交叉反应在I型变态反应诊断中的意义

Significance of cross-reactivity for the diagnosis of type I allergy

IgE介导的I型变态反应的诊断需结合临床病史、体内检测和体外血清学检测结果进行特异性病因诊断。由于过敏原间交叉反应的影响，为其病因诊断带来困扰。阐述交叉反应的常见原因，包括结构类似的蛋白家族和交叉反应性糖类决定簇，并提出临床工作中的应对策略。在出现过敏原特异性IgE阳性并排除交叉反应性糖类决定簇一IgE干扰后，应进一步考虑进行过敏原组分检测，为患者提供个体特异性过敏原谱。

The diagnosis of IgE-mediated type I allergy requires detailed clinical history, as well as in vivo testing and in vitro serological tests for allergen-specific IgE antibodies. The existence of allergenic cross- reactivity has increased the difficulty in etiological diagnosis. This paper is aimed at illustrating the common molecular mechanisms of allergenic cross-reactivity, such as the structural similarity in protein families and cross-reactivity of carbohydrate determinants （CCD）, and describing strategies to manage this condition in clinical practice. It is recommended to measure specific IgEs against allergen components in patients with allergen-specific IgEs when the interference from anti-CCD IgE is excluded, which may provide not only a more personalized allergen profile but also more information for specific immunotherapy.