아토피피부염 환자에서 소아와 성인의 MAST CLA 검사에 의한 혈청 총 IgE 검사와 알레르겐 특이항체 검사 성적의 평가

Abstract

BACKGROUND: The multiple allergosorbent test chemiluminescent assay (MAST-CLA) system is a simple method for measuring total and allergen-specific IgE antibodies in the serum of patients with atopic dermatitis. Total IgE, however, is much frequently higher, even if no allergen-specific IgE antibodies can be detected in serum. OBJECTIVE: The purpose of this study was to evaluate total IgE class, the allergen frequencies and their correlations in MAST-CLA in child and adult atopic dermatitis patients respectively. METHODS: A total of fifty two adult patients and ninety child patients with atopic dermatitis were evaluated by MAST-CLA between march 2002 and march 2005 at Soonchunhyang hospital. Positive rates of specific IgE and the total serum IgE level of the MAST-CLA allergy system were compared between child and adult patients. RESULTS: Among the subjects, 84.5% (80.0% for child patients and 92.3% for adult patients) of patients showed an elevated serum total IgE (more than class level 2) and 54.9% (45.6% for child patients, 71.2% for adult patients) revealed at least more than one allergen-specific IgE by MAST-CLA. The average 3.76 (3.39 for child patients, 4.16 for adult patients) different allergens was simultaneously detected in a single positive serum. Commonly-positive allergen rates, in descending order, were D. farinae 44.4%, D. pteronyssynos 38.7% and house dust 26.8%. Furthermore, the higher total serum IgE level in adult patients, the more probability of allergen-specific IgE positive results being disclosed (p<0.05). The number of allergen-specific IgE positive results was increased in a higher serum total IgE level (p<0.05). But total IgE positive rates which had allergen-specific antibody negative patients was 37.5% (45.8% for child patients, 25.0% for adult patients). Good correlation was obtained between total IgE levels and number of positive allergen-specific IgE in MAST-CLA, with 0.551 correlation coefficiency (p<0.05). CONCLUSION: Our study suggested that the MAST-CLA allergy system is a useful screening test to detect allergen- specific IgE and to evaluate patients with atopic dermatitis. But other allergen screening tests should be used for detecting allergens, when MAST-CLA total IgE class is increased over class 2 with no detectable specific IgE.