尘螨致敏蛋白组分在变应性鼻炎和哮喘中的差异及其临床意义  

Profiles of IgE sensitization to dust mite allergen components in patients with allergic rhinitis and asthma

作　　者：王晓艳 普晓瑜 陈力嘉 郭淼颖 郑长波 王洪田 王学艳 WANG Xiaoyan;PU Xiaoyu;CHEN Lijia;GUO Miaoying;ZHENG Changbo;WANG Hongtian;WANG Xueyan(Department of Allergy,Beijing Shijitan Hospital,Capital Medical University,Beijing,100038,China;Allergy Center,Beijing Shijitan Hospital,Capital Medical University;Department of Otolaryngology Head and Neck Surgery,Beijing Shijitan Hospital,Capital Medical University)

机构地区：[1]首都医科大学附属北京世纪坛医院变态反应科,北京100038 [2]首都医科大学附属北京世纪坛医院变态反应中心 [3]首都医科大学附属北京世纪坛医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第8期576-581,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：北京市卫健委首发专项(No:首发2022-2-2082);中国铁路集团公司科技课题(No:J2021Z603);北京市医管中心培育计划(NO:PX2022030)。

摘　　要：目的研究变应性鼻炎(AR)、AR伴哮喘综合征(ARAS)患者的尘螨致敏组分蛋白差异及其临床意义。方法回顾性分析42例AR伴或不伴哮喘患者的临床资料,分为AR组和ARAS组。采用ImmunoCAP过敏原检测系统检测体外血清户尘螨和粉尘螨sIgE浓度。同时采用蛋白芯片法进行户尘螨组分(Der p 1、Der p 2、Der p 7、Der p 10、Der p 21、Der p 23)和粉尘螨组分(Der f 1、Der f 2)检测,分析尘螨过敏原及其组分在AR组和ARAS组中的表达差异。结果31例AR和11例ARAS纳入研究。户尘螨阳性率为100.0%,粉尘螨为97.6%。尘螨组分蛋白致敏率由高到低依次为Der p 1(73.8%)、Der f 1(66.7%)、Der f 2(64.3%)、Der p 2(61.9%)。ARAS组的尘螨组分蛋白Der f 1(100.0%和54.8%,P=0.006)、Der p 2(90.9%和51.6%,P=0.021)、Der f 2(100.0%和51.6%,P=0.004)致敏率显著高于AR组。AR组户尘螨sIgE浓度显著低于ARAS组[(7.65±12.15)kUA/L和(15.20±18.77)kUA/L,P<0.05]。ARAS组Der p 1[(5.39±4.61)kUA/L和(2.03±2.97)kUA/L,P=0.013]、Der p 2[(8.82±13.58)kUA/L和(2.78±5.80)kUA/L,P=0.001]、Der p 23[(1.76±3.88)kUA/L和(0.28±0.65)kUA/L,P<0.001]的sIgE浓度显著高于AR组。相关性分析发现Der p 1、Der p 2、Der f 1、Der f 2具有高度正相关性(P<0.01)。户尘螨组分致敏表现出多重致敏的特点,42例患者中,66.7%出现≥2种的户尘螨组分蛋白阳性,AR组为58.1%,ARAS组为90.9%。ARAS组更倾向于多种组分致敏,≥3种的组分致敏率显著高于AR组(54.6%和29.1%,P<0.05)。结论ARAS较AR患者尘螨浓度更高,Der p 1、Der f 1、Der p 2、Der f 2是主要致敏蛋白组分,致敏率在ARAS患者中更高。Der p 1、Der p 2、Der p 23的浓度在ARAS患者中更高。ARAS患者更倾向于多重组分致敏。Objective To study the differences and clinical significance of dust mite allergen components in allergic rhinitis(AR)and allergic rhinitis with asthma syndrome(ARAS)patients.Methods The clinical data of 42 AR patients were retrospectively analyzed and patients were divided into AR and ARAS group.The serum sIgE concentrations of house dust mites were detected by ImmunoCAP system.The allergen components of Der p(Der p 1,Der p 2,Der p 7,Der p 10,Der p 21,Der p 23)and Der f(Der f 1,Der f 2)were analyzed by protein microarray method.The concentration differences of dust mite allergen and its components in AR and ARAS groups were analyzed.Results Thirty-one cases of AR and 11 cases of ARAS were included.The positive rate of Der p and Der f was 100.0%and 97.6%,respectively.The highest sensitization rates of Der p allergen components were as following:Der p 1(73.8%),Der f 1(66.7%),Der f 2(64.3%)and Der p 2(61.9%).The sensitization rates of Der f 1(100.0%vs 54.8%,P=0.006),Der p 2(90.9%vs 51.6%,P=0.021)and Der f 2(100.0%vs 51.6%,P=0.004)in ARAS group were significantly higher than those in AR group.The sIgE concentrations of Der p in AR group were significantly lower than those in ARAS group([7.65±12.15]kUA/L vs[15.20±18.77]kUA/L,P<0.05).The sIgE concentrations of Der p 1([5.39±4.61]kUA/L vs[2.03±2.97]kUA/L,P=0.013),Der p 2([8.82±13.58]kUA/L vs[2.78±5.80]kUA/L,P=0.001),Der p 23([1.76±3.88]kUA/L vs[0.28±0.65]kUA/L,P<0.001)was significantly higher in ARAS group than that of AR group.Correlation analysis showed that Der p 1,Der p 2,Der f 1 and Der f 2 had high positive correlation(P<0.01).The dust mite components sensitization showed a multiple-sensitized mode.66.7%of the 42 patients were positive for two or more components while it was 58.1%of the AR group and 90.9%of the ARAS group.The sensitization rate of 3 or more components in ARAS group was significantly higher than that in AR group(54.6%vs 29.1%,P<0.05).Conclusion The concentration of dust mites allergens in ARAS group is higher than that in AR group.Der p 1,

关 键 词：变应性鼻炎伴哮喘综合征 户尘螨 粉尘螨 致敏组分 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]