山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (3): 1-6.doi: 10.6040/j.issn.1673-3770.0.2022.184

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变态反应检测与诊断的临床应用及意义

程雷1,2,3,许秋艳2,4,陈浩5   

  1. 1.南京医科大学第一附属医院/江苏省人民医院 耳鼻咽喉科, 江苏 南京 210029;
    2.南京医科大学第一附属医院/江苏省人民医院 过敏诊疗中心, 江苏 南京 210029;
    3.南京医科大学国际变态反应研究中心, 江苏 南京 210029;
    4.南京医科大学附属苏州科技城医院 儿科, 江苏 苏州 215153;
    5.华中科技大学同济医学院附属同济医院 过敏反应科, 湖北 武汉 430030
  • 发布日期:2022-06-15
  • 通讯作者: 程雷. E-mail:chenglei@jsph.org.cn
  • 基金资助:
    江苏高校优势学科建设工程(JX10231801)

Clinical use and significance of allergy testing and diagnostics

CHENG Lei1,2,3, XU Qiuyan2,4, CHEN Hao5   

  1. 1. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China;
    2. Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China;
    3. International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, Jiangsu, China;
    4. Department of Pediatrics, Suzhou Science & Technology Town Hospital, Nanjing Medical University, Suzhou 215153, Jiangsu, China;
    5.Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
  • Published:2022-06-15

摘要: 变态反应疾病是当今全球最常见的疾病之一,而且疾病负担继续在增加。明确变应原致敏并识别引起变态反应疾病的变应原对于制定疾病管理策略至关重要。介绍目前国内外在诊断IgE介导的Ⅰ型变态反应中最常用的体内和体外检测方法及其临床意义。

关键词: 变应原, 免疫球蛋白E, 皮肤试验, 血清学检测, 诊断

Abstract: Allergic diseases are among the most prevalent diseases worldwide and their burden on healthcare systems continues to increase. Confirmation of allergen sensitization and the identification of causal allergens are essential for developing management strategies for these maladies. This paper provides an updated introduction of the most commonly used detection methods, both in vivo and in vitro, in the diagnosis of type I IgE-mediated allergy and its clinical significance.

Key words: Allergens, Immunoglobulin E, Skin tests, Serologic tests, Diagnosis

中图分类号: 

  • R392.8
[1] Cheng L, Chen J, Fu Q, et al. Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis[J]. Allergy Asthma Immunol Res, 2018, 10(4): 300-353. doi:10.4168/aair.2018.10.4.300.
[2] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国变应性鼻炎诊断和治疗指南(2022年,修订版)[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(2): 106-129. doi:10.3760/cma.j.cn115330-20211228-00828. Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Group of Rhinology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association.Chinese guideline for diagnosis and treatment of allergic rhinitis(2022, revision)[J]. Chin J Otorhinolaryngol Head Neck Surg, 2022, 57(2): 106-129. doi: 10.3760/cma.j.cn115330-20211228-00828.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组、小儿学组.儿童变应性鼻炎诊断和治疗指南(2022年,修订版)[J].中华耳鼻咽喉头颈外科杂志, 2022,57(4): 392-404. doi: 10.3760/cma.j.cn115330-20220303-00092. Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Groups of Rhinology and Pediatrics, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association.Guideline for diagnosis and treatment of pediatric allergic rhinitis(2022, revision)[J].Chin J Otorhinolaryngol Head Neck Surg, 2022, 57(4): 392-404. doi: 10.3760/cma.j.cn115330-20220303-00092.
[4] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国慢性鼻窦炎诊断和治疗指南(2018)[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(2): 81-100. doi:10.3760/cma.j.issn.1673-0860.2019.02.001. Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Group of Rhinology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association.Chinese guidelines for diagnosis and treatment of chronic rhinosinusitis(2018)[J]. Chin J Otorhinolaryngol Head Neck Surg, 2019, 54(2): 81-100. doi: 10.3760/cma.j.issn.1673-0860.2019.02.001.
[5] Popov TA, Passalacqua G, González-Díaz SN, et al. Medical devices in allergy practice[J]. World Allergy Organ J, 2020, 13(10): 100466. doi:10.1016/j.waojou.2020.100466.
[6] Ansotegui IJ, Melioli G, Canonica GW, et al. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper[J]. World Allergy Organ J, 2020, 13(2): 100080. doi:10.1016/j.waojou.2019.100080.
[7] Chen H, Li J, Cheng L, et al. China consensus document on allergy diagnostics[J]. Allergy Asthma Immunol Res, 2021, 13(2): 177-205. doi:10.4168/aair.2021.13.2.177.
[8] Xu Q, Jiang Q, Yang L, et al. IgE and IgG4 repertoire in asymptomatic HDM-sensitized and HDM-induced allergic rhinitis patients[J]. Int Arch Allergy Immunol, 2021, 182(12): 1200-1211. doi:10.1159/000517824.
[9] 中华医学会呼吸病学分会哮喘学组.奥马珠单抗治疗过敏性哮喘的中国专家共识(2021版)[J]. 中华结核和呼吸杂志, 2022,45(4): 341-354. doi: 10.3760/cma.j.cn112147-20220115-00051. Chinese Thoracic Society Asthma Group. Chinese expert consensus on the use of Omalizumab in allergic asthma(2021 version)[J]. Chin J Tuberc Respir Dis, 2022, 45(4): 341-354. doi: 10.3760/cma.j.cn112147-20220115-00051.
[10] 国家呼吸系统疾病临床医学研究中心, 中华医学会儿科学分会呼吸学组哮喘协作组, 中国医药教育协会儿科专业委员会, 等. 奥马珠单抗在儿童过敏性哮喘临床应用专家共识[J]. 中华实用儿科临床杂志, 2021, 36(12): 881-890. doi:10.3760/cma.j.cn101070-20210531-00621. China National Clinical Research Center for Respiratory Diseases, Cooperative Group of Asthma, the Subspecialty Group of Respiratory, the Society of Pediatrics, Chinese Medical Association, China Medicine Education Association Committee on Pediatrics, et al. Expert consensus on the clinical application of Omalizumab in children with allergic asthma[J]. Chin J Appl Clin Pediatr, 2021, 36(12): 881-890. doi: 10.3760/cma.j.cn101070-20210531-00621.
[11] Zhao Z, Cai T, Chen H, et al. Expert consensus on the use of omalizumab in chronic urticaria in China[J]. World Allergy Organ J, 2021, 14(11): 100610. doi:10.1016/j.waojou.2021.100610.
[12] Oguma T, Taniguchi M, Shimoda T, et al. Allergic bronchopulmonary aspergillosis in Japan: a nationwide survey[J]. Allergol Int, 2018, 67(1): 79-84. doi:10.1016/j.alit.2017.04.011.
[13] Zhang C, Jiang Z, Shao C. Clinical characteristics of allergic bronchopulmonary aspergillosis[J]. Clin Respir J, 2020, 14(5): 440-446. doi:10.1111/crj.13147.
[14] 杨晴, 陆美萍, 程雷. 苏皖地区变应性鼻炎患者气传变应原皮肤点刺试验和血清特异性IgE检测的一致性及相关性分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(1): 40-46. doi:10.6040/j.issn.1673-3770.0.2020.279. YANG Qing, LU Meiping, CHENG Lei. Agreement and association analyses of skin prick testing and serum specific IgE assay for aeroallergen detection in patients with allergic rhinitis from Jiangsu and Anhui areas[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(1): 40-46. doi:10.6040/j.issn.1673-3770.0.2020.279.
[15] 陈静, 程雷. 变应性鼻炎的变应原组分诊断[J]. 中国中西医结合耳鼻咽喉科杂志, 2021, 29(3): 161-162, 183. doi:10.16542/j.cnki.issn.1007-4856.2021.03.001.
[16] Muluk NB, Cingi C. Oral allergy syndrome[J]. Am J Rhinol Allergy, 2018, 32(1): 27-30. doi:10.2500/ajra.2018.32.4489.
[17] Feng M, Su Q, Lai X, et al. Functional and immunoreactive levels of IgG4 correlate with clinical responses during the maintenance phase of house dust mite immunotherapy[J]. J Immunol, 2018, 200(12): 3897-3904. doi:10.4049/jimmunol.1701690.
[18] Feng M, Zeng X, Su Q, et al. Allergen immunotherapy-induced immunoglobulin G4 reduces basophil activation in house dust mite-allergic asthma patients[J]. Front Cell Dev Biol, 2020, 8: 30. doi:10.3389/fcell.2020.00030.
[19] Yang L, Yang Y, Xu Q, et al. Specific IgE and IgG4 profiles of house dust mite components in allergen-specific immunotherapy[J]. Front Immunol, 2021, 12: 786738. doi:10.3389/fimmu.2021.786738.
[20] Santos A, Alpan O, Hoffmann HJ. Basophil activation test: mechanisms and considerations for use in clinical trials and clinical practice[J]. Allergy, 2021, 76(8): 2420-2432. doi:10.1111/all.14747.
[21] Zhang Y, Lan F, Zhang L. Advances and highlights in allergic rhinitis[J]. Allergy, 2021, 76(11): 3383-3389. doi:10.1111/all.15044.
[22] Agache I, Eguiluz-Gracia I, Cojanu C, et al. Advances and highlights in asthma in 2021[J]. Allergy, 2021, 76(11): 3390-3407. doi:10.1111/all.15054.
[23] Xu X, Reitsma S, Wang DY, et al. Highlights in the advances of chronic rhinosinusitis[J]. Allergy, 2021, 76(11): 3349-3358. doi:10.1111/all.14892.
[24] Lieberman JA. The changing diagnostic world in allergy and immunology[J]. Ann Allergy Asthma Immunol, 2021, 127(1): 1-2. doi:10.1016/j.anai.2021.05.003.
[25] 张敏, 张颖莹, 邱昌余, 等. 2021年度变态反应学领域重要进展[J]. 中华医学信息导报, 2022, 37(4): 9. doi:10.3760/cma.j.issn.1000-8039.2022.04.106.
[26] 王学艳, 祁海, 张罗. 从全球变应性鼻炎流行趋势看加强变应性鼻炎防治的中国行动[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(4): 373-378. doi: 10.3760/cma.j.cn115330-20210927-00637. WANG Xueyan, QI Hai, ZHANG Luo. Perspectives for prevention and treatment of allergic rhinitis in China[J]. Chin J Otorhinolaryngol Head Neck Surg, 2022, 57(4): 373-378. doi: 10.3760/cma.j.cn115330-20210927-00637.
[27] 程雷. 变应性鼻炎指南修订促进临床规范化诊疗[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(4): 413-417. doi: 10.3760/cma.j.cn115330-20220325-00134. CHENG Lei. Revising allergic rhinitis guidelines to standardize clinical diagnosis and treatment[J]. Chin J Otorhinolaryngol Head Neck Surg, 2022, 57(4): 413-417. doi:10.3760/cma.j.cn115330-20220325-00134.
[28] 敖天, 程雷. 慢性鼻窦炎伴鼻息肉的内型研究及其指导下的精准控制与治疗[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 7-14. doi: 10.6040/j.issn.1673-3770.1.2022.005. AO Tian, CHENG Lei. An endotype study of chronic rhinosinusitis with nasal polyps and precise control and treatment under the guidance[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 36(3):7-14. doi: 10.6040/j.issn.1673-3770.1.2022.005.
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