Allergology Department, Clínica Universidad de Navarra, Pamplona, Spain.
Member of the Spanish Research Network on Allergies (ARADyAL) RD 1600060031 of the ISCIII, Madrid, Spain.
J Investig Allergol Clin Immunol. 2022 Jun 20;32(3):206-212. doi: 10.18176/jiaci.0691. Epub 2021 Apr 8.
To determine the usefulness of the in vitro and in vivo methods used in the diagnosis of kiwifruit allergy and to specifically assess the impact of seed proteins on sensitivity.
We performed skin prick tests (SPTs) using various commercial extracts, homemade pulp, and seed extracts and prick-prick tests with kiwifruit on 36 allergic patients. The presence of specific IgE (sIgE) was assessed using the ImmunoCAP (kiwifruit extract), ELISA (Act d 1, Act d 2), ISAC, and FABER assays. Immunoblotting of seed extract was carried out, and a single-blind oral food challenge was performed with whole seeds in seed-sensitized individuals.
The prick prick test with kiwifruit demonstrated the highest diagnostic capacity (81.8% sensitivity and 94.1% specificity) among the in vivo tests. The sIgE levels measured using ImmunoCAP (kiwifruit extract) showed a similar sensitivity to that of global ISAC and FABER (63.9%, 59.5%, and 58.3%, respectively). Act d 1 was the major allergen. Sensitization to Act d 1 was associated with positive sIgE results to whole kiwifruit extract detected by ImmunoCAP (P<.000). A positive SPT result to kiwifruit seeds was associated with severe symptoms induced by kiwifruit (P=.019) as a marker of advanced disease, but not with clinically relevant sensitization. Challenge testing with kiwifruit seeds performed on 8 seed-sensitized patients yielded negative results.
Sensitization to Act d 1 is associated with a positive result in conventional diagnostic techniques, whereas kiwifruit seed sensitization does not increase the sensitivity of the diagnostic techniques evaluated.
确定用于诊断奇异果过敏的体外和体内方法的有用性，并特别评估种子蛋白对敏感性的影响。
我们对 36 名过敏患者进行了各种商业提取物、自制果肉和种子提取物的皮肤点刺试验 (SPT) 和奇异果点刺-点刺试验。使用 ImmunoCAP（奇异果提取物）、ELISA（Act d 1、Act d 2）、ISAC 和 FABER 测定法评估特异性 IgE (sIgE) 的存在。进行了种子提取物的免疫印迹，并且在种子致敏个体中进行了整个种子的单盲口服食物挑战。
在体内试验中，奇异果点刺-点刺试验显示出最高的诊断能力（81.8%的敏感性和 94.1%的特异性）。使用 ImmunoCAP（奇异果提取物）测量的 sIgE 水平与全球 ISAC 和 FABER 具有相似的敏感性（分别为 63.9%、59.5%和 58.3%）。Act d 1 是主要过敏原。对 Act d 1 的致敏与 ImmunoCAP 检测到的整个奇异果提取物的阳性 sIgE 结果相关（P<.000）。对奇异果种子的 SPT 阳性结果与奇异果引起的严重症状相关（P=.019），这是疾病进展的标志物，但与临床相关的致敏无关。对 8 名种子致敏患者进行的奇异果种子口服挑战试验结果为阴性。
对 Act d 1 的致敏与常规诊断技术的阳性结果相关，而奇异果种子致敏不会增加评估的诊断技术的敏感性。
