应用新型微阵列芯片法检测呼吸道过敏疾病患者过敏原谱

Analysis of allergen spectrum in patients with respiratory allergic disease by using a novel microarray chip assay

目的:病因诊断的局限性导致过敏性鼻炎和哮喘患者的症状反复发作,严重影响生活质量,因此明确过敏原在疾病的诊治防治中起着关键作用。方法:广州医科大学附属第一医院2016年1月~2018年12月确诊为过敏性鼻炎和(或)哮喘患者,并经ImmunoCAP系统检测血清sIgE为多重过敏原阳性的患者血清245例,进一步采用微阵列芯片法检测本地区19种常见过敏原特异性IgE,对呼吸道过敏性疾病患者过敏原谱及共同致敏现象进行分析。结果:螨(包括屋尘螨、粉尘螨和热带无爪螨)是呼吸道过敏症患者的主要过敏原,粉尘螨(86.94%)的阳性率最高,其次为屋尘螨(84.49%);食物过敏原中蟹(21.63%)阳性率最高。吸入性过敏原(91.02%)比食物过敏原(35.92%)阳性率高(χ2=160.417,P<0.01)。鼻炎组、哮喘组、鼻炎合并哮喘组的主要过敏原均为3种螨虫(屋尘螨、粉尘螨和热带无爪螨)和蟑螂,其中鼻炎合并哮喘组患者的猫毛、狗毛、蟑螂、虾蟹过敏原阳性率高于其他两组疾病患者,其中以狗毛和蟑螂过敏原的差异具有统计学意义(χ2=9.371,P<0.01;χ2=8.66,P<0.05)。利用系统聚类分析和相关性分析可将19项过敏分为5类不同致敏模式:第一类:屋尘螨/粉尘螨/热带螨/蟹/虾/蟑螂;第二类:狗牙根草/梯牧草/小麦/大豆/花生/矮豚草/杏仁;第三类:猫毛/狗毛/牛奶;第四类:曲霉菌/白色念珠菌;第五类:鸡蛋白。结论:微阵列芯片技术的引入有效克服当前过敏原检测市场医疗成本高,血清需求量大的缺点,可以大通量筛查患者过敏原谱敏感性,为临床医生提供相关过敏原谱,同时更好的解释共同致敏和交叉过敏现象。

Objective:The limitation of etiological diagnosis leads to recurrent episodes of allergic rhinitis and asthma patients,which seriously affects the quality of life.Therefore,it is clear that allergen diagnosis plays a key role in the diagnosis and treatment of diseases.Methods:The patients were diagnosed as allergic rhinitis and/or asthma patients in the First Affiliated Hospital of Guangzhou Medical University from January 2016 to December 2018.The serum sIgE was detected by the ImmunoCAP system as 245 patients with multiple allergen-positive patients.And used the microarray chip method to detect 19 common allergen sIgE.The allergen spectrum and parallel sensitization of patients with respiratory allergic diseases were analyzed.Results:Mite(including Der.pteronyssinus,Der.farinae,Blomia tropicalis)were the main allergens in patients with respiratory allergies.Der.farina(86.94%)had the highest positive rate,followed by Der.pteronyssinus(84.49%);Crab(21.63%)had the highest positive rate in food allergens.The positive rate of aeroallergen(91.02%)was significantly higher than food allergen(35.92%)(χ2=160.417,P<0.01).The main allergens in the rhinitis,asthma,rhinitis with asthma groups were all three mites(including Der.pteronyssinus,Der.farinae,Blomia tropicalis)and cockroach.The positive rate of cat dander,dog dander,cockroach,shrimp and crab allergens in rhinitis and asthma group was significantly higher than that in the other two groups,and the difference was statistically significant only in the dog dander and cockroach(χ2=9.371,P<0.01;χ2=8.66,P<0.05).Using Hierarchical cluster analysis and correlation analysis,19 allergies can be classified into 5 different sensitization patterns:The first cluster:Der.pteronyssinus/Der.farina/Blomia tropicalis/Crab/Shrimp/Cockroach;The second cluster:Bermuda grass/Timothy grass/Wheat/Soybean/Peanut/Ragweed/Almond;Third cluster:Cat dander/Dog dander/Milk;the fourth cluster:Aspergillus fumigatus/Candida albicans;the fifth cluster:Egg white.Conclusion:The introduction of microarray technology effectively solves the shortcomings of high medical cost and large serum demand in the current allergen testing market.It is possible to screen the sensitivity of the patient′s allergen group in a large amount of flux,to provide clinicians with relevant allergen spectrum and to better explain parallel sensitization and cross-allergy.