Predictive value of skin prick tests using recombinant allergens for diagnosis of peanut allergy
Predictive value of skin prick tests using recombinant allergens for diagnosis of peanut allergy
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DOI：
10.1016/j.jaci.2006.04.053
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发表时间：
2006-07-01
影响因子：
14.2
通讯作者：
Kanny, Gisele
中科院分区：
文献类型：
--
作者：
Astier, Catherine;Morisset, Martine;Kanny, Gisele
背景：目前花生过敏的诊断依赖于缺乏标准化的天然提取物。重组 DNA 技术可以生产具有生化特征的纯蛋白质。它们对于花生过敏诊断的有用性尚未确定。目的：本研究旨在评估 3 种主要重组花生过敏原的诊断价值。方法：重组 (r) Ara h1、rAra h2 和 rAra h3 根据重组过敏原良好生产规范的建议生产。对 30 名花生过敏患者和 30 名无食物过敏的对照受试者进行了皮肤点刺试验 (SPT) 和 IgE ELISA 检测：其中 15 名非过敏性受试者，15 名对桦树花粉过敏。通过临床评分对疾病严重程度进行分级。结果：所有花生过敏患者的rAra h 2 SPT结果均呈阳性； 40% 的受试者与 rAra h 1 发生反应，27% 的受试者与 rAra h 3 发生反应。没有对照受试者与任何重组过敏原发生反应。 53% 的患者观察到对 rAra h 2 单敏。 SPT 大小和特异性 IgE 水平均与疾病严重程度无关。然而，对 rAra h 2 单敏的患者的严重程度评分显着低于多敏受试者，针对花生提取物和 rAra h2 的特异性 IgE 水平也较低。结论：针对个体重组花生过敏原的皮肤点刺试验似乎是一种安全有效的诊断工具。对 rAra h2 和 rArah I 和/或 rArah3 的共敏可预测更严重的反应。临床意义：SPT 可使用重组花生过敏原来诊断和评估过敏严重程度。
Background: Current diagnosis of peanut allergy relies on natural extracts that lack standardization. Recombinant DNA technology allows production of pure biochemically characterized proteins. Their usefulness for peanut allergy diagnosis is not established.Objective: This study aimed to evaluate the diagnostic value of the 3 major recombinant peanut allergens.Methods: Recombinant (r) Ara h1, rAra h2, and rAra h3 were produced according to the recommendations of good manufacturing practice for recombinant allergens. Skin prick tests (SPTs) and IgE ELISA assays were performed in 30 patients with peanut allergy and 30 control subjects without food allergy: 15 nonatopic and 15 sensitized to birch pollen. Disease severity was graded by clinical scoring.Results: All patients with peanut allergy showed positive SPT results to rAra h 2; 40% reacted with rAra h 1 and 27% with rAra h 3. No control subjects reacted with any of the recombinant allergens. Monosensitization to rAra h 2 was observed in 53% of patients. Neither SPT size nor levels of specific IgE were correlated with the disease severity. However, patients with monosensitization to rAra h 2 had a significantly lower severity score than polysensitized subjects and a lower level of specific IgE against peanut extract and rAra h2.Conclusion: Skin prick tests to individual recombinant peanut allergens appear to be a safe and effective diagnostic tool. Cosensitization to rAra h2 and rArah I and/or rAra h3 is predictive of more severe reactions.Clinical implications: Recombinant peanut allergens can be used by SPTs for diagnosis and evaluation of allergy severity.