Sensitivity and specificity of MAST chemiluminescence assay of allergen-specific immunoglobulin in allergic Thai children: comparison to the skin prick test

Background and objective: The prevalence of allergic diseases is increasing in Thailand. For the diagnosis of allergic disease, in-vivo and in-vitro clinical tests are required. This paper examined the effectiveness of multiple allergosorbent test (MAST) chemiluminescence assay (CLA) technique of serum allergen-specific immunoglobulin (IgE) in allergic Thai children by comparing the sensitivity and specificity to the skin prick test. Methods: One-hundred children with allergic diseases (age: 3-18 years old; 62 male and 38 female) were included. The diagnosis of allergy was based on patient history, physical finding, and skin prick test. Fourteen allergens (6 aeroallergens and 8 food allergens) were tested for this study. Allergen-specific IgE test was performed in patient serum using the MAST CLA technique Optigen Universal Panel 20. The food allergens were mixed-shellfish, shrimp, mixed-fish, cow milk, peanut, egg white, wheat, and soybean. The results by the skin prick test and the MAST CLA were graded into five levels (0-4), where level 3 and 4 were defined positive and levels 0-2 negative. Results: In the skin prick test, the following aeroallergens were positive: Dermatophagoides pteronyssinus, Dermatophagoides farinae, cockroach (German, American or mixed) and cat, as well as some for food allergens such as mixed-shellfish, shrimp, cow milk, and mixed-fish. In the allergen-specific IgE by MAST CLA, the following aeroallergens were positive: Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat, cockroach-mix and dog. Food allergens were positive for cow milk, wheat, egg white, peanut and soybean. The sensitivity and specificity of the MAST CLA against the skin prick test was more than 50%, while the specificity was more than 88%. The result with the 14 allergen commercial panel combination showed that the sensitivity and specificity was highest. Conclusions: The MAST CLA for the in-vitro determination of allergen-specific IgE in patient serum can be used for screening and diagnosis of allergic Thai children.