Department of Allergology and Clinical Immunology, University Clinic of Navarra, School of Medicine, Pamplona, Spain.
Clin Exp Allergy. 2011 Oct;41(10):1440-6. doi: 10.1111/j.1365-2222.2011.03818.x. Epub 2011 Jul 13.
Few data on the diagnostic accuracy in pollinosis of the microarray ISAC of allergens are available.
We aim to comparatively analyse ISAC CRD103 with the whole-extract ImmunoCAP in grass and cypress pollen allergy, evaluating the suitability of the manufacturer's recommended cut-off points for both techniques.
We studied 120 atopic patients grouped into grass and cypress pollen-allergic patients and controls based on clinical history and skin prick tests. Specific IgE against Phleum pratense and Cupressus arizonica by ImmunoCAP and ISAC CRD103 were performed on all subjects.
In the grass pollen group (43 allergic/26 controls), both microarray and CAP showed high sensitivity (Se) and specificity (Sp) values (ISAC: Se 97.7, Sp 92.3; CAP: Se 95.3, Sp 96.1) for recommended cut-off points. Comparing the optimal (ISAC: 0.4 ISU; CAP: 0.33 kU/L) with the recommended cut-off points within the same technique, diagnostic agreement was observed in both techniques. Thus, CAP and ISAC showed similar diagnostic performance in grass pollen allergy when using recommended cut-off points. In cypress pollen group (12 allergic/92 controls), the microarray (Se: 91.7, Sp 91.3) showed similar Se but significantly higher Sp (P=0.034) than CAP (Se: 91.7, Sp: 80.4) using recommended cut-off points. However, although diagnostic performance of the microarray did not change when comparing the optimal (0.82 ISU) with the recommended cut-off point, CAP improved diagnosis of cypress pollen allergy, when applying the optimal (0.66 kU/L)(CAP Se: 91.7, Sp: 89.1) instead of the manufacturer's recommended cut-off point. Thus, when the most suitable cut-off point for both techniques (ISAC: 0.3 ISU; CAP: 0.66 kU/L) is selected, microarray and CAP provide equivalent diagnoses.
Component-based microarray ISAC CRD103 and whole-allergen CAP showed high Se and Sp diagnosing equally grass and cypress pollen allergy. The cut-off point for each allergen should be properly applied for both techniques.
关于过敏原微阵列 ISAC 在花粉症中的诊断准确性的数据很少。
我们旨在比较分析 ISAC CRD103 与全提取免疫 CAP 在草花粉和柏树花粉过敏中的应用，评估两种技术制造商推荐的截断值的适用性。
我们根据临床病史和皮肤点刺试验将 120 名特应性患者分为草花粉和柏树花粉过敏患者和对照组。所有患者均进行 Phleum pratense 和 Cupressus arizonica 的特异性 IgE 检测，采用 ImmunoCAP 和 ISAC CRD103 进行检测。
在草花粉组（43 例过敏/26 例对照）中，微阵列和 CAP 均显示出高灵敏度（Se）和特异性（Sp）值（ISAC：Se 97.7，Sp 92.3；CAP：Se 95.3，Sp 96.1），适用于推荐的截断值。在同一技术中比较最佳（ISAC：0.4 ISU；CAP：0.33 kU/L）和推荐的截断值，两种技术的诊断一致性均得到观察。因此，在使用推荐的截断值时，CAP 和 ISAC 在草花粉过敏中表现出相似的诊断性能。在柏树花粉组（12 例过敏/92 例对照）中，微阵列（Se：91.7，Sp：91.3）显示出相似的 Se，但显著高于 CAP（Se：91.7，Sp：80.4），使用推荐的截断值。然而，尽管在比较最佳（0.82 ISU）和推荐的截断值时微阵列的诊断性能没有改变，但 CAP 提高了柏树花粉过敏的诊断，当应用最佳（0.66 kU/L）（CAP Se：91.7，Sp：89.1）而不是制造商推荐的截断值时。因此，当选择两种技术（ISAC：0.3 ISU；CAP：0.66 kU/L）的最佳截断值时，微阵列和 CAP 提供等效的诊断。
基于成分的微阵列 ISAC CRD103 和全过敏原 CAP 均能高度准确地诊断草花粉和柏树花粉过敏。两种技术都应适当应用每种过敏原的截断值。
