Use of specific IgE in assessing the relevance of fungal and dust mite allergens to atopic dermatitis: A comparison with asthmatic and nonasthmatic control subjects
Use of specific IgE in assessing the relevance of fungal and dust mite allergens to atopic dermatitis: A comparison with asthmatic and nonasthmatic control subjects
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DOI：
10.1016/s0091-6749(99)70024-2
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发表时间：
1999-12-01
影响因子：
14.2
通讯作者：
Wheatley, LM
中科院分区：
文献类型：
--
作者：
Scalabrin, DMF;Bavbek, S;Wheatley, LM
背景：虽然过敏原已被认为是特应性皮炎(AD)的加重因素，但关于特异性IgE的意义的流行病学数据很少。目的：我们试图比较AD患者与哮喘和非哮喘对照组对尘螨和真菌的致敏作用。方法：对73例中、重度AD患者进行总IgE和对屋尘螨、交链孢霉、烟曲霉、白色念珠菌、呋喃马拉色菌和红色毛癣菌的特异性IgE检测。同时检测156例哮喘患者和212例非哮喘对照组血清中D、A、M三种抗原的总IgE和特异性IgE。结果：抗D、A、M三种抗原的总IgE和IgE抗体之间呈正相关，成人AD患者血清中M-Furur特异性IgE的发生率明显高于儿童(P<；AD患者、哮喘患者和非哮喘患者的血清总IgE水平较高(95%比42%和17%)，毛呋喃(53%比1%和0.5%)，交替A(49%比29%和18%)。在对尘螨过敏的患者血清中，无论临床状态如何，屋尘螨特异性IgE对总IgE水平的贡献是相似的。结论：我们的结果表明，中至重度AD与尘螨和毛霉菌的致敏密切相关(优势比分别为45.6和132，与混合对照血清相比)。这些结果表明，环境过敏原和定植真菌都有助于疾病的严重程度，这与避螨和抗真菌治疗在这些患者的治疗中可能是有益的观点一致。
Background: Although allergens have been implicated as aggravating factors in atopic dermatitis (AD), there is little epidemiologic data on the significance of specific IgE.Objective: We sought to compare sensitization to dust mite and fungi between patients with AD and asthmatic and nonasthmatic control subjects.Methods: Total IgE and specific IgE to Dermatophagoides pteronyssinus, Alternaria alternata, Aspergillus fumigatus, Candida albicans, Malassezia furfur, and Trichophyton rubrum were measured in 73 patients with moderate to severe AD. Total IgE and IgE specific for D pteronyssinus, A alternata, and M furfur were also measured in sera from 156 asthmatic and 212 nonasthmatic control subjects.Results: Positive correlations were found between total IgE and IgE antibodies specific for each of the antigens, IgE specific for M furfur was observed more frequently in adults compared with children with AD (P < .01), AD sera had higher levels of total IgE and a higher prevalence of positive sera to D pteronyssinus (95% vs 42% and 17% for subjects with AD, asthmatic subjects, and nonasthmatic subjects, respectively), M furfur (53% vs 1% and 0.5%), and A alternata (49% vs 29% and 18%). Among the sera from subjects allergic to mites, the contribution of IgE specific for D pteronyssinus to the total IgE levels was similar regardless of the clinical status.Conclusions: Our results demonstrate that moderate-to-severe AD is strongly associated with sensitization to dust mite and M furfur (odds ratios, 45.6 and 132 vs pooled control sera). These results suggest that both environmental allergens and colonizing fungi contribute to the severity of disease, which is consistent with the view that mite avoidance and antifungal treatment can be beneficial in the treatment of these patients.