背景:缺乏准确的测试阻碍了虾过敏的临床管理。分子诊断已显示出更准确地反映临床反应性,但尚未建立虾过敏原的全谱及其临床相关性。因此,我们试图理解虾的过敏原,调查并比较两个不同人群的过敏受试者中过敏原的致敏模式和诊断价值。
方法:从香港和泰国的85名具有攻击证实或医生诊断的虾过敏的受试者收集血清。通过蛋白质印迹法探测斑节对虾的IgE结合蛋白,并通过质谱鉴定。合成重组虾变应原,并通过ELISA分析IgE致敏作用。
结果:鉴定出10种IgE结合蛋白,并产生了11种重组虾过敏原的综合小组。香港受试虾的主要过敏原为肌钙蛋白C(Penm6)及糖原磷酸化酶(Penm14,47.1%),原肌球蛋白(笔m1,41.2%)和肌浆钙结合蛋白(笔m4,35.3%),而泰国受试者是Penm1(68.8%),笔m6(50.0%)和脂肪酸结合蛋白(笔m13,37.5%)。基于成分的测试产生的曲线下面积值(0.77-0.96)明显高于虾提取物-IgE测试(0.70-0.75)。然而,最佳成分测试在人群之间有所不同;Penm1-IgE测试仅在泰国队列中增加了诊断价值,而对其他成分的致敏是香港患者虾过敏的更好预测因素。
结论:Penm14被鉴定为预测攻击结果的新型虾过敏原。分子诊断比常规测试更能预测虾过敏,但相关的组成部分是人口依赖的。
Clinical management of shrimp allergy is hampered by the lack of accurate tests. Molecular diagnosis has been shown to more accurately reflect the clinical reactivity but the full spectrum of shrimp allergens and their clinical relevance are yet to be established. We therefore sought to comprehend the allergen repertoire of shrimp, investigate and compare the sensitization pattern and diagnostic value of the allergens in allergic subjects of two distinct populations.
Sera were collected from 85 subjects with challenge-proven or doctor-diagnosed shrimp allergy in Hong Kong and Thailand. The IgE-binding proteins of Penaeus monodon were probed by Western blotting and identified by mass spectrometry. Recombinant shrimp allergens were synthesized and analyzed for IgE sensitization by ELISA.
Ten IgE-binding proteins were identified, and a comprehensive panel of 11 recombinant shrimp allergens was generated. The major shrimp allergens among Hong Kong subjects were troponin C (Pen m 6) and glycogen phosphorylase (Pen m 14, 47.1%), tropomyosin (Pen m 1, 41.2%) and sarcoplasmic-calcium binding protein (Pen m 4, 35.3%), while those among Thai subjects were Pen m 1 (68.8%), Pen m 6 (50.0%) and fatty acid-binding protein (Pen m 13, 37.5%). Component-based tests yielded significantly higher area under curve values (0.77-0.96) than shrimp extract-IgE test (0.70-0.75). Yet the best component test differed between populations; Pen m 1-IgE test added diagnostic value only in the Thai cohort, whereas sensitizations to other components were better predictors of shrimp allergy in Hong Kong patients.
Pen m 14 was identified as a novel shrimp allergen predictive of challenge outcome. Molecular diagnosis better predicts shrimp allergy than conventional tests, but the relevant component is population dependent.