尘螨是主要的过敏原之一,广泛分布于全球各地,尤其是在家庭环境中,屋尘螨、粉尘螨和热带无爪螨是最常见的种类.已知的尘螨致敏组分超过35种,其中Der p 1、Der p 2和Der p 23是主要组分.目前,临床主要采用粗提物进行皮肤点刺试验和血清特异性免疫球蛋白 E(specific immunoglobulin E,sIgE)检测进行尘螨过敏的初步诊断,不能精确识别具体的致敏组分.考虑到不同地区和人群对尘螨的致敏蛋白存在显著差异,尘螨过敏原组分诊断在精确确定致敏组分方面显得尤为重要.这不仅对于过敏原的回避有指导意义,也对确定尘螨免疫治疗方案至关重要.为加强对尘螨分子诊断的认识并促进我国变态反应学科与国际接轨,本文对近期欧洲过敏与临床免疫学会发布的《过敏原组分诊断指导建议2.0》进行内容解读与阐释.
Molecular diagnostic strategies and management of dust mite allergy
Dust mites are one of the most important allergens,widely distributed around the world,especially in household environments.Dermatophagoides pteronyssinus,Dermatophagoides farinae and Blomia tropicalis are the most common species of dust mites.There are more than 35 known sensitization components of dust mites,among which Der p 1,Der p 2 and Der p 23 are the major components.Clinically,allergen skin test and serum specific immunoglobulin E(slgE)detection are widely used in the preliminary diagnosis of dust mite allergy.However,these methods cannot accurately identify specific dust mite sensitization components.Considering that there are significant differences in the allergenic components of dust mites in different regions and populations,component-resolved diagnosis of dust mite is particularly important in accurately determining the allergenic components.This is not only of guiding significance for allergen avoidance,but also important for determining the immunotherapy regimen for dust mites.In order to strengthen the understanding of the molecular diagnosis of dust mites and promote the integration of allergy science in China with the international standards,this article interprets the"Allergy Molecular Allergology User's Guide 2.0"published recently by the European Academy of Allergy and Clinical Immunology.