真菌特异性IgE与支气管哮喘严重程度

Specific IgE response to fungi and asthma severity

目的真菌致敏与哮喘的关系密切,但是真菌与哮喘严重程度之间的关系还不太清楚。本研究探讨100例哮喘患者的严重程度与真菌致敏原以及非真菌致敏原之间的关系。方法收集2010～2011年门诊及住院的哮喘患者100例。根据哮喘严重程度分级将其分为轻度、中度和重度。使用酶联免疫捕获法检测所有患者血清中针对5种真菌致敏原以及7种非真菌致敏原的特异性IgE(specific IgE,sIgE)水平。结果真菌致敏原中曲霉菌、青霉菌和白色念珠菌的sIgE水平在重度哮喘患者中明显高于中度及轻度患者(P<0.001或P<0.05),中度哮喘患者明显高于轻度患者(P<0.05)。而链铬孢子菌sIgE水平在3组哮喘患者之间没有明显差别。3组哮喘患者草分支孢子菌的sIgE水平均为阴性。非真菌致敏原的sIgE水平在3组哮喘患者之间没有明显差别。结论真菌致敏原可能与哮喘患者的严重程度密切相关,而非真菌致敏原与哮喘患者的严重程度没有关系。

OBJECTIVE Multiple studies have linked fungal exposure to asthma, but the link to severity of asthma is controversial. METHODS We compared the severity of asthma in 100 patients, which was classified by severity as mild （n=52） , moderate （n=24） or severe （n=24） , with the specific IgE titers against 5 mold allergens and 7 non-mold allergens. RESULTS Positive rates of Aspergillus-slgE, Penicillium-slgE and Candida -slgE were higher in the patients with severe asthma than patients with moderate and mild asthma （P〈0.001 or P〈0.05） , and higher in the patients with moderate asthma than patients with mild asthma （P〈0.05） . But there were no differences of the positive rates of Alternaria-sgE among different severity groups of patients. The Cladosporium- slgE was negative in all of the patients. There were no differences of the positive rate of non-mold allergens in all groups. CONCLUSION These findings support the suggestions that mold sensitization may be associated with the asthma severity.