A comparison of specific IgE and skin prick test results to common environmental allergens using the HYTEC™ 288.

Although skin-prick testing (SPT) is commonly used by allergists in the evaluation of allergy, in-vitro testing for specific IgE (sIgE) is an attractive alternate because it can be performed remotely and is of utility when SPT is contraindicated, as in patients on anti-histamines, or with dermatitis or severe eczema. It is, however, necessary to determine the extent of correlation between the in-vitro and in-vivo methods. In this study, we examined the qualitative concordance between SPT and sIgE as measured on the HYTEC™288 platform for 10 commonly encountered inhalant allergens in 232 subjects, and analysed the performance characteristics for the HYTEC™288. Overall concordance between SPT and sIgE was >70% for all allergens tested. Sensitivity ranged from 25% to 95%, depending on the allergen, while specificity was significantly higher for all allergens (78-97%). NPV was >85% for all allergens tested, while PPV was more variable, ranging from 22% to 88%. These results are similar to findings in other studies comparing SPT with sIgE. Lack of concordance in a percentage of samples might be partly attributed to differences in allergen preparations for SPT and HYTEC™ 288. Follow-up studies utilizing identical allergen preparations for both in-vivo and in-vitro testing may address these discrepancies.

Serodiagnosis of Mycobacterium avium complex pulmonary disease in the USA.

Diagnosis of Mycobacterium avium complex pulmonary disease (MAC-PD) can be difficult. A previous study from Japan reported the usefulness of a serodiagnostic test for MAC-PD. The objective of this study was to evaluate the usefulness of the test in similar patients in the USA. 100 patients with known or suspected MAC-PD and 52 healthy volunteers were enrolled into the study at National Jewish Health, Denver, CO, USA. Serum glycopeptidolipid core immunoglobulin A antibody levels were measured with an enzyme immunoassay (EIA) kit and routine clinical evaluations were performed. The patients were divided into two groups based on clinical evaluation: 87 patients with MAC-PD that met American Thoracic Society criteria, and 13 who did not meet the criteria. The sensitivity and specificity (cut-off point 0.3 U·mL(-1)) of the serodiagnostic test for diagnosing MAC-PD were 70.1% and 93.9%, respectively. Among the 44 patients in the MAC-PD group with two or more positive sputum cultures within the previous 6 months, sensitivity was 81.8%. The EIA kit demonstrated good sensitivity and specificity for the identification of MAC-PD, particularly in patients with two or more positive cultures, and may be useful for rapid MAC-PD diagnosis.

A pilot study to assess inflammatory biomarker changes when raltegravir is added to a virologically suppressive HAART regimen in HIV-1-infected patients with limited immunological responses.

BACKGROUND: Despite successful suppression of HIV-1 with HAART, some patients do not have robust immunological recovery. Chronic inflammation from persistent immune activation could contribute to this poor response, resulting in HIV-1 disease progression and the development of some non-HIV-1 comorbidities. METHODS: We conducted a pilot study of 30 HIV-1-infected patients with undetectable viral loads and poor CD4(+) T-cell responses on long-term stable HAART to assess whether the addition of raltegravir would have an effect on biomarkers of chronic inflammation. A total of 26 patients were followed for 1 year on the intensified regimen. In addition to T-cell responses, we evaluated changes in activated CD4(+) and CD8(+) T-cells, several pro-inflammatory cytokines and chemokines and memory cell responses to HIV-1-associated peptides. RESULTS: Although there was no improvement in CD4(+) T-cell counts, the percentage change in CD4(+)%, CD4(+)/CD8(+) ratios and RANTES (regulated on activation normal T-cells expressed and secreted) increased significantly while the percentage change in CD8(+) T-cell counts and CD8(+)%, activated CD4(+) T-cells and several pro-inflammatory chemokines and cytokines decreased significantly. The percentage change in HIV-1-specific nef, pol set 1, gag and env memory T-cells also declined. CONCLUSIONS: The addition of raltegravir to a virologically suppressive HAART regimen in patients with poor immunological responses resulted in the reduction of several pro-inflammatory biomarkers; increases were seen in RANTES levels and CD4(+)/CD8(+) T-cell ratios. The clinical relevance of these observations is beyond the scope of this study.