Department of Dermatology and Allergy, Charité Universitätsmedizin-Berlin, Berlin, Germany.
Department of Otorhinolaryngology, University Hospital, Ghent, Belgium.
Allergy. 2009 Oct;64(10):1507-1515. doi: 10.1111/j.1398-9995.2009.02089.x.
Skin prick testing is the standard for diagnosing IgE-mediated allergies. A positive skin prick reaction, however, does not always correlate with clinical symptoms. A large database from a Global Asthma and Allergy European Network (GA(2)LEN) study with data on clinical relevance was used to determine the clinical relevance of sensitizations against the 18 most frequent inhalant allergens in Europe. The study population consisted of patients referred to one of the 17 allergy centres in 14 European countries (n = 3034, median age = 33 years). The aim of the study was to assess the clinical relevance of positive skin prick test reactions against inhalant allergens considering the predominating type of symptoms in a pan-European population of patients presenting with suspected allergic disease.
Clinical relevance of skin prick tests was recorded with regard to patient history and optional additional tests. A putative correlation between sensitization and allergic disease was assessed using logistic regression analysis.
While an overall rate of >or=60% clinically relevant sensitizations was observed in all countries, a differential distribution of clinically relevant sensitizations was demonstrated depending on type of allergen and country where the prick test was performed. Furthermore, a significant correlation between the presence of allergic disease and the number of sensitizations was demonstrated.
This study strongly emphasizes the importance of evaluating the clinical relevance of positive skin prick tests and calls for further studies, which may, ultimately, help increase the positive predictive value of allergy testing.
皮肤点刺测试是诊断 IgE 介导过敏的标准。然而,阳性皮肤点刺反应并不总是与临床症状相关。利用来自全球哮喘和过敏欧洲网络(GA[2]LEN)研究的大型数据库,该研究具有有关临床相关性的数据,用于确定欧洲 18 种最常见吸入性过敏原致敏的临床相关性。研究人群由来自欧洲 14 个国家的 17 个过敏中心的患者组成(n=3034,中位数年龄=33 岁)。该研究的目的是评估在疑似过敏性疾病患者的泛欧人群中,考虑到主要症状类型,对吸入性过敏原的阳性皮肤点刺试验反应的临床相关性。
根据患者病史和可选的附加测试记录皮肤点刺试验的临床相关性。使用逻辑回归分析评估致敏与过敏性疾病之间的潜在相关性。
尽管所有国家的总临床相关致敏率>或=60%,但根据进行点刺试验的过敏原和国家的类型,显示出不同的临床相关致敏分布。此外,还证明了过敏疾病的存在与致敏数量之间存在显著相关性。
这项研究强烈强调了评估阳性皮肤点刺试验临床相关性的重要性,并呼吁进行进一步的研究,这最终可能有助于提高过敏测试的阳性预测值。