Comparative analysis of serum IgE detected by ImmunoCAP and EUROLine assays / 医学研究生学报

Objective The diagnosis of allergic diseases mainly relies on the allergen skin test or in vitro specific IgE test. This study was to explore the diagnostic efficiency of EUROLine and its application in southern China by reference to the standard method of the immunoenzymatic capsulated hydrophilic carrier polymer (ImmunoCAP).Methods Using the EUROLine system, we examined 12 common specific IgEs (sIgE) from 283 patients with multiple sensitizations in the First Affiliated Hospital of Guangzhou Medical University, including cockroach (i6), dog dander (e2), cat dander (e1), Mugwort (w6), ragweed (w1), dust mites (ds1), chicken protein (f1), milk (f2), crab (f23), shrimp (f24), peanut (f13) and soybean (f14).Results EUROLine showed that house dust mite allergens were the main aeroallergens in southern China, with a positive rate of 66.3%, while egg white had the highest positive rate (53.2%) in food allergens. The overall rate of the allergens detected by EUROLine was consistent to that of ImmunoCAP by 60.8%-90.1%, the positive rate by 63.3%-93.6%, and the negative rate by 54.5%-95.2%. The Kappa value of EUROLine was 0.203-0.702 in detecting each allergen and >0.6 with cat hair, egg white, peanut, milk and mugwort. The rank correlation coefficient between ImmunoCAP and EUROLine was >0.7 for dust mite combination, cat hair, mugwort, egg white, milk, peanut and crab allergens, with the highest consistency rate for egg white (93.17% \[191/205\]), the lowest for shrimp (70.83% \[170/240\]), and an overall consistency rate of 82.68% (1542/1865).Conclusion The EUROLine system has a high diagnostic performance, and it is inexpensive, efficient and applicable in the detection of allergens in southern China.

Cow's Milk-related Symptom Score as a predictive tool for cow's milk allergy in Indian children aged 0–24 months

BACKGROUND: Cow's milk protein causes an unfavorable and unwanted reaction in some individuals called cow's milk protein allergy (CMPA). It is more often imprecise and easily missed in primary care settings. Cow's Milk-related Symptom Score (CoMiSS) was developed as a screening and awareness tool to suggest the presence of CMPA using general, dermatological, gastrointestinal, and respiratory symptoms. OBJECTIVE: Assess the utility of CoMiSS in the diagnosis of CMPA in Indian children aged between 0 and 24 months. METHODS: A pilot multicentric, observational, longitudinal study was conducted over a period of 4 months among infants aged 0–24 months with symptoms suggestive of CMPA to measure the positive and negative predictive value of CoMiSS. A predesigned questionnaire was used to record the information via CoMiSS. The patients were confirmed of having CMPA via oral food challenge/skin prick test or ImmunoCAP test. RESULTS: A total of 83 children were enrolled in the study and majority of them had gastrointestinal complaints (61%, 51 of 83) followed by respiratory (41%, 34 of 83) and skin complaints (33%, 27 of 83). CoMiSS was >12 in 72.3% of the infants and amongst them 84.3% were confirmed via oral food challenge/ImmunoCAP test. The positive and negative predictive values for CoMiSS were 93% and 33% respectively. CONCLUSION: CoMiSS can help predict CMPA in children aged less than 2 years in the Indian primary care setting, aiding in early diagnosis. Prospective randomized studies are needed to evaluate the use of CoMiSS further.

Performance of the PROTIA(TM) Allergy-Q(R) System in the Detection of Allergen-specific IgE: A Comparison With the ImmunoCAP(R) System

PURPOSE: The PROTIA(TM) Allergy-Q(R) enzyme immunoassay (EIA) is a recently developed screening assay for specific immunoglobulin E (sIgE) for multiple allergens. The ImmunoCAP(R) fluorescent EIA (FEIA) system is the most widely used method for sIgE detection. In this study, we evaluated the performance of the Allergy-Q(R) system compared to the ImmunoCAP(R) system. METHODS: We compared the 2 systems using sera from 260 Korean allergy patients suffering from asthma (26.5%), allergic rhinitis (42.3%), atopic dermatitis (67.7%), and food allergy (18.1%). We compared sIgE-measurement results for 7 inhalant allergens, 5 food allergens, and 4 microorganism allergens. RESULTS: Overall, 1,799 paired assay results were analyzed. Except mugwort and alternaria, most of the allergen-sIgE results showed intra-class correlation coefficients of >0.5. Inter-assay class associations were reliable for most allergens (gamma=0.858-0.987, P<0.001). Passing-Bablok regression analysis showed multiple differences in intercept and slope. The inter-method concordance was moderate to substantial for most allergens (kappa=0.713-0.898, P<0.001). CONCLUSIONS: The PROTIA(TM) Allergy-Q(R) EIA system exhibited good detection performance compared to the ImmunoCAP(R) FEIA system in Korean allergic patients. However, because of methodological differences between the 2 assays, careful clinical implication is required for the interpretation of Allergy-Q(R) EIA results.

Analysis of ImmunoCAP(R) ISAC Results of Chronic Spontaneous Urticaria Patients: Comparison with Skin Prick and the MAST-EIA Tests / 대한피부과학회지

BACKGROUND: In vivo and/or in vitro diagnostic tests to identify possible allergens have been conducted for patients with chronic spontaneous urticaria (CSU) in order to identify any predisposing factors and avoid unnecessary restrictions. OBJECTIVE: The purpose of this study was to evaluate the diagnostic effectiveness of ImmunoCAP(R) ISAC (ISAC) in CSU patients. METHODS: A total of 31 patients with CSU were tested by ISAC and Multiple Allergen Simultaneous Test enzyme immunoassays (MAST-EIA). A skin prick test (SPT) was performed for 17 out of 31 patients. The results of ISAC and MAST-EIA were evaluated based on the SPT results. RESULTS: For 17 patients, with SPT used as the reference standard, ISAC compared with MAST-EIA showed lower sensitivity (22.2% vs. 26.5%), higher specificity (100% vs. 95.7%), higher positive predictive value (100% vs. 52.9%), and lower negative predictive value (86.9% vs. 87.7%). The agreement rate was more favorable for ISAC than for MAST-EIA (87.3% vs. 85.1%; kappa=0.324 vs. 0.263). For 31 patients, the agreement rate between ISAC and MAST-EIA was 83.9% for both Dermatophagoides farinae and Dermatophagoides pteronyssinus. Correlation coefficients (Rho) between ISAC and MAST-EIA for each allergen were 0.690 and 0.675, respectively. CONCLUSION: For CSU patients, specificity, positive predictive value, and the agreement rate of ISAC were similar or superior to those of MAST-EIA. In addition, ISAC provides valuable information on the possible sensitization to different allergen sources by elucidating cross-reactive components. With careful clinical correlations in interpretation, ISAC can be a useful diagnostic tool to detect allergens in CSU patients.

Analysis of Polycheck Allergy Results of the Recent Two Years: Comparison with Skin Prick Test and ImmunoCAP

BACKGROUND: Multiple Antigen Simultaneous Test (MAST)-immunoblot assay is a practical and economical test, which has been recently introduced nationwide. Authors investigated test efficiency of a MAST-immunoblot assay, Polycheck Allergy (PA). METHODS: A total of 3,153 patients were tested by PA and the results were compared with the results of ImmunoCAP and skin prick test (SPT) in 532 and 75 patients, respectively. The correlation with the lgE results measured by VIDAS was also analyzed. RESULTS: The agreements of PA with SPT were 87.8% in the Inhalant Panel and 89.3% in the Food Panel and the agreement of ImmunoCAP with SPT was 95.2%. The most common allergens giving positive reactions were Dermatophagoides farinae (46.2%) and Dermatophagoides pteronyssinus (40.0%). SPT taken as a reference, PA compared with ImmunoCAP showed higher agreement (D. farinae, 76.0 vs. 70.7%; D. pteronyssinus, 76.0 vs. 74.4%), sensitivity (D. farinae, 72.7 vs. 68.2%; D. pteronyssinus, 75.0 vs. 71.2%) and specificity (D. farinae, 85.0 vs. 81.3%) except for the specificity for D. pteronyssinus (78.3 vs. 87.5%). The rate of allergen specific IgE positive patients was higher than that of negative patients when total IgE was over 100 kU/L. CONCLUSIONS: Our results showed that the agreement, sensitivity and specificity of PA were similar to or better than those of the previously established test, ImmunoCAP. The allergen specific IgE results of PA were in correlation with total IgE. PA may be used for testing allergen specific IgE to diagnose and treat allergic diseases.

Analysis of Polycheck Allergy Results of the Recent Two Years: Comparison with Skin Prick Test and ImmunoCAP

BACKGROUND: Multiple Antigen Simultaneous Test (MAST)-immunoblot assay is a practical and economical test, which has been recently introduced nationwide. Authors investigated test efficiency of a MAST-immunoblot assay, Polycheck Allergy (PA). METHODS: A total of 3,153 patients were tested by PA and the results were compared with the results of ImmunoCAP and skin prick test (SPT) in 532 and 75 patients, respectively. The correlation with the lgE results measured by VIDAS was also analyzed. RESULTS: The agreements of PA with SPT were 87.8% in the Inhalant Panel and 89.3% in the Food Panel and the agreement of ImmunoCAP with SPT was 95.2%. The most common allergens giving positive reactions were Dermatophagoides farinae (46.2%) and Dermatophagoides pteronyssinus (40.0%). SPT taken as a reference, PA compared with ImmunoCAP showed higher agreement (D. farinae, 76.0 vs. 70.7%; D. pteronyssinus, 76.0 vs. 74.4%), sensitivity (D. farinae, 72.7 vs. 68.2%; D. pteronyssinus, 75.0 vs. 71.2%) and specificity (D. farinae, 85.0 vs. 81.3%) except for the specificity for D. pteronyssinus (78.3 vs. 87.5%). The rate of allergen specific IgE positive patients was higher than that of negative patients when total IgE was over 100 kU/L. CONCLUSIONS: Our results showed that the agreement, sensitivity and specificity of PA were similar to or better than those of the previously established test, ImmunoCAP. The allergen specific IgE results of PA were in correlation with total IgE. PA may be used for testing allergen specific IgE to diagnose and treat allergic diseases.

Measurement of Hymenoptera venom specific IgE by the IMMULITE 3gAllergy in subjects with negative or positive results by ImmunoCAP

BACKGROUND: Patients may receive negative results from a specific IgE (sIgE) test such as the ImmunoCAP (CAP) despite a documented history of systemic reaction to a Hymenoptera sting. Thus, further testing may be required using another serological method or venom skin prick tests to confirm allergy diagnosis and correct species. OBJECTIVE: To evaluate the sensitivity and the specificity of CAP and IMMULITE 3gAllergy (IMMULITE) for detecting sIgE to Paper wasp (WA) and Yellow Jacket (YJ) venoms using patient clinical history as the comparator. METHODS: Sera from 70 participants with a history of systemic reactions (SR) to WA and/or YJ stings were tested using CAP and IMMULITE. Fifty participants from this group had negative results on CAP. To assess specificity, sera from 71 participants who had never experienced either a WA or YJ sting were tested using CAP and IMMULITE. Fifty participants from this group tested positive using CAP. RESULTS: In participants with a history of systemic reaction to a Hymenoptera sting, yet who tested negative for WA and/or YJ sIgE according to CAP, the positivity rate according to IMMULITE was 20-42% using 0.10 IUA/mL as the limit of detection (LoD), per the manufacturer's specification. When the LoD for CAP (0.35 IUA/mL) was applied to the IMMULITE results, positivity according to IMMULITE was 14-26%. Overall, sensitivity, specificity, and agreement with SR were greater for IMMULITE than for CAP. For YJ: sensitivity (IMMULITE:CAP), 42.8%:28.5%; specificity, 53.5%:39.4%; agreement, 48.2%:34%. For WA, sensitivity (IMMULITE:CAP), 58.6%:28.5%; specificity, 49.3%:47.8%; agreement, 43.9%:38.3%. CONCLUSION: The IMMULITE performed well for detecting sIgE to Hymenoptera venom

Detection of Allergen Specific IgE by AdvanSure Allergy Screen Test / 대한진단검사의학회지

BACKGROUND: In vitro serum allergen-specific IgE tests have been routinely used in the clinical diagnosis of allergic diseases. We evaluated the clinical usefulness of a newly introduced multiple antigen screen test, Advansure Allergy Screen (LG Life Science, Korea) (LG-Screen) for the detection of allergen specific IgE. METHODS: A total of 180 sera (80 for inhalant and 100 for food panels) were tested by LG-Screen and RIDA Allergy Screen (R-biopharm, Germany) (RIDA-Screen) assays. According to the 58-60 specific allergens or allergen groups, the positive rates and agreement rates were analyzed using the cut off levels of class 2. For the quantitation of total IgE and specific IgE, nephelometry and ImmunoCAP test were performed in the sera showing discrepant results between the two allergy screen assays. RESULTS: The agreement rate and kappa value (k) of total IgE between the two allergy screen assays was 73.9% and 0.333. LG-Screen showed higher agreement rate with nephelometry than RIDA-Screen. The positive rates to common outdoor inhalant and food allergens were significantly higher in RIDA-Screen. Overall agreement rate of specific IgE between the two allergy screen assays for 58 allergens was 86.7% (6,086/7,020) (k, 0.293). In samples showing discrepant results between the two allergy screen assays, concordance rate of allergy screen assay with ImmunoCAP assay was 70.9% (449/633) for LG-Screen (k, 0.585) and 29.1% (184/633) for RIDA-Screen (k, -0.303). CONCLUSIONS: LG-Screen showed a favorable agreement with RIDA-Screen and ImmunoCAP assays, and it could be used for the detection of allergen specific IgE in the clinical laboratory.