肥大细胞、嗜碱细胞与药物过敏及过敏性休克的诊断标志物  

Mast Cell and Basophil,Diagnostic Biomarkers for Drug Allergy and Anaphylaxis

作　　者：周晓鹰[1,2] 王晶晶[2] 储奕[2] 

机构地区：[1]英国南安普顿大学医学院 [2]常州大学制药工程与生命科学学院,江苏常州213164

出　　处：《常州大学学报（自然科学版）》2017年第3期69-76,共8页Journal of Changzhou University：Natural Science Edition

基　　金：British Medical Research Council;UK(G0500729);常州科技局国际交流研究基金项目(KYJ1520305);常州大学高层次人才引进启动基金项目(ZMF14020066)

摘　　要：药物过敏及其导致的过敏性休克对医患双方都是很严重问题,过敏的发生不可预测,且可危及生命。随着全世界新药新化合物的不断出现,药物过敏问题变得越来越常见和突出。目前药物过敏的诊断方法主要是皮试、皮内点刺、皮肤斑贴、激发试验和血液特异性IgE水平,但这些方法都有一定的限制,而皮试等体内试验本身就具有极大的风险,所以研究诊断生物标志物以及建立体外诊断方法和过敏预测系统则尤其必要。肥大细胞和嗜碱细胞是过敏反应的核心细胞,其激活释放化学介质是这些细胞的主要特征。近10年来,对于药物过敏及过敏性休克发生的细胞激活机制、细胞特异性介质的特征以及作为诊断标志物的研究有了很大的进展,其中包括肥大细胞特异性蛋白酶:类胰蛋白酶、类糜蛋白酶、羧肽酶;嗜碱细胞活化的细胞表面标志物CD63、CD203C和特异性的basogranulin;还有其他和过敏症状相关的体内化学介质,如组胺、二肽肽酶Ⅰ、血管紧张素转化酶和缓激肽等。由于过敏反应是一个复杂的快速的病理反应,其诊断需要多重复合标志物的协同使用,所以荧光染料、电化学和生物信息科学的交叉融合和技术设计是快速即时体外诊断方法的发展趋势,对过敏体质及症状的及时发现和病情的早期控制和对人类生活质量的提高都有着重要的意义。Drug allergies and its leading to anaphylactic shock are very serious problems for patients and clinicians.The incidence of allergies is unpredictable and life threatening.With the rapid development of new drugs and new chemical compounds,drug allergy problems seem to be more common and prominent.Current drugs allergy diagnostic methods are mainly in vivo skin prick test,intra-dermal techniques,and serum antigen-specific IgE test.These methods have certain restrictions and limited arranges,and even in vivo test(such as skin test)itself will have great risks.Therefore,study on diagnostic markers,establishment of in vitro diagnostic methods and predicting test systems are particularly important.Mast cells and basophils are core cells during allergic reaction development,which is characterized by cell activation/degranulation and then release the chemical mediators.This article described the cell activation mechanisms in drug allergies and anaphylactic shock,and also discussed cell-specific mediators as the diagnostic markers,including mast cell-specific proteases:tryptase,chymase and carboxypeptidase;the cell surface markers of basophile activation of CD63,CD203 C,and basophile specific mediator basogranulin.This article also discussed other relevant mediators associated with allergies,such as histamine,dipeptidyl peptidaseⅠ,angiotensin converting enzyme and bradykinin,and suggested that the multiple bio-markers system should be fully developed for allergic or anaphylaxis diagnostics.The combined and cross-fields studies between the choices of fluorescent dyes,electrochemistry and biological information science will be the direction of development for the rapid,real-time in vitro diagnostic methods,which is of great significance to the timely and rapid discovery of disease and early control of disease progress,as well as to the improvement of human health and life quality.

关 键 词：药物过敏 过敏性休克 肥大细胞 嗜碱细胞 诊断标志物 

分 类 号：R392.8[医药卫生—免疫学]