Screening and diagnosis of acute and chronic bird-related hypersensitivity pneumonitis by serum IgG and IgA antibodies to bird antigens with ImmunoCAP®
Screening and diagnosis of acute and chronic bird-related hypersensitivity pneumonitis by serum IgG and IgA antibodies to bird antigens with ImmunoCAP®
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DOI：
10.1016/j.alit.2020.09.003
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发表时间：
2021-03-23
影响因子：
6.8
通讯作者：
Miyazaki, Yasunari
中科院分区：
文献类型：
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作者：
Shirai, Tsuyoshi;Tanino, Yoshinori;Miyazaki, Yasunari
背景：鸟抗原是过敏性肺炎（HP）中最相关的抗原之一。鸟类抗原的可能来源是鸟类饲养、羽毛制品和含鸟粪的肥料。在HP的筛查和诊断中，应规范禽特异性抗体的检测。本研究的目的是阐明血清IgG（sIgG）和伊加（sIgA）抗体在多中心临床研究中使用ImmunoCAP（R）筛查和诊断急性/慢性鸟类相关HP中的效用。方法：我们通过进行多机构研究来执行临床性能测试，以测量针对鸽子的sIgG/sIgA水平，免疫CAP（R）系统检测29例急性和46例慢性鸟类相关HP患者的鹦鹉和虎皮鹦鹉抗原。在急性鸟源性HP和慢性鸟源性HP急性发作的受试者中，针对三种鸟类抗原的sIgG/sIgA水平显著较高（复发型）比对照组。对于sIgG，受试者工作特征（ROC）分析的最佳截断值分别为鸽子24.6mgA/L、鹦鹉14.0mgA/L和虎皮鹦鹉8.7mgA/L。通过检测多种鸟抗原和结合两种鸟sIgG值，急性和复发型慢性鸟相关HP患者的敏感性和特异性分别为85-91%和73- 80%。结论：应用ImmunoCAP（R）检测鸽、鹦鹉和虎皮鹦鹉血清sIgG/sIgA水平，可用于禽源性HP的筛查和诊断。Copyright（C）2020，日本变态反应学会.制作和主办：Elsevier B. V.
Background: Bird antigens are some of the most relevant antigens in hypersensitivity pneumonitis (HP). Possible sources of bird antigens are bird breeding, feather products and fertilizer with fowl droppings. For the screening and diagnosis of HP, the measurement of bird-specific antibodies should be standardized. The aim of this study was to clarify the utility of serum IgG (sIgG) and IgA (sIgA) antibodies to bird antigens in screening and diagnosing acute/chronic bird-related HP with ImmunoCAP (R) in multicentre clinical research.Methods: We executed a clinical performance test by conducting a multi-institutional study to measure the levels of sIgG/sIgA against pigeon, parrot and budgerigar antigens by the ImmunoCAP (R) system in 29 acute and 46 chronic bird-related HP patients.Results: The levels of sIgG/sIgA against the bird antigens of the three species were significantly higher in subjects with acute bird-related HP and chronic bird-related HP with acute episodes (recurrent type) than in the control subjects. For sIgG, the optimal cutoff values by receiver operating characteristic (ROC) analysis were 24.6 mgA/L for pigeon, 14.0 mgA/L for parrot, and 8.7 mgA/L for budgerigar. By measuring multiple bird antigens and combining sIgG values of two species, the sensitivity and specificity for acute and recurrent-type chronic bird-related HP patients were 85-91% and 73-80%, respectively. For recurrent and insidious types of chronic bird-related HP, the sensitivity and specificity were 48-61% and 73-80%, respectively.Conclusions: Measurement of the levels of sIgG/sIgA against pigeon, budgerigar and parrot antigens by ImmunoCAP (R) was useful for screening and diagnosis in bird-related HP. Copyright (C) 2020, Japanese Society of Allergology. Production and hosting by Elsevier B.V.