来自LEAD队列的成人哮喘患者微阵列过敏原分子的分子IgE致敏分析:一种精准医学方法。

IF 12 1区 医学 Q1 ALLERGY
Allergy Pub Date : 2025-08-30 DOI:10.1111/all.70017
Huey-Jy Huang, Robab Breyer-Kohansal, Katarzyna Niespodziana, Charmaine J M Lim, Marie-Kathrin Breyer, Rudolf Valenta, Sylvia Hartl
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引用次数: 0

摘要

背景:哮喘是一种慢性呼吸系统疾病,包括不同的表型和内源性疾病。鉴别过敏性与非过敏性哮喘的诊断工具需要新的精准医学治疗。目的:确定奥地利LEAD(肺、心、社会、身体)队列中成人哮喘患者对多种微阵列过敏原分子的IgE致敏谱;比较IgE致敏和非IgE致敏哮喘患者;并为致敏患者定义可能的过敏原特异性免疫治疗概念。方法:在893例有哮喘病史的患者中,分析哮喘患者(n = 436)对来自空气和食物过敏原的110种微阵列分子的IgE致敏性,并通过皮肤点刺试验(SPT)分析10种过敏原提取物(英车前草、艾草、豚草、timothy草、白蜡树、螨虫、狗、猫、alternnaria alternata和Fagales混合物)的IgE致敏性。比较IgE致敏哮喘变应原分子患者与非IgE致敏哮喘患者的临床哮喘相关参数。结果:63种微阵列呼吸道过敏原对哮喘患者的IgE致敏率为73.2%。呼吸道室外变应原分子认知度最高的是Bet v 1(32.8%)和Ole e 1(23.2%),其次是草花粉、豚草和艾草变应原。最常见的呼吸道室内变应原分子是Fel d1(42.7%),其次是屋尘螨和犬类变应原分子。微阵列过敏原允许识别IgE反应性谱,表明对不同过敏原来源的真正致敏。ige致敏的哮喘患者明显比非ige致敏的哮喘患者年轻(中位年龄44岁对58岁)。呼吸道过敏原致敏患者肺功能(FEV1、FVC和FEV/FVC)明显优于非ige致敏的哮喘患者,呼吸困难较少,但变应性支气管炎较多。与非ige致敏的哮喘患者相比,更多的ige致敏患者使用抗组胺药,但吸入皮质类固醇较少。有趣的是,与未致敏的哮喘患者相比,接受ics治疗和未接受ics治疗的致敏患者的嗜酸性粒细胞计数均较低。结论:分子变态反应诊断可检出成人哮喘患者真性IgE致敏;使精准医学为基础的个性化治疗形式分层,如基于过敏原的免疫治疗(AIT)和/或哮喘生物治疗的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Molecular IgE Sensitization Profiling With Micro-Arrayed Allergen Molecules in Adult Patients With Asthma From the LEAD Cohort: A Precision Medicine Approach.

Background: Asthma is a chronic respiratory disease comprising different pheno- and endotypes. Diagnostic tools for the identification of allergic versus non-allergic asthma are needed for new precision medicine-based treatments.

Objective: To determine IgE sensitization profiles to multiple micro-arrayed allergen molecules in adult patients with asthma in the Austrian LEAD (Lung, hEart, sociAl, boDy) cohort; to compare IgE- and non-IgE sensitized patients with asthma; and to define possible allergen-specific immunotherapy concepts for sensitized patients.

Methods: Out of 893 patients with a history of asthma, patients with current asthma (n = 436) were analyzed for IgE sensitizations to 110 micro-arrayed molecules from airborne and food allergen sources and by skin prick testing (SPT) with 10 allergen extracts (English plantain, mugwort, ragweed, timothy grass, ash tree, mites, dog, cat, Alternaria alternata, and Fagales mix). Clinical asthma-related parameters were compared between patients with IgE sensitization to asthma allergen molecules and non-IgE sensitized patients with asthma.

Results: IgE sensitization was detected in 73.2% of patients with asthma using 63 micro-arrayed respiratory allergens. The most recognized respiratory outdoor allergen molecules were Bet v 1 (32.8%) and Ole e 1 (23.2%) followed by grass pollen, ragweed, and mugwort allergens. Fel d 1 was the most frequently recognized respiratory indoor allergen molecule (42.7%) followed by house dust mite and dog allergen molecules. Micro-arrayed allergens allowed the identification of IgE reactivity profiles indicative of genuine sensitizations to different allergen sources. IgE-sensitized patients were significantly younger than non-IgE-sensitized patients with asthma (median age 44 versus 58 years). Patients sensitized to respiratory allergens showed significantly better lung function (FEV1, FVC and FEV/FVC) and less dyspnea but more allergic bronchitis than non-IgE-sensitized patients with asthma. More IgE-sensitized patients used antihistamines but fewer inhaled corticosteroids than non-IgE-sensitized patients with asthma. Interestingly, eosinophil counts were lower both in ICS-treated as well as untreated sensitized patients than in non-sensitized patients with asthma.

Conclusion: Molecular allergy diagnosis allowed the detection of genuine IgE sensitizations in adult patients with asthma; enabling stratification for precision medicine-based forms of personalized treatments such as allergen-based immunotherapy (AIT) and/or administration of biological treatments in asthma.

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来源期刊
Allergy
Allergy 医学-过敏
CiteScore
26.10
自引率
9.70%
发文量
393
审稿时长
2 months
期刊介绍: Allergy is an international and multidisciplinary journal that aims to advance, impact, and communicate all aspects of the discipline of Allergy/Immunology. It publishes original articles, reviews, position papers, guidelines, editorials, news and commentaries, letters to the editors, and correspondences. The journal accepts articles based on their scientific merit and quality. Allergy seeks to maintain contact between basic and clinical Allergy/Immunology and encourages contributions from contributors and readers from all countries. In addition to its publication, Allergy also provides abstracting and indexing information. Some of the databases that include Allergy abstracts are Abstracts on Hygiene & Communicable Disease, Academic Search Alumni Edition, AgBiotech News & Information, AGRICOLA Database, Biological Abstracts, PubMed Dietary Supplement Subset, and Global Health, among others.
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