过敏性鼻炎儿童过敏原谱及屋尘螨组分致敏模式：一项两阶段研究
Allergen Spectrum and House Dust Mite Component-Resolved Sensitization Patterns in Children with Allergic Rhinitis: A Two-Stage Study.
文献信息
| PMID | 42974113 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xudong Xu |
| 作者单位 | Department of Laboratory Medicine, Hangzhou Children's Hospital, Hangzhou, Zhejiang, 310014, 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： 屋尘螨（HDM）是过敏性鼻炎（AR）儿童主要的室内过敏原，但传统的二元报告掩盖了致敏强度及组分特异性特征。
方法： 这项两阶段回顾性横断面研究纳入2036名AR儿童（1-15岁）。采用免疫印迹法检测血清sIgE针对19种过敏原（≥0.35 kU/L为阳性）。将屋尘螨阳性样本分为六个致敏等级。在第二阶段，110名HDM阳性儿童接受了针对Der p 1、Der p 2、Der f 1、Der f 2、Der p 23和Der p 10的组分解析诊断。
结果： 屋尘螨是最常见的过敏原（43.91%，894/2036；95% CI 41.77-46.07%）。男孩阳性率高于女孩（46.34% vs 39.50%；OR 1.32，95% CI 1.10-1.59），但在已致敏儿童中，高等级致敏（≥4级）在性别间相似（69.08% vs 66.43%，P=0.427）。在横断面分析中，6级致敏（>100 kU/L）的比例随年龄增长而增加，从3岁时的15.00%增至5岁时的25.51%和6岁时的34.58%。组分阳性率分别为：Der f 1 72.73%（80/110）、Der p 1 70.91%（78/110）、Der f 2 64.55%（71/110）、Der p 2 62.73%（69/110）、Der p 23 41.82%（46/110）和Der p 10 11.82%（13/110）。Der p 1与Der p 23共致敏仅见于53.85%的Der p 1阳性儿童。仅对屋尘螨（0.91%；95% CI 0.16-4.97%）或Der p 23（0.91%；95% CI 0.16-4.97%）致敏的情况罕见。
结论： HDM是华东地区儿童AR的主要过敏原。横断面分析发现高等级致敏比例随年龄增长而增加，在5-6岁左右最为明显。CRD显示Der p 23是主要致敏组分，其致敏常独立于第1组过敏原发生。由于未评估临床过敏表型和AIT结局，组分解析谱用于指导AIT选择的效用尚需前瞻性验证。
英文摘要
BACKGROUND: House dust mite (HDM) is the predominant indoor allergen in children with allergic rhinitis (AR), but conventional binary reporting obscures both sensitization intensity and component-specific profiles.
METHODS: This two-stage retrospective cross-sectional study enrolled 2036 children (1-15 years) with AR. Serum sIgE against 19 allergens was measured by immunoblot (≥0.35 kU/L positive). D. pteronyssinus-positive samples were stratified into six sensitization grades. In Stage 2, 110 HDM-positive children underwent component-resolved diagnostics for Der p 1, Der p 2, Der f 1, Der f 2, Der p 23, and Der p 10.
RESULTS: D. pteronyssinus was the most prevalent allergen (43.91%, 894/2036; 95% CI 41.77-46.07%). Boys had higher positivity than girls (46.34% vs 39.50%; OR 1.32, 95% CI 1.10-1.59), but among sensitized children, high-grade sensitization (≥grade 4) was similar between sexes (69.08% vs 66.43%, P=0.427). In cross-sectional analyses, the proportion of grade 6 sensitization (>100 kU/L) increased with age, from 15.00% at age 3 to 25.51% at age 5 and 34.58% at age 6. Component positivity rates were: Der f 1 72.73% (80/110), Der p 1 70.91% (78/110), Der f 2 64.55% (71/110), Der p 2 62.73% (69/110), Der p 23 41.82% (46/110), and Der p 10 11.82% (13/110). Co-sensitization between Der p 1 and Der p 23 occurred in only 53.85% of Der p 1-positive children. Exclusive sensitization to D. farinae (0.91%; 95% CI 0.16-4.97%) or Der p 23 (0.91%; 95% CI 0.16-4.97%) was rare.
CONCLUSION: HDM is the leading allergen in pediatric AR in East China. Cross-sectional analyses identified an age-associated increase in the proportion of high-grade sensitization that was most evident around 5-6 years of age. CRD revealed Der p 23 as a major sensitizing component whose sensitization frequently occurred independently of group 1 allergens. Because clinical allergy phenotypes and AIT outcomes were not assessed, the utility of component-resolved profiles for guiding AIT selection requires prospective validation.