过去20年中乳胶敏化的特性变化。,International Archives of Allergy and Immunology

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过去20年中乳胶敏化的特性变化。
International Archives of Allergy and Immunology ( IF 2.5 ) Pub Date : 2018-09-14 , DOI: 10.1159/000492191
Mohamed M Saleh ₁ , Susann Forkel ₁ , Michael P Schön _{1,

2,

3} , Thomas Fuchs ₁ , Timo Buhl _{4,

5,

6}

Affiliation

背景技术天然橡胶乳胶（NRL）过敏通常根据病史，皮肤过敏测试和血清学分析来诊断。然而，由于（i）耗时的特性，（ii）用于皮肤测试的胶乳制剂不可商业获得，以及（iii）使用内部制备的测试溶液变得越来越困难，因此越来越多地放弃了皮肤测试。由于越来越多的监管障碍。有鉴于此，我们评估了当前和以前怀疑乳胶过敏患者的概况差异。方法用ImmunoCAP同时分析历史队列（1995-2001年，n = 149例患者）和目前（2014-2015年，n = 48例）的皮肤测试阳性患者的血清特异性IgE。如果血清学筛查呈阳性（≥0.35kU / L），进行了成分分辨的诊断，包括蛋白水解酶和交叉反应性碳水化合物决定簇（CCD）。结果与1990年代88％（131/149）的皮肤试验阳性患者相反，当前队列中只有51.1％（24/47）的乳胶特异性IgE阳性。尽管在1990年代有48.3％（72/149）的患者有令人信服的阳性病史，但目前的皮肤试验阳性患者很少报告相关的病史（8.5％，4/47）。怀疑有乳胶过敏的前患者对乳胶的特异性IgE水平显着高于无过敏的前致敏个体（p <0.001）。但是，在当前皮肤试验阳性的过敏和敏感患者中，这种显着差异消失了。结论在过去的20年中，乳胶过敏患者的敏化特性发生了显着变化。NRL致敏性与临床过敏之间的区别仍然是诊断上的挑战。我们的数据突出显示了对乳汁过敏的正确诊断，需要结合所有三个标准（即患者病史，皮肤测试和特定IgE分析）。

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Profile Shift in Latex Sensitization over the Last 20 Years.

BACKGROUND Natural rubber latex (NRL) allergy is commonly diagnosed according to medical history, skin allergy tests, and serological analyses. However, skin tests are increasingly being abandoned because of (i) their time-consuming nature, (ii) latex preparations for skin tests being not commercially available, and (iii) the use of in-house prepared test solutions is becoming ever more difficult due to increasing regulatory hurdles. In this light, we have evaluated differences in the profiles of current and former patients with suspected latex allergy. METHODS Sera of skin test-positive patients from a historic cohort (1995-2001, n = 149 patients) and currently (2014-2015, n = 48 patients) were simultaneously analyzed for specific IgE to latex by ImmunoCAP. If the serological screening was positive (≥0.35 kU/L), component-resolved diagnostics including profilins and cross-reactive carbohydrate determinants (CCDs) were performed. RESULTS In contrast to 88% (131/149) of the skin test-positive patients from the 1990s, only 51.1% (24/47) of the current cohort were found positive for specific IgE to latex. While 48.3% (72/149) of the patients had a convincing positive history in the 1990s, current skin test-positive patients rarely reported a relevant medical history (8.5%, 4/47). Specific IgE levels to latex were significantly higher in former patients with suspected latex allergy (p < 0.001) than in former sensitized individuals without allergy. However, this significant difference was lost in current allergic and sensitized patients with positive skin tests. CONCLUSION Sensitization profiles in patients with latex allergy have changed significantly over the last 2 decades. Discrimination between NRL sensitization and clinical allergy remains a diagnostic challenge. Our data highlight the need for a combination of all 3 criteria, i.e., patient history, skin test, and analysis of specific IgE, for a correct diagnosis of latex allergy.

更新日期：2019-11-01

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