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  • Title: [Analysis of the effectiveness of cross-reactive carbohydrate antigen determinant antibody adsorbents in identifying allergen-specific IgE antibodies].
    Author: Zhao WL, Cai B, Shi CQ, Su ZZ, Feng WH.
    Journal: Zhonghua Yu Fang Yi Xue Za Zhi; 2024 Sep 06; 58(9):1379-1383. PubMed ID: 39290020.
    Abstract:
    This study aimed to investigate the influence of anti-cross-reactive carbohydrate determinant IgE antibodies (anti-CCD IgE) on the detection of allergen-specific IgE (sIgE) antibodies, as well as the application value of anti-CCD IgE adsorbents in detecting allergen sIgE. In this cross-sectional study, a total of 2 636 test samples from patients who received treatment in West China Hospital of Sichuan University and tested allergen sIgE using the western blot method from October 2020 to May 2021 were analyzed. In these samples, 709 samples tested postive of allergen sIgE. 46 stochastic venous serum samples that tested positive in both sIgE and anti-CCD IgE and 1 serum sample that tested positive in sIgE but negative in anti-CCD IgE were collected. These samples were processed by anti-CCD IgE adsorbents, followed by allergen sIgE detection. The difference between the two detection results before and after adsorption was analyzed. The allergen test results showed that the positive rate of anti-CCD IgE in samples was 2.6% (69/2 636) during the period of sample collection. After treatment with anti-CCD IgE adsorbents, the top three allergen-sIgE of the positive rate changed from tree combination 2 (willow/poplar/elm), common ragweed and peanut to dust mite combination, cockroach and crab. The positive anti-CCD IgE results of 46 samples all turned negative and the total positive sIgE antibody dropped by 62.8%; the positive rate of sIgE antibodies with the class result ≥2 significantly decreased after treatment with anti-CCD IgE adsorbents, especially the positive rate of common ragweed dropped by 96.2%. The results of positive samples showed that multiple sIgE antibodies declined by different ranges, involving up to 11 antibodies with a maximum decline of 4 classes. Strongly positive sIgE antibodies (the class result ≥4) also had a high conversion rate of negative (25.0%-100%). The positive sIgE antibodies in about 60% of the samples decreased by more than 2, and the sIgE antibodies in 17.4% of the samples turned completely negative. There was no change in the allergen sIgE detection results of the sample with negative anti-CCD IgE after treatment. In conclusion, sIgE antibodies including targeting common ragweed, humulus, tree combination 2 (willow/poplar/elm), etc. are susceptible to false positives caused by anti-CCD IgE. Treatment of samples with anti-CCD IgE adsorbents can significantly reduce the risk of false positives caused by anti-CCD IgE. It is necessary to pretreat samples that were anti-CCD IgE positive with anti-CCD IgE adsorbents, which can make laboratory results more accurate and provide a reference for diagnosis and prevention of allergic diseases. 本研究旨在探讨抗交叉反应性糖类抗原决定簇 IgE 抗体（anti-CCD IgE）对过敏原特异性 IgE（sIgE）抗体检测的干扰，以及 anti-CCD IgE 吸附剂在过敏原 sIgE 检测中的应用价值。采用横断面研究，回顾性分析2020年 10 月至 2021 年 5 月就诊于四川大学华西医院并以免疫印迹法行过敏原 sIgE 检测样本2 636例，其中过敏原 sIgE 阳性样本共计709例。随机收集过敏原 sIgE 阳性且交叉反应性糖类抗原决定簇（cross-reactive carbohydrate determinants，CCD）指示带为阳性的患者血清样本共 46 例，sIgE 阳性但 CCD 指示带阴性血清样本 1 例，使用 anti-CCD IgE 吸附剂处理这些样本，再次进行过敏原 sIgE 检测，分析吸附前、后两次检测结果的差异。结果显示，本研究收集样本期间过敏原检测样本的 CCD 指示带阳性率为 2.6%（69/2 636）。47 例样本经 anti-CCD IgE 吸附剂处理后，阳性率排名前三的过敏原 sIgE 从树组合 2（柳树/杨树/榆树）、普通豚草、花生变更为尘螨组合、蟑螂和蟹。46 例样本的 anti-CCD IgE 阳性结果全部转阴，sIgE 抗体阳性总量下降了 62.8%；阳性强度等级≥2 的 sIgE 抗体经 anti-CCD IgE 吸附剂处理后阳性率显著降低，其中普通豚草阳性率降低达 96.2%。阳性样本结果呈多 sIgE 抗体不同幅度下降，最多涉及 11 种抗体，最大降幅 4 级，强阳性（阳性强度等级≥4）sIgE 抗体也有较高的转阴比例（25.0%~100%）。约 60% 样本的阳性 sIgE 抗体减少 2 种以上，17.4% 样本的 sIgE 抗体转为全阴。1 例 anti-CCD IgE 阴性样本处理后过敏原 sIgE 检测结果无变化。综上，普通豚草、葎草、树木组合 2（柳树/杨树/榆树）等 sIgE 易受 anti-CCD IgE 影响，导致假阳性，经 anti-CCD IgE 吸附剂处理样本后可明显减少因 anti-CCD IgE 干扰引起的假阳性；anti-CCD IgE 阳性样本使用 anti-CCD IgE 吸附剂进行预处理很有必要，可使实验室结果更准确，为过敏性疾病的诊断和预防提供参考依据。.
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