收稿日期: 2024-10-11
录用日期: 2024-12-08
网络出版日期: 2025-06-25
基金资助
国家自然科学基金青年科学基金项目(81900015)
Analysis of serum allergen test results in children with allergic diseases in Shanghai
Received date: 2024-10-11
Accepted date: 2024-12-08
Online published: 2025-06-25
目的:分析上海过敏性疾病患儿血清过敏原分布情况,为过敏性疾病的防治提供诊疗依据。方法:纳入2021年至2023年在瑞金医院儿科门诊就诊的诊断为过敏性疾病的连续病例(包括支气管哮喘、变应性鼻炎、特应性皮炎等共560例),通过散射比浊法检测其血清中的总IgE抗体,用免疫印记法检测血清中过敏原特异性IgE种类,并进行回顾性分析。结果:560例患儿中,总IgE阳性率高且存在多种过敏原阳性,过敏原主要以粉尘螨(59.11%)、屋尘螨(58.75%)、牛奶(28.04%)、鸡蛋(22.14%)和念珠分枝交链黑曲霉(21.43%)为主,过敏原分布无性别差异(P>0.05)。吸入性过敏原中,屋尘螨、粉尘螨、猫毛皮屑随年龄增长逐渐上升,其中7~15岁患儿的阳性率最高(72.55%、71.76%、26.67%),差异具有统计学意义(P<0.05);食入性过敏原中,牛奶在幼儿期阳性率最高(34.55%),其后随年龄增长阳性率逐渐下降(P<0.05)。吸入性过敏原中,念珠分枝交链黑曲霉阳性率有季节差异(P<0.05),其中秋季最高(28.89%)。蟑螂阳性的患儿中虾/蟹阳性率高达38.5%,且蟑螂与甲壳类食物间的致敏性显著相关(P<0.05)。结论:上海地区过敏性疾病的儿童中,吸入性过敏原阳性率最高的是粉尘螨,其余依次是屋尘螨、猫毛皮屑,且分布具有年龄差异;食入性过敏原阳性率最高的是牛奶,其余依次是鸡蛋白、花生/黄豆、羊肉/牛肉、腰果、开心果、杏仁、核桃。蟑螂与虾/蟹间的致敏性强相关,提示甲壳类食物致敏的儿童需高度警惕存在蟑螂致敏。
赵雪奇 , 闾佳佳 , 吴群 . 上海地区儿童过敏性疾病血清过敏原检测结果分析[J]. 诊断学理论与实践, 2025 , 24(03) : 333 -341 . DOI: 10.16150/j.1671-2870.2025.03.013
Objective To analyze the distribution of serum allergens in children with allergic diseases in Shanghai and provide diagnostic and therapeutic evidence for the prevention and management of allergic diseases. Methods A total of 560 children diagnosed with allergic diseases (including bronchial asthma, allergic rhinitis, and atopic dermatitis) who attended the pediatric outpatient clinic at Ruijin Hospital from 2021 to 2023 were enrolled. Total serum IgE levels were measured using scattering turbidimetry, and specific serum IgE antibodies against various allergens were detected by immunoblotting. A retrospective analysis was performed. Results 1. Among the 560 children, the positive rate of total IgE was high, and multiple allergens were commonly found. 2. The allergens were mainly Dermatophagoides farinae (59.11%), Dermatophagoides pteronyssinus (58.75%), cow’s milk (28.04%), egg (22.14%) and Aspergillus niger with rosary branches (21.43%). No significant gender differences were observed in allergen distribution (P>0.05). 3. For inhalant allergens, the positive rates of Dermatophagoides farinae, Dermatophagoides pteronyssinus, and cat dander increased with age, with the highest rates observed in children aged 7-15 years (72.55%, 71.76%, and 26.67%, respectively), and the differences were statistically significant (P<0.05). For food allergens, the positive rate for cow’s milk was highest during early childhood (34.55%) and decreased with age (P<0.05). 4. Regarding inhalant allergens, the positive rate for Aspergillus niger with rosary branches showed seasonal variation (P<0.05), peaking in autumn (28.89%). Among children sensitized to cockroaches, the positive rate for shrimp/crab was as high as 38.5%, and a significant correlation was observed between cockroach sensitization and crustacean food allergens (P<0.05). Conclusions In children with allergic diseases in Shanghai, the most common inhalant allergen is Dermatophagoides farinae, followed by Dermatophagoides pteronyssinus and cat dander, with age-related differences observed. The most common food allergen is cow’s milk, followed by egg white, peanut/soy, lamb/beef, cashew, pistachio, almond, and walnut. There is a significant correlation between cockroach and shrimp/crab sensitization, suggesting that children sensitized to crustaceans should be closely monitored for potential cockroach sensitization.
Key words: Allergic diseases; IgE; Allergens
| [1] | MENG Y, WANG C, ZHANG L. Advances and novel developments in allergic rhinitis[J]. Allergy, 2020, 75(12), 3069-3076. |
| [2] | ZHANG P. The role of diet and nutrition in allergic di-seases[J]. Nutrients, 2023, 15 (17):3683. |
| [3] | NU?EZ-BORQUE E, FERNANDEZ-BRAVO S, YUSTE-MONTALVO A, et al. Pathophysiological, cellular, and molecular events of the vascular system in anaphylaxis[J]. Front Immunol, 2022,13,836222. |
| [4] | WONG G W K, LI J, BAO Y X, et al. Pediatric allergy and immunology in China[J]. Pediatr Allergy Immunol, 2018, 29 (2), 127-132. |
| [5] | 王睿坤, 梁洁琼, 韩伟, 等. 2001-2021年中国儿童青少年过敏性鼻炎患病率的Meta分析[J]. 中华预防医学杂志, 2022, 56(6):784-793. |
| WANG R K, LIANG J Q, HAN W, et al. Meta-analysis of the prevalence of allergic rhinitis in children and adolescents in China from 2001 to 2021[J]. Chin J Prev Med, 2022, 56(6):784-793. | |
| [6] | 刘传合, 洪建国, 尚云晓, 等. 中国16城市儿童哮喘患病率20年对比研究[J]. 中国实用儿科杂志, 2015, 30(8):596-600. |
| LIU C H, HONG J G, SHANG Y X, et al. A 20-year comparative study of the prevalence of childhood asthma in 16 cities in China[J]. Chin J Pract Pediatr, 2015, 30(8):596-600. | |
| [7] | 张晓梅, 张慧敏, 赖宇, 等. 血清特异性IgE和总IgE测定在过敏性疾病中的诊断价值[J]. 实验与检验医学, 2017, 35(2):231-233. |
| ZHANG X M, ZHANG H M, lAI Y, et al. The diagnostic value of serum-specific IgE and total IgE assays in allergic diseases[J]. Exp Lab Med, 2017, 35(2):231-233. | |
| [8] | DE BENEDICTIS F M, BUSH A. Janus looks both ways: How do the upper and lower airways interact?[J]. Paediatr Respir Rev, 2020,34:59-66. |
| [9] | 韩晶晶, 陈红兵, 张雯雯, 等. 2032例过敏性疾病儿童过敏原分析[J]. 南京医科大学学报(自然科学版), 2015, 35(3):411-413. |
| HAN J J, CHEN H B, ZHANG W W, et al. Analysis of allergens in 2032 children with allergic diseases[J]. J Nanjing Med Univ (Nature Sci Ed), 2015, 35(3):411-413. | |
| [10] | 金菲, 高岭, 杨大恒, 等. 2021—2022年南京地区儿童特异性过敏原定量检测分析及其临床价值[J]. 临床检验杂志, 2024, 42(3):226-230. |
| JIN F, GAO L, YANG D H, et al. Quantitative detection analysis and clinical value of child-specific allergens in Nanjing from 2021 to 2022[J]. J Clin Lab, 2024, 42(3):226-230. | |
| [11] | 蒋佩军, 俞凤, 王海燕. 10110例过敏性疾病患者血清过敏原检测与分析[J]. 中国卫生检验杂志, 2013, 23(13):2776-2777,2780. |
| JIANG P J, YU F, WANG H Y. Detection and analysis of serum allergens in 10110 patients with allergic diseases[J]. Chin J Health Inspect, 2013, 23(13):2776-2777,2780. | |
| [12] | 李琪, 张云飞, 许政敏. 复旦大学附属儿科医院2413例过敏性鼻炎患儿过敏原筛查结果分析[J]. 中国实用儿科杂志, 2019, 34(3):209-211. |
| LI Q, ZHANG Y F, XU Z M. Analysis of allergen scree-ning results in 2413 children with allergic rhinitis in the Pediatric Hospital of Fudan University[J]. Chin J Pract Pediatr, 2019, 34(3):209-211. | |
| [13] | BISCHOFF S C. Food allergies[J]. Curr Treat Options Gastroenterol, 2007, 10 (1):34-43. |
| [14] | 苏大冬, 杨蓓, 袁土良. 血清总IgE含量及特异性IgE检测在临床儿童过敏性疾病中的诊断意义[J]. 中国医学创新, 2024, 21(25):157-161. |
| SU D D, YANG B, YUAN T L. Diagnostic significance of serum total IgE content and specific IgE detection in clinical pediatric allergic diseases[J]. Chin Med Innov, 2024, 21(25):157-161. | |
| [15] | 杨宇溪, 邓耀波, 芮黎, 等. 418例儿童过敏性疾病血清过敏原检测分析[J]. 云南医药, 2023, 44(5):43-46. |
| YANG Y X, DENG Y B, RUI L, et al. Analysis of serum allergen detection in 418 cases of allergic diseases in children[J]. Yunnan Med, 2023, 44(5):43-46. | |
| [16] | BARNE C, ALEXIS N E, BERNSTEIN J A, et al. Climate change and our environment: the effect on respiratory and allergic disease[J]. J Allergy Clin Immunol Pract, 2013, 1(2):137-141. |
| [17] | BARNES CS. Impact of climate change on pollen and respiratory disease[J]. Curr Allergy Asthma Rep, 2018, 18(11):59. |
| [18] | 陈香梅, 张亮, 齐立明, 等. 北京地区3236例过敏性疾病患者血清过敏原的季节差异分析[J]. 河北医科大学学报, 2019, 40(10):1180-1184. |
| CHEN X M, ZHANG L, QI L M, et al. Seasonal differential analysis of serum allergens in 3236 patients with allergic diseases in Beijing[J]. J Hebei Med Univ, 2019, 40(10):1180-1184. | |
| [19] | WONG L, HUANG C H, LEE B W. Shellfish and house dust mite allergies: Is the link tropomyosin?[J]. Allergy Asthma Immunol Res, 2016, 8(2):101-106. |
| [20] | WEGHOFER M, THOMAS W R, KRONQVIST M, et al. Variability of IgE reactivity profiles among European mite allergic patients[J]. Eur J Clin Invest, 2008, 38(12):959-965. |
| [21] | WESTRITSCHNIG K, SIBANDA E, HOMAS W, et al. Analysis of the sensitization profile towards allergens in central Africa[J]. Clin Exp Allergy, 2003, 33(1):22-27. |
| [22] | BECKER S, GR?GER M, CANIS M, et al. Tropomyosin sensitization in house dust mite allergic patients[J]. Eur Arch Otorhinolaryngol, 2012, 269(4):1291-1296. |
| [23] | MCGOWAN E C, PENG R, SALO P M, et al. Cockroach, dust mite, and shrimp sensitization correlations in the National Health and Nutrition Examination Survey[J]. Ann Allergy Asthma Immunol, 2019, 122(5):536-538,e1. |
| [24] | 泰淑红, 魏园玉, 宋晓妍, 等. 2013-2021年郑州地区10664例患者常见过敏原流行特征分析[J]. 临床检验杂志, 2024, 42(1):18-21. |
| TAI S H, WEI Y Y, SONG X Y, et al. Analysis of the epidemiological characteristics of common allergens in 10,664 patients in zhengzhou region from 2013 to 2021[J]. J Clin Lab Sci, 2024, 42(1):18-21. | |
| [25] | CASALE T B, FIOCCHI A, GREENHAWT M. A practical guide for implementing omalizumab therapy for food allergy[J]. J Allergy Clin Immunol, 2024, 153(6):1510-1517. |
| [26] | RAJAKULENDRAN M, THAM E H, SOH J Y, et al. Novel strategies in immunotherapy for allergic diseases[J]. Asia Pac Allergy, 2018, 8(2):e14. |
| [27] | 中国医药教育协会儿科专业委员会, 中华医学会儿科学分会呼吸学组哮喘协作组, 福棠儿童医学发展研究中心过敏(变态)反应学科规范化建设研究组, 等. 儿童过敏性哮喘尘螨过敏原特异性免疫治疗循证指南(医生版)[J]. 中华实用儿科临床杂志, 2024, 39(6):401-417. |
| China Medicine Education Association Committee on Pediatrics, Cooperative Group of Asthma, the Subspecialty Group of Respiratory, the Society of Pediatrics, Chinese Medical Association, The Group of Standardized Construction for Allergy Disciplinary, Futang Research Center of Pediatric Development, et al. Evidence-based guideline for dust mite allagenimmunotherapy in children with allergic asthma (Medical Version)[J]. Chin J Pract Clin Pediatr, 2024, 39(6):401-417. |
/
| 〈 |
|
〉 |