变态反应学实验室诊断基础

Q3 Medicine
Christos Arsenis, Styliani Taka,  Chrysanthi Skevaki
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引用次数: 0

摘要

过敏性疾病的多样性及其相关的潜在机制使得过敏诊断特别具有挑战性。体内和体外试验有多种选择,但对结果的解释必须始终与临床病史相结合。本文的重点是实验室诊断,其中几种诊断测试已经开发针对过敏级联的不同部分。这些测试的结果可能表明临床过敏的存在,但也提供了疾病严重程度、治疗方案和治疗反应性的信息。一线测试包括过敏原特异性IgE (sIgE)抗体测量,在选择确切的测试时需要考虑几个因素。其中,需要考虑要测试的过敏原,过敏原提取物与分子成分的使用,交叉反应性方面,成本和地理致敏模式。在主要的商业上可用的自动化平台之间存在技术上的区别,这通常反映在它们的测试结果的差异上。诊断上具有挑战性的病例可以通过评估关键效应细胞(即嗜碱性细胞、肥大细胞和嗜酸性细胞)的测试以及针对几种释放的介质(包括胰蛋白酶、脂质和组胺)的测试来补充。总的来说,非基于ige的实验室检测需要进一步的标准化和研究,以支持其临床应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fundamentals of laboratory diagnostics in allergology

The diversity of allergic disorders and their associated underlying mechanisms render allergy diagnosis particularly challenging. There is a palette of available in vivo and in vitro tests, while result interpretation must always be made in conjunction with clinical history. The focus of the present article is on laboratory diagnostics, where several diagnostic tests have been developed targeting different parts of the allergic cascade. The results of these tests may indicate the presence of clinical allergy but also provide information on disease severity, treatment options, and therapy responsiveness. First-line testing involves allergen specific IgE (sIgE) antibody measurements, and several considerations are required when choosing the exact test. Among others, the allergens to be tested, the use of allergen extracts versus molecular components, cross-reactivity aspects, cost, and geographical sensitization patterns need to be considered. There are technical distinctions between main commercially available automated platforms, which is often reflected by differences in their test results. Diagnostically challenging cases can be supplemented by tests assessing the key effector cells, i.e., basophils, mast cells, and eosinophils, as well as by tests targeting several of the released mediators, including tryptase, lipids, and histamine. Overall, non-IgE-based laboratory tests need additional standardization and research to support their clinical utility.

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来源期刊
Allergo Journal International
Allergo Journal International Medicine-Immunology and Allergy
CiteScore
4.60
自引率
0.00%
发文量
31
期刊介绍: Allergo Journal International is the official Journal of the German Society for Applied Allergology (AeDA) and the Austrian Society for Allergology and Immunology (ÖGAI). The journal is a forum for the communication and exchange of ideas concerning the various aspects of allergy (including related fields such as clinical immunology and environmental medicine) and promotes German allergy research in an international context. The aim of Allergo Journal International is to provide state of the art information for all medical and scientific disciplines that deal with allergic, immunological and environmental diseases. Allergo Journal International publishes original articles, reviews, short communications, case reports, and letters to the editor. The articles cover topics such as allergic, immunological and environmental diseases, the latest developments in diagnosis and therapy as well as current research work concerning antigens and allergens and aspects related to occupational and environmental medicine. In addition, it publishes clinical guidelines and position papers approved by expert panels of the German, Austrian and Swiss Allergy Societies. All submissions are reviewed in single-blind fashion by at least two reviewers. Originally, the journal started as a German journal called Allergo Journal back in 1992. Throughout the years, English articles amounted to a considerable portion in Allergo Journal. This was one of the reasons to extract the scientific content and publish it in a separate journal. Hence, Allergo Journal International was born and now is the international continuation of the original German journal. Nowadays, all original content is published in Allergo Journal International first. Later, selected manuscripts will be translated and published in German and included in Allergo Journal.
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