儿童过敏性疾病实验室诊断与应用

Advances and utility of laboratory investigation in diagnosis of pediatric allergic diseases

近年来儿童过敏性疾病的快速增长, 临床应采用适当的诊断策略, 确定其免疫机制和致病过敏原, 以有效治疗和预防过敏性疾病。在此过程中实验室诊断起到至关重要的作用。目前儿童过敏性疾病的实验室诊断主要分为体内试验及体外试验。体内试验主要包含皮肤测试和过敏原激发试验, 激发试验是确诊过敏性疾病的"金标准"。体外试验主要包括过敏原特异性免疫球蛋白E(IgE)、辅助型T细胞2(Th2)相关细胞因子和肥大细胞活动标志物等, 这些试验可明确机体的过敏状态及其免疫机制, 对过敏性疾病的有效治疗, 如避免接触过敏原、过敏原特异性免疫治疗和抗IgE治疗等有重要价值。

The rapid increase of childhood allergic disorders has become one of the major challenges in the pediatric health care system.Laboratory diagnosis is essential in order to determine appropriate strategies towards best clinical practice strategies,including accurate diagnosis,prophylaxis and optimized management.Once there are sufficient clinical grounds to support a diagnosis of allergy,confirmatory in vivo and in vitro tests should be performed.In vivo tests mainly include skin prick tests and allergen provocation tests.Provocation tests are the gold standard for diagnosing allergic diseases.In vitro tests mainly include allergen-specific IgE antibody,Th2 related cytokines,and mast cell activity markers.These tests can clarify the immune state status of the patient and lead to optimized treatment,such as avoiding allergens avoidance,allergens-specific immunotherapy,and anti-IgE therapy.Controlling disease progress and preventing relapses can benefit children who are suffering from the consequences of allergies.