目的:观察舌下免疫治疗(SLIT)疗效与尘螨组分sIgE和sIgG4水平变化的相关性.方法:回顾性分析2018年4月～2021年10月就诊于某院过敏反应科并行SLIT的过敏性鼻炎患儿(n=37),根据治疗1年后症状和药物综合评分(CSMS)分为控制稳定组(n=25)和控制不稳定组(n=12),比较两组患儿9种重要尘螨致敏蛋白组分(Der p 1/Der f 1、Der p 2/Der f 2、Der p 5、Der p 7、Der p 10、Der p 21和Der p 23)sIgE和sIgG4的水平变化.结果:Der p 1/Der f 1和Der p 2/Der f 2为主要致敏蛋白组分,其治疗前sIgE阳性率为86.5%～94.6%,其中Der p 2的sIgE浓度高于Der p 1(P＜0.0001)、Der p 5(P＜0.001)、Der p 7(P＜0.001)、Der p 10(P＜0.001)、Der p 21(P＜0.01);Der f 2的sIgE浓度高于Der f 1(P＜0.0001)、Der p 5(P＜0.0001)、Der p 7(P＜0.0001)、Der p 10(P＜0.0001)、Der p 21(P＜0.0001)和Der p 23(P＜0.01).治疗前Der f 2的sIgG4浓度高于其他组分(P＜0.0001),控制不稳定组中Der f 1的sIgG4阳性率(33.3%)高于控制稳定组(4.0%,P＜0.05),且控制不稳定组中Der f 1和Der p 10的sIgG4浓度高于控制稳定组(P＜0.05).治疗1年后,控制稳定组患儿Der f 1和Der p 2的sIgG4水平高于治疗前(P＜0.05).结论:尘螨致敏过敏性鼻炎患儿应用SLIT治疗后,Der f 1和Der p 2的sIgG4浓度升高明显,提示SLIT疗效较好,为临床评估SLIT疗效提供了线索.
Abstract
Objective:To observe the correlation between the efficacy of sublingual immunotherapy(SLIT)and the levels of sIgE and sIgG4 against house dust mite components.Methods:A retrospective analysis was performed for children with allergic rhinitis(n=37)who visited the allergy department of a hospital and received SLIT during April 2018 to October 2021.They were assigned to a stable control group(n=25)and an unstable control group(n=12)according to the combined symptom and medication score(CSMS)at one year of treatment.The levels of sIgE and sIgG4 against 9 important house dust mite components(Der p 1/Der f 1,Der p 2/Der f 2,Der p 5,Der p 7,Der p 10,Der p 21,and Der p 23)were compared between two groups.Results:Der p 1/Der f 1 and Der p 2/Der f 2 were the main house dust mite components,and their sIgE positive rates before treatment were 86.5%～94.6%.The concentration of sIgE against Der p 2 was higher than that against Der p 1(P<0.0001),Der p 5(P<0.001),Der p 7(P<0.001),Der p 10(P<0.001),and Der p 21(P<0.01);the concentration of sIgE against Der f 2 was higher than that against Der f 1(P<0.0001),Der p 5(P<0.0001),Der p 7(P<0.0001),Der p 10(P<0.0001),Der p 21(P<0.0001),and Der p 23(P<0.01).The sIgG4 concentration against Der f 2 was higher than that against other components before treatment(P<0.0001).The positive rate of sIgG4 against Der f 1 was higher in the unstable control group(33.3%)than in the stable control group(4.0%,P<0.05),and the concentrations of sIgG4 against Der f 1 and Der p 10 were higher in the unstable control group than in the stable control group(P<0.05).After 1-year treatment,the levels of sIgG4 against Der f 1 and Der p 2 in stable control group were higher than those before treatment(P<0.05).Conclusion:After SLIT treatment for children with allergic rhinitis sensitized by dust mites,the significant increase in the sIgG4 concentrations of Der f 1 and Der p 2 may indicate that these children might have a better therapeutic effect,which provides clues for clinical evaluation of the efficacy of SLIT.
关键词
儿童/舌下免疫治疗/过敏性疾病/尘螨致敏蛋白组分/疗效预测标志物
Key words
children/sublingual immunotherapy/allergic diseases/house dust mite sensitizing protein components/efficacy predictive markers
维普
万方数据