MAST<sup>®</sup>法にてスクリーニングされた喘息患者におけるアレルゲン特異的IgE抗体の検索:—ImmunoCAP<sup>®</sup>の意義— FACTORS ASSOCIATED WITH THE PRESENCE OF ALLERGEN-SPECIFIC IgE RESPONSES IN ASTHMA PATIENTS WHO HAD NO IgE RESPONSES DETECTABLE BY MAST-26

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【目的】MAST<sup>®</sup>と比較しImmunoCAP<sup>®</sup>は特異的IgE抗体検出力が高い.MASTでスクリーニングされた喘息患者に対しImmunoCAPによる精査が推奨される患者の特徴を検討する.【方法】MASTにて14種類の吸入抗原特異的IgE抗体がすべて陰性の48名(A群)とダニへの強い感作が認められた44名(B群)の喘息患者を対象とし,ゴキブリやガなどに対しImmunoCAPを実施した.【結果】A群の27.1%においてImmunoCAPが陽性となった.少なくとも一つのアレルゲンに対するImmunoCAP陽性と総IgE値とが関連した(<i>p</i>=0.0007).B群では,ゴキブリ,ガのImmunoCAP陽性率は各々27.8%,52.3%であり,これらの感作も総IgE値と関連した(<i>p</i>=0.0003).【結論】総IgE値が一定の値を超える喘息患者では,MASTが陽性でなくても,ゴキブリやガを含め幅広く吸入抗原に対し感作されている可能性があり,ImmunoCAPによるアレルゲン精査が有用である.

<b>Aim:</b> To elucidate the characteristics of patients with asthma who have specific IgE responses to inhaled allergens detected by ImmunoCAP, which is not detectable by MAST-26. <b>Methods:</b> A total of 168 patients with adult asthma who reside in the Kanto region were recruited. Levels of total serum IgE and allergen specific IgE antibodies towards 14 common inhaled allergens (MAST-26) were measured. Among these samples, 48 patients with no detectable allergen-specific IgE (group A) and 44 patients with strong sensitization to <i>Dermatophagoides farinae</i> (group B) were selected for further assessment of their sensitization to inhaled allergens such as cockroach and moth using ImmunoCAP. <b>Results:</b> In group A, ImmunoCAP detected specific IgE responses to some inhaled allergens in 27.1% of the patients. The strongest predictive factor for the presence of allergen-specific IgE responses detected by ImmunoCAP was elevated levels of total serum IgE (<i>p</i>=0.0007). In group B, the presence of IgE responses specific to cockroach or moth by ImmunoCAP were found in 27.8% or 52.3% of the patients, respectively. The predictive factor for the presence of these positive IgE responses was also elevated levels of total serum IgE (<i>p</i>=0.0003). <b>Conclusion:</b> Asthma patients with no detectable specific IgE responses to any inhaled allergens by MAST-26 may be still sensitized to common inhaled allergens, including cockroach and moth. Thus, the presence of allergen-specific IgE responses may be re-assessed by ImmunoCAP in patients with asthma, especially when patients have higher levels of total serum IgE.

収録刊行物

  • アレルギー

    アレルギー 64(9), 1242-1253, 2015

    一般社団法人 日本アレルギー学会

各種コード

  • NII論文ID(NAID)
    130005130144
  • NII書誌ID(NCID)
    AN00012583
  • 本文言語コード
    JPN
  • ISSN
    0021-4884
  • NDL 記事登録ID
    026862448
  • NDL 請求記号
    Z19-32
  • データ提供元
    NDL  J-STAGE 
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