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Immunological methods for diagnosis and monitoring of IgE-mediated allergy caused by industrial sensitizing agents (IMExAllergy)

机译：诊断和监测IgE介导的IgE介导的过敏的诊断和监测（Inexallergy）

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摘要

Industrial sensitizing agents (allergens) in living and working environments play an important role in eliciting type 1 allergic disorders including asthma and allergic rhinitis. Successful management of allergic diseases necessitates identifying their specific causes (ie, identify the causative agent(s) and the route of contact to allergen: airborne, or skin contact) to avoid further exposure. Identification of sensitization by a sensitive and validated measurement of specific IgE is an important step in the diagnosis. However, only a limited number of environmental and occupational allergens are available on the market for use in sIgE testing. Accordingly, specific in-house testing by individual diagnostic and laboratory centers is often required. Currently, different immunological tests are in use at various diagnostic centers that often produce considerably divergent results, mostly due to lack of standardized allergen preparation and standardized procedures as well as inadequate quality control. Our review and meta-analysis exhibited satisfactory performance of sIgE detection test for most high molecular weight (HMW) allergens with a pooled sensitivity of 0.74 and specificity of 0.71. However, for low molecular weight (LMW) allergens, pooled sensitivity is generally lower (0.28) and specificity higher (0.89) than for HMW tests. Major recommendations based on the presented data include diagnostic use of sIgE to HMW allergens. A negative sIgE result for LMW agents does not exclude sensitization. In addition, the requirements for full transparency of the content of allergen preparations with details on standardization and quality control are underlined. Development of standard operating procedures for in-house sIgE assays, and clinical validation, centralized quality control and audits are emphasized. There is also a need for specialized laboratories to provide a custom service for the development of tests for the measurement of putative novel occupational allergens that are not commercially available.
机译：生活和工作环境中的工业敏化剂（过敏原）在引发1型过敏性疾病中起重要作用，包括哮喘和过敏性鼻炎。成功的过敏性疾病管理需要鉴定其特定原因（即，鉴定致病剂和接触途径至过敏原：空气或皮肤接触）以避免进一步暴露。通过敏感和验证的特定IgE测量鉴定敏化是诊断的重要步骤。然而，仅在市场上使用有限数量的环境和职业过敏原用于SiGe测试。因此，通常需要各个诊断和实验室中心的具体内部测试。目前，在各种诊断中心使用不同的免疫检测，这些诊断中心通常会产生显着发散的结果，主要是由于缺乏标准化过敏原制备和标准化程序以及质量控制不足。我们的审查和META分析表现出最高分子量（HMW）过敏原的SiGe检测试验的令人满意的性能，其汇总灵敏度为0.74，特异性为0.71。然而，对于低分子量（LMW）过敏原，合并的敏感性通常较低（0.28），比HMW试验更高（0.89）。基于所提出的数据的主要建议包括诊断使用SiGe对HMW过敏原。 LMW代理的负SiGe结果不排除敏化。此外，强调了具有标准化和质量控制细节的过敏原制剂含量全透明度的要求。强调，在内部SiGe测定的标准操作程序开发标准操作程序，并强调了临床验证，集中质量控制和审计。还需要专门的实验室提供定制服务，以便在不商业上获得的推定新型职业过敏原的测量的测试。

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  • 来源
    《Allergy》 |2019年第10期|共13页
  • 作者

    Baur Xaver; Akdis Cezmi A.; Budnik Lygia Therese; Cruz Maria Jesus; Fischer Axel; Foerster-Ruhrmann Ulrike; Goeen Thomas; Goksel Ozlem; Heutelbeck Astrid R.; Jones Meinir; Lux Harald; Maestrelli Piero; Munoz Xavier; Nemery Benoit; Schluenssen Vivi; Sigsgaard Torben; Traidl-Hoffmann Claudia; Siegel Paul;

  • 作者单位

    European Soc Environm &

    Occupat Med Berlin Germany;

    Christine Kuhne Ctr Allergy Res &

    Educ UZH Swiss Inst Allergy &

    Asthma Res Davos Switzerland;

    Univ Med Ctr Hamburg Eppendorf Inst Occupat &

    Maritime Med Translat Toxicol &

    Immunol Unit;

    Vall dHebron Hosp Pneumol Dept Barcelona Spain;

    Charite Univ Med Berlin Clin Res Unit Allergy Berlin Germany;

    Charite Univ Med Berlin ENT Clin Berlin Germany;

    Friedrich Alexander Univ Erlangen Nurnberg Inst &

    Outpatient Clin Occupat Social &

    Environm;

    EGE Univ Lab Occupat &

    Environm Resp Dis &

    Asthma Pulm Immunol &

    Allergy Izmir Turkey;

    Friedrich Schiller Univ Jena Inst Occupat Environm &

    Social Med Jena Germany;

    Imperial Coll London Natl Heart &

    Lung Inst London England;

    Friedrich Schiller Univ Jena Inst Occupat Environm &

    Social Med Jena Germany;

    Univ Padua Dept Cardiol Thorac &

    Vasc Sci Padua Italy;

    Vall dHebron Hosp Pneumol Dept Barcelona Spain;

    Katholieke Univ Leuven Ctr Environm &

    Hlth Dept Publ Hlth &

    Primary Care Leuven Belgium;

    Natl Res Ctr Working Environm Copenhagen Denmark;

    Aarhus Univ Dept Publ Hlth Environm Occupat &

    Hlth Aarhus Denmark;

    Christine Kuhne Ctr Allergy Res &

    Educ UZH Swiss Inst Allergy &

    Asthma Res Davos Switzerland;

    NIOSH Div Morgantown Hlth Effects Lab Ctr Dis Control &

    Prevent Morgantown WV USA;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 医学免疫学;
  • 关键词

    asthma; IgE; occupational allergies; rhinitis; urticaria;

    机译：哮喘;IgE;职业过敏;鼻炎;荨麻疹;

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