Institute for Occupational and Social Medicine, University of Göttingen, Waldweg 37, 37037 Göttingen, Germany.
Int Arch Occup Environ Health. 2011 Feb;84(2):203-10. doi: 10.1007/s00420-010-0561-z. Epub 2010 Jul 24.
The diagnosis of cattle-related sensitization is complicated by the variability and complexity of cattle allergen extracts.
To evaluate a modified diagnostic procedure leading to more accurate results especially in the early phase of sensitization.
We tested 27 claw trimmers with and 65 without cattle-related symptoms using two commercially available cattle allergen extracts. We also used a self-prepared cattle allergen mix designed to represent the full spectrum of cattle allergens from a typical agricultural workplace.
More than 50% of symptomatic claw trimmers showed negative test results with commercial extracts and a sensitization cutoff point of 0.35 kU/l. In contrast, with the self-prepared cattle allergen mix, positive results were observed for almost all of them. Evaluating the results of the commercial test kits at different cutoff levels, we found an ideal cutoff point to improve the sensitivity at 0.2 kU/l.
Additional tests with self-made cattle hair extracts can help to bridge the diagnostic gap seen in patients showing cattle-related symptoms, but negative results in commercially available tests. For early-stage sensitization screening, we propose to lower the cutoff level indicating sensitization to 0.2 kU/l.
由于牛过敏原提取物的多样性和复杂性，牛相关致敏的诊断较为复杂。
评估一种改良的诊断程序，以获得更准确的结果，特别是在致敏的早期阶段。
我们使用两种市售的牛过敏原提取物对 27 名有和 65 名无牛相关症状的爪子修剪工进行了测试。我们还使用了一种自制的牛过敏原混合物，旨在代表典型农业工作场所的牛过敏原的全貌。
超过 50%的有症状爪子修剪工对商业提取物的检测结果为阴性，且致敏截断值为 0.35 kU/l。相比之下，使用自制的牛过敏原混合物，几乎所有的结果均为阳性。在不同截断水平评估商业检测试剂盒的结果时，我们发现将截断值提高到 0.2 kU/l 可以提高敏感性。
用自制的牛毛提取物进行额外的测试有助于弥合有牛相关症状的患者与商业检测之间的诊断差距。对于早期致敏筛查，我们建议将致敏截断值降低到 0.2 kU/l。
