State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Sci Prog. 2021 Jan-Mar;104(1):36850421997277. doi: 10.1177/0036850421997277.
Different methods have different diagnostic value under diverse clinical conditions. This study was conducted to analyze the clinical practical value of different assays in different situations and to establish the concept of an allergen diagnosis strategy.This study used Phadia CAP, Advan Sure (AdvS), Euroline Camera (ELC), and Allergy Lateral Flow Assay (ALFA) kits to detect allergen specific immunoglobulin E (sIgE) in the sera from 30 allergic asthma patients, with Phadia CAP as the gold standard.This study found high sensitivity for in AdvS (92.6%), ELC (88.9%), and ALFA (85.2%), but poor sensitivity for in all three assays. Furthermore, the AdvS, ELC, and ALFA assays could detect 20, 21, and 8 allergens in one panel, respectively. The combination of the results showed that 93.3% and 46.7% of patients tested positive for ≥5 and ≥10 types of allergens, respectively. All patients who were tested positive for the Marine fish mixture were positive for both Shrimp and Crab. Similarly, patients who were tested positive for Chicken also tested positive for Pork. Optimal scale analysis showed a strong connection between Peanut, Soybean, Wheat, Japanese Hop, Western ragweed, and Oak allergens (Cronbach's α = 91.1%).The ELC assay was more suitable for use in pollen-rich areas, whereas the ALFA assay was easy to establish in areas with poor medical conditions. An allergen diagnosis strategy needs to be considered for use in clinical practice.
不同的方法在不同的临床情况下具有不同的诊断价值。本研究旨在分析不同检测方法在不同情况下的临床实用价值,并建立过敏原诊断策略的概念。
本研究采用 Phadia CAP、AdvanSure(AdvS)、Euroline Camera(ELC)和 Allergy Lateral Flow Assay(ALFA)试剂盒检测 30 例过敏性哮喘患者血清中的过敏原特异性免疫球蛋白 E(sIgE),以 Phadia CAP 为金标准。
本研究发现 AdvS(92.6%)、ELC(88.9%)和 ALFA(85.2%)对具有较高的灵敏度,但三种检测方法对的灵敏度均较差。此外,AdvS、ELC 和 ALFA 检测试剂盒在一个检测面板中可分别检测到 20、21 和 8 种过敏原。组合结果显示,93.3%和 46.7%的患者分别检测到≥5 和≥10 种过敏原阳性。所有对 Marine fish mixture 检测呈阳性的患者对 Shrimp 和 Crab 均呈阳性。同样,对 Chicken 检测呈阳性的患者对 Pork 也呈阳性。最佳标度分析显示花生、大豆、小麦、日本豚草、豚草和栎树过敏原之间存在很强的关联(Cronbach's α=91.1%)。
ELC 检测法更适用于花粉丰富的地区,而 ALFA 检测法易于在医疗条件较差的地区建立。在临床实践中需要考虑采用过敏原诊断策略。