Yang Jinyoung, Lee Hyeyoung, Choi Ae Ran, Park Ki Hyun, Ryu Ji Hyeong, Oh Eun-Jee
a Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine , The Catholic University of Korea , Seoul , Korea.
b Department of Laboratory Medicine, International St. Mary's Hospital, College of Medicine , Catholic Kwandong University , Incheon , Korea.
Scand J Clin Lab Invest. 2018 Nov-Dec;78(7-8):606-612. doi: 10.1080/00365513.2018.1528506. Epub 2018 Oct 30.
In vitro allergen-specific immunoglobulin E (sIgE) measurement has been used as an important diagnostic tool for allergic diseases. Currently, quantitative sIgE levels are detected mainly by using ImmunoCAP and Immulite 2000 assay system. These two systems have the same calibration scale at 0-100 kUA/L, but they differ in used allergens, detection methods and automation systems. We compared 1600 paired sIgE results for 204 allergic patients, including 100 paired sIgE assay results for each of 16 allergens (Alternaria alternata, birch-alder mix, cat dander, D. farinae, D. pteronyssinus, dog dander, buckwheat, crab, egg white, mackerel, milk, peach, peanut, shrimp, soybean and wheat flour). Inter-method comparison was performed for qualitative data with a cutoff of 0.35 kUA/L and a detection limit of 0.1 kUA/L, semi-quantitative class results and quantitative data. In qualitative comparisons, the overall concordance rate ranged from 81.0% to 99.0% (k: 0.599-0.949) with the cutoff value of 0.35 kUA/L. It also ranged from 80.0% to 99.0% (k: 0.521-0.951) with the detection limit of 0.1 kUA/L. The class results from these two assays showed good agreements for all allergens. For quantitative sIgE results, these two assays showed moderate positive correlations for Dog dander (r = 0.683) and Mackerel (r = 0.573) but high to very high correlations for the other 14 allergens (r = 0.734-0.972). Immulite 2000 and ImmunoCAP assays demonstrated good concordance and correlation for 16 common allergens, but international standards against each specific allergen for calibration and harmonization of sIgE tests are still needed.
体外变应原特异性免疫球蛋白E(sIgE)检测已用作过敏性疾病的一项重要诊断工具。目前,主要通过使用免疫捕获法(ImmunoCAP)和免疫发光2000分析系统来检测定量sIgE水平。这两种系统在0至100 kUA/L具有相同的校准范围,但在所用变应原、检测方法和自动化系统方面存在差异。我们比较了204例过敏患者的1600对sIgE检测结果,包括16种变应原(链格孢、桦木-桤木混合物、猫皮屑、粉尘螨、屋尘螨、狗皮屑、荞麦、蟹、蛋清、鲭鱼、牛奶、桃子、花生、虾、大豆和小麦粉)中每种变应原的100对sIgE检测结果。对定性数据进行方法间比较,其临界值为0.35 kUA/L,检测限为0.1 kUA/L,同时还对半定量分级结果和定量数据进行比较。在定性比较中,临界值为0.35 kUA/L时,总体一致性率为81.0%至99.0%(Kappa值:0.599至0.949)。检测限为0.1 kUA/L时,总体一致性率也为80.0%至99.0%(Kappa值:0.521至0.951)。这两种检测方法的分级结果对所有变应原均显示出良好的一致性。对于定量sIgE结果,这两种检测方法对狗皮屑(r = 0.683)和鲭鱼(r = 0.573)显示出中度正相关,但对其他14种变应原显示出高至非常高的相关性(r = 0.734至0.972)。免疫发光2000和免疫捕获法检测对16种常见变应原显示出良好的一致性和相关性,但仍需要针对每种特定变应原的国际标准来校准和统一sIgE检测。