曲霉致敏在哮喘诊断中的新机遇。

Y. Kozlova, A. Uchevatkina, L. Filippova, O. Aak, V. Kuznetsov, E. Frolova, N. Vasilyeva, N. Klimko
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引用次数: 0

摘要

背景:对曲霉菌致敏的哮喘诊断。由于病情严重,病程不受控制,并有可能形成过敏性支气管肺曲霉病,因此变得越来越重要。目的:探讨流式细胞术嗜碱性粒细胞活化试验诊断曲霉致敏哮喘的可行性。材料与方法:对118例哮喘患者进行检查。采用酶免疫分析法测定血清中总IgE和对空气过敏原的特异性IgE水平。采用致敏性试剂盒(Cellular Analysis of Allergy, Beckman-Coulter, USA)流式细胞术研究嗜碱性粒细胞活化。用变应原烟曲霉(Alcor Bio, Russia)刺激嗜碱性细胞。结果:第一组57例哮喘患者对曲霉菌不敏感。第二组包括36例对曲霉菌过敏的哮喘患者。第三组包括25例过敏性支气管肺曲菌病患者。对曲霉菌致敏的哮喘患者被烟曲霉变应原激活的嗜碱性细胞数量。变应性支气管肺曲霉病明显高于哮喘组,达8.1 [5.2];20.9 %和84.6 % [75.7;94.0]%,差异有统计学意义(p 0.001)。实验组的刺激指数在0.7 ~ 72.6之间。鉴别曲霉菌哮喘患者的最佳诊断点(切点)。致敏刺激指数大于2.4,过敏性支气管肺曲菌病患者刺激指数为15.95。在所有对曲霉菌过敏的患者中。特异性IgE水平与曲霉菌呈显著正相关。被变应原烟曲霉激活的嗜碱性细胞百分比(r= 0.792,p 0.001)和刺激指数(r= 0.796,p 0.05)。结论:嗜碱性粒细胞活化试验可作为对曲霉菌致敏哮喘的附加诊断方法。过敏性支气管肺曲霉菌病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New opportunities in the diagnosis of asthma with sensitization to Aspergillus spp.
BACKGROUND:Diagnosis of asthma with sensitization toAspergillusspp. is becoming increasingly important due to the severe, uncontrolled course of the disease and the possibility of the formation of allergic bronchopulmonary aspergillosis. AIM:To evaluate the possibility of using the basophil activation test using flow cytometry for the diagnosis of asthma with sensitization toAspergillusspp. MATERIALS AND METHODS:118 patients with asthma were examined. The levels of total IgE and specific IgE to aeroallergens were determined in the blood serum by the enzyme immunoassay. Basophil activation was studied by flow cytometry using the Allergenicity kit (Cellular Analysis of Allergy, Beckman-Coulter, USA). The allergenAspergillus fumigatus(Alcor Bio, Russia) was used to stimulate basophils. RESULTS:The first group consisted of 57 patients with asthma without sensitization toAspergillusspp. The second group included 36 patients with asthma with sensitization toAspergillusspp. The third group consisted of 25 patients with allergic bronchopulmonary aspergillosis. The number of basophils activated by theAspergillusfumigatusallergen in patients with asthma with sensitization toAspergillusspp. and allergic bronchopulmonary aspergillosis was significantly higher than in the asthma group and amounted to 8.1 [5.2; 20.9]% and 84.6 [75.7; 94.0]%, respectively (p 0.001). The stimulation index in the study groups ranged from 0.7 to 72.6. The optimal diagnostic point (cut off) for identifying patients with asthma withAspergillusspp. sensitization there was an stimulation index value of more than 2.4, and for patients with allergic bronchopulmonary aspergillosis 15.95. Among all patients with sensitization toAspergillusspp. a positive correlation was established between the level of specific IgE toAspergillusspp. and the percentage of basophils activated by the allergenAspergillusfumigatus(r= 0.792,p 0.001) and stimulation index (r= 0.796,p 0.05). CONCLUSIONS:The basophil activation test can be used as an additional diagnostic method for asthma with sensitization toAspergillusspp. and allergic bronchopulmonary aspergillosis.
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