRLR13-008）

摘　　要：目的 探讨呼吸道疾患者对真菌致敏的免疫球蛋白E （specific ImmunoglobulinE,sIgE）水平及多重致敏现象.方法 筛选广州医科大学附属第一医院烟曲霉sIgE阳性且级别大于等于三级的哮喘或变态反应性支气管肺曲霉菌病（ABPA）成人患者,分为烟曲霉致敏哮喘组及ABPA组.采用ImmunoCAP 1000荧光酶联免疫系统检测患者血清点青霉、分支孢霉、烟曲霉、白假丝酵母霉、链格孢霉与长蠕孢霉sIgE浓度.结果 ABPA患者烟曲霉sIgE显著高于烟曲霉致敏哮喘患者（P＜0.05）[26.7 （13.3,54.3） kU/L vs 12.7 （5.90,33.4） kU/L]、白假丝酵母sIgE[7.90 （1.40,6.00） kU/L vs 1.00 （0.40,6.00） kU/L]、点青霉sIgE[17.6 （6.80,37.6） kU/L vs 4.30 （4.30,4.30） kU/L]、链格孢sIgE[2.60 （1.70,16.0）kU/L vs 0.90 （0.40,2.10） kU/L].所有患者皆有多重霉菌致敏现象,各霉菌sIgE水平存在不同程度相关,最优尺度分析显示烟曲霉与链格孢霉关系最近（Cronbach＆#39;s Alpha=95.7％）.结论烟曲霉菌致敏患者常伴多重霉菌过敏现象,或因霉菌间分泌相同的致敏蛋白引起,多种霉菌sIgE浓度的检测或可作为真菌致敏哮喘辅助检查.Objective To investigate the levels of specific immunoglobulin E （sIgE） against several fugal species and status of multiple fugal sensitization in patients with respiratory diseases.Methods We recruited a cohort of adult patients diagnosed with asthma or allergic bronchopulmonary aspergillosis （ABPA） and were positive （grade 3 or higher response） to aspergillus fumigates （ASF）.Accordingly,the subjects were assigned to ASF-induced asthma group or ABPA group.The patients were measured for serum levels of IgEs against penicillum notatum,cladosporium,aspergillus fumigatus,candida albicans,alternaria and helminthosporium by a fluorescent enzyme linked immunosorbent assay （ImmunoCAP 1000）.Results Compared with ASF-induced asthma patients,the ABPA group had significantly higher levels of sIgE against aspergillus fumigatus [26.7（13.3,54.3） kU/L vs 12.7（5.9,33.4） kU/L],candida albicans [7.9 （1.4,6.0） kU/L vs 1.0 （0.4,6.0） kU/L],penicillium notatum [17.6 （6.8,37.6） kU/L vs 4.3 （4.3,4.3） kU/L],and alternaria [2.6 （1.7,16.0） kU/L vs 0.9 （0.4,2.1） kU/L] （all P 〈 0.05）.All patients were sensitized to multiple fungal species.There were significant correlations between the sIgE levels of fungus in these subjects （all P 〈0.05）.Multivariate analysis with optimal scaling identified a closest relationship between aspergillus fumigatus and alternaria （Cronbach＆#39;s Alpha =95.7%）.Conclusions ASF-sensitized patients are usually atopic to several other fungal species,probably resulting from sensitization to certain identical proteins secreted by the fungi.SIgE detection targeting at multiple fungal species may help in diagnosing fungal allergic asthma.

关 键 词：呼吸道疾病 烟曲霉致敏 特异性IGE 

分 类 号：R56[医药卫生—呼吸系统]