鼻分泌物Der p特异性IgE作为屋尘螨相关过敏性鼻炎潜在无创诊断生物标志物：一项单中心横断面诊断准确性研究。
Nasal Secretion Der p-Specific IgE as a Potential Non-Invasive Diagnostic Biomarker for House Dust Mite-Related Allergic Rhinitis: A Single-Center Cross-Sectional Diagnostic-Accuracy Study.
文献信息
| PMID | 42877264 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Fei Ye |
| 作者单位 | Department of Otolaryngology, Huangpu People's Hospital of Zhongshan, Zhongshan, Guangdong, People's Republic of China. |
| 期刊 | Journal of asthma and allergy |
| SCI 分区 | Q2 |
| IF | 3.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 鼻分泌物特异性IgE（sIgE）可能反映过敏性鼻炎（AR）的局部黏膜反应性，但其相对于鼻激发试验的诊断性能仍不确定。
目的： 评估鼻分泌物屋尘螨（HDM）Der p特异性IgE（Der p sIgE）对HDM相关AR的诊断价值及其与鼻敏感性和全身致敏的关联。
方法： 在这项单中心横断面诊断准确性研究中，139例连续转诊的可疑HDM相关AR参与者接受了标准化HDM鼻激发试验（NPT）；排除24例参与者后，纳入115例，并分类为AR（NPT阳性：Lebel评分≥5且具有典型常年性鼻炎；n=88）或非AR对照（NPT阴性，无典型病史；n=27）。使用无菌棉球在一侧鼻孔非侵入性采集鼻分泌物15分钟，并通过化学发光免疫分析（NOVEOS）在洗脱液中定量Der p sIgE，血清IgE在同一平台检测。通过ROC曲线下面积（AUC）评估诊断准确性。
结果： AR患者鼻Der p sIgE高于对照（1.14 vs 0.03 kUA/L；P<0.001）；AUC为0.84（95%CI 0.76-0.91）。在≥0.1 kUA/L时，敏感性为80.7%，特异性为66.7%；在≥3.5 kUA/L时，观察到的特异性为100.0%（95%CI 87.5-100.0）。88/88例AR参与者和10/27例对照存在全身HDM致敏。鼻Der p sIgE随鼻敏感性升高而升高（P<0.001），并与NPT评分（ρ=0.37）、血清总IgE（ρ=0.47）和血清Der p sIgE（ρ=0.42；所有q<0.001）相关。
结论： 非侵入性采集的鼻Der p sIgE可区分HDM相关AR与非AR对照，并反映局部鼻反应性的强度。在等待前瞻性验证之前，它可能作为NPT的潜在无创辅助手段。
英文摘要
BACKGROUND: Nasal secretion specific IgE (sIgE) may reflect local mucosal reactivity in allergic rhinitis (AR), but its diagnostic performance against nasal provocation remains uncertain.
OBJECTIVE: To evaluate nasal secretion Dermatophagoides pteronyssinus-specific IgE (Der p sIgE) for house dust mite (HDM)-related AR and its associations with nasal sensitivity and systemic sensitization.
METHODS: In this single-center cross-sectional diagnostic-accuracy study, 139 consecutive participants referred for suspected HDM-related AR underwent standardized HDM nasal provocation testing (NPT); after exclusion of 24 participants, 115 were included and classified as AR (positive NPT: Lebel score ≥ 5 with typical perennial rhinitis; n = 88) or non-AR controls (negative NPT, no typical history; n = 27). Nasal secretions were collected non-invasively with sterile cotton wool in one nostril for 15 min, and Der p sIgE was quantified in the eluate by chemiluminescent immunoassay (NOVEOS), with serum IgE on the same platform. Diagnostic accuracy was assessed by the area under the ROC curve (AUC).
RESULTS: Nasal Der p sIgE was higher in AR than controls (1.14 vs 0.03 kUA/L; P < 0.001); AUC was 0.84 (95% CI 0.76-0.91). At ≥ 0.1 kUA/L, sensitivity was 80.7% and specificity 66.7%; at ≥ 3.5 kUA/L, observed specificity was 100.0% (95% CI 87.5-100.0). Systemic HDM sensitization was present in 88/88 AR participants and 10/27 controls. Nasal Der p sIgE rose with nasal sensitivity (P < 0.001) and correlated with NPT score (ρ = 0.37), serum total IgE (ρ = 0.47), and serum Der p sIgE (ρ = 0.42; all q < 0.001).
CONCLUSION: Non-invasively collected nasal Der p sIgE distinguished HDM-related AR from non-AR controls and tracked the intensity of local nasal reactivity. It may serve as a potential non-invasive adjunct to NPT, pending prospective validation.