Al Hawi Yasmeen, Nagao Mizuho, Furuya Kanae, Sato Yasunori, Ito Setsuko, Hori Hiroki, Hirayama Masahiro, Fujisawa Takao
Allergy Center and Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan.
Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan.
Allergy Asthma Immunol Res. 2021 Jan;13(1):141-153. doi: 10.4168/aair.2021.13.1.141.
ImmunoCAP® (ImmunoCAP) and IMMULITE® 2000 3gAllergy™ (3gAllergy) systems are major quantitative allergen-specific immunoglobulin E (sIgE) assay methods. Due to the heterogeneous nature of allergenic extracts and differences in the assay format, quantitation of allergen-sIgEs is not expected to correlate well between different methods. However, we have recently reported good agreement between the methods in the diagnosis of egg allergy. This study aimed to determine and correlate the predictive values of sIgE by the two systems in the diagnosis of milk and wheat allergies.
Children who had undergone oral food challenge (OFC) for the diagnosis of milk and wheat allergies were enrolled. The OFCs were performed to diagnose either true allergy in the 1-year-old group (A) or tolerance in the 2- to 6-year-old group (B). Milk, casein and β-lactoglobulin, and wheat and ω-5 gliadin sIgE values were measured using the 2 systems. The predictive accuracy of each sIgE for the OFC outcome was assessed using receiver operating characteristic (ROC) curves. The probability of a positive OFC outcome was estimated by logistic regression analysis.
A total of 395 patients were recruited from 7 primary care clinics and 19 hospitals in Japan. Milk and wheat OFCs were performed for 87 and 102 group A patients, and 124 and 82 group B patients, respectively. ROC analysis yielded similar areas under the curve for the 2 assays (0.7-0.9). The log-transformed sIgE data showed a strong linear correlation with the estimated probabilities (R > 0.9).
The 2 systems may be interchangeable for diagnosis of milk and wheat allergies in young children.
免疫捕获法（ImmunoCAP）和免疫发光法2000 3g过敏检测系统（3gAllergy）是主要的定量过敏原特异性免疫球蛋白E（sIgE）检测方法。由于过敏原提取物的异质性以及检测形式的差异，不同方法之间过敏原 - sIgE的定量结果预计不会有很好的相关性。然而，我们最近报告了这两种方法在鸡蛋过敏诊断中具有良好的一致性。本研究旨在确定这两种系统检测的sIgE在牛奶和小麦过敏诊断中的预测价值并进行相关性分析。
纳入因诊断牛奶和小麦过敏而接受口服食物激发试验（OFC）的儿童。OFC用于诊断1岁组（A组）的真正过敏或2至6岁组（B组）的耐受性。使用这两种系统测量牛奶、酪蛋白和β-乳球蛋白以及小麦和ω-5麦醇溶蛋白的sIgE值。使用受试者操作特征（ROC）曲线评估每种sIgE对OFC结果的预测准确性。通过逻辑回归分析估计OFC结果为阳性的概率。
从日本的7家初级保健诊所和19家医院共招募了395名患者。分别对87名A组患者和124名B组患者进行了牛奶OFC，对102名A组患者和82名B组患者进行了小麦OFC。ROC分析得出两种检测方法的曲线下面积相似（0.7 - 0.9）。对数转换后的sIgE数据与估计概率显示出很强的线性相关性（R > 0.9）。
这两种系统在幼儿牛奶和小麦过敏的诊断中可能具有互换性。
