卡拉奇常见环境呼吸道过敏原的致敏情况

文献信息

中文摘要

目的： 识别卡拉奇过敏性鼻炎和过敏性哮喘患者对常见环境过敏原的致敏情况，并评估皮肤点刺试验（SPT）与过敏原特异性免疫球蛋白E（IgE）免疫印迹法之间的一致性。
研究设计： 描述性横断面研究。研究地点和时间：巴基斯坦卡拉奇Indus医院与健康网络免疫学系，2025年4月至12月。
方法： 纳入64例过敏性鼻炎和/或过敏性哮喘患者。使用结构化问卷收集人口学和临床数据。参与者接受SPT。风团比阴性对照大≥3 mm视为阳性。使用Euroimmun免疫印迹法检测血清过敏原特异性IgE，水平≥0.35 kU/L视为致敏指示。记录绝对嗜酸性粒细胞计数和总IgE水平。使用SPSS 21版分析数据。采用卡方检验或Fisher精确检验评估分类变量，采用McNemar检验比较配对阳性率，采用Cohen kappa评估一致性。p值<0.05视为有统计学意义。
结果： 在64例患者中（平均年龄31.1 ± 14.1岁；32例[50.0%]为女性），56.3%（n = 36）在SPT中显示对至少一种过敏原致敏，而免疫印迹为68.8%（n = 44）。SPT识别出的最常见过敏原为原棉（18.8%，n = 12）和大麻（17.2%，n = 11）。免疫印迹显示对屋尘螨（Dermatophagoides [D.] pteronyssinus）（28.1%，n = 18）和D. farinae（25.0%，n = 16）致敏，其次为杂草花粉（混合1）和德国小蠊，各为14.1%（n = 9）。18例（28.1%）患者存在嗜酸性粒细胞增多，26例（40.6%）观察到高血清总IgE。McNemar检验显示两种方法的总体阳性率差异无统计学意义（p = 0.115），而二者一致性为一般（κ = 0.344；p = 0.004）。
结论： 卡拉奇的呼吸道过敏以致敏模式多样为特征。屋尘螨致敏占主导，而原棉和大麻致敏反映了当地常见暴露。SPT与过敏原特异性IgE免疫印迹显示一致性一般，但识别出不同的致敏谱。
关键词： 过敏性鼻炎，过敏性哮喘，皮肤点刺试验，过敏原特异性IgE，免疫印迹，致敏。

英文摘要

OBJECTIVE: To identify sensitisation to common environmental allergens among patients with allergic rhinitis and allergic asthma in Karachi and to assess the agreement between skin prick testing (SPT) and allergen-specific immunoglobulin E (IgE) immunoblotting.
STUDY DESIGN: A descriptive cross-sectional study. Place and Duration of the Study: Department of Immunology, the Indus Hospital and Health Network, Karachi, Pakistan, from April to December 2025.
METHODOLOGY: Sixty-four patients with allergic rhinitis and/or allergic asthma were included. Demographic and clinical data were collected using a structured questionnaire. Participants underwent SPT. Wheals ≥3 mm larger than negative controls were considered positive. Serum allergen- specific IgE was measured using the Euroimmun immunoblot assay, with levels ≥0.35 kU/L considered indicative of sensitisation. Absolute eosinophil counts and total IgE levels were recorded. Data were analysed using SPSS version 21. Chi-square or Fisher's exact tests were used to assess categorical variables, McNemar's test was used to compare paired positivity, and Cohen's kappa was used to assess agreement. A p-value of <0.05 was considered statistically significant.
RESULTS: Of 64 patients (mean age, 31.1 ± 14.1 years; 32 [50.0%] females), 56.3% (n = 36) showed sensitisation to at least one allergen on SPT, compared with 68.8% (n = 44) on immunoblot. The most common allergens identified on SPT were raw cotton (18.8%, n = 12) and cannabis (17.2%, n = 11). Immunoblot showed sensitisation to Dermatophagoides (D.) pteronyssinus (28.1%, n = 18) and D. farinae (25.0%, n = 16), followed by weed pollens (mix 1) and German cockroach, each at 14.1% (n = 9). Eosinophilia was present in 18 (28.1%) patients, and high serum total IgE was observed in 26 (40.6%). The difference in overall positivity between the two methods was not statistically significant on McNemar's test (p = 0.115), while their agreement was fair (κ = 0.344; p = 0.004).
CONCLUSION: Respiratory allergy in Karachi is characterised by diverse patterns of sensitisation. Sensitisation to house dust mites is predominant, while sensitisation to raw cotton and cannabis reflects common local exposures. SPT and allergen-specific IgE immunoblot showed fair agreement but identified differing sensitisation profiles.
KEY WORDS: Allergic rhinitis, Allergic asthma, Skin prick test, Allergen-specific IgE, Immunoblot, Sensitisation.