Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano (MI), Italy.
Allergy. 2022 Oct;77(10):3028-3040. doi: 10.1111/all.15329. Epub 2022 May 9.
Diagnosis of food allergies is challenging, as combining information from specific IgE (sIgE)-sensitization pattern and skin prick tests (SPTs) with clinical history is necessary for a personalized management of allergic patients. The aim of this study was to compare two molecular tests, the ImmunoCAP ISAC (ISAC) and the Allergy Explorer, version 2 (ALEX ) in the context of pollen food syndrome (PFS) diagnosis in a real-life scenario, to assess the benefit of multiplex testing in PFS patients.
Diagnosis of food allergy was performed in 53 patients. Allergen-sIgE concentrations were measured with ISAC and ALEX . Results for sIgE were statistically compared with each other, with SPT results and with clinical presentation of the patients.
Using ISAC as reference test for sIgE measurements, the average sensitivity of ALEX for PR-10 allergens was 83.2% and the average specificity 88.0%. If only low sIgE concentrations were included, the sensitivity was 60.8% and the specificity 91.1%. Apple and hazelnut sensitizations were confirmed in most patients by concordance of sIgE and SPT results. Significant correlations were shown between clinical symptoms and Mal d 1- and Gly m 4-sIgE levels measured by both tests and for Cor a 1-sIgE levels measured by ALEX . In eight patients, profilin related symptoms were supported by Hev b 8-sensitization.
Multiplex testing is beneficial to understand patient-specific individual sensitization profiles and to providing personalized management recommendations. In the future, custom-designed test kits might enable reducing costs of multiplex testing for specific patient groups without compromising the diagnostic value.
食物过敏的诊断具有挑战性，因为结合特异性 IgE（sIgE）致敏模式和皮肤点刺试验（SPTs）与临床病史对于过敏患者的个性化管理是必要的。本研究的目的是在现实情况下比较两种分子检测方法，即 ImmunoCAP ISAC（ISAC）和 Allergy Explorer，版本 2（ALEX），以评估在花粉食物综合征（PFS）患者中进行多重检测的益处。
对 53 名患者进行了食物过敏诊断。使用 ISAC 和 ALEX 测量过敏原 sIgE 浓度。将 sIgE 的结果与彼此、SPT 结果和患者的临床表现进行统计学比较。
使用 ISAC 作为 sIgE 测量的参考测试，ALEX 对 PR-10 过敏原的平均敏感性为 83.2%，平均特异性为 88.0%。如果仅包括低 sIgE 浓度，则敏感性为 60.8%，特异性为 91.1%。苹果和榛子致敏在大多数患者中通过 sIgE 和 SPT 结果的一致性得到确认。通过两种测试测量的 Mal d 1-和 Gly m 4-sIgE 水平以及通过 ALEX 测量的 Cor a 1-sIgE 水平显示出与临床症状之间存在显著相关性。在 8 名患者中，与过敏症状相关的前蛋白被 Hev b 8 致敏所支持。
多重检测有助于了解患者特异性的个体致敏谱，并提供个性化的管理建议。未来，定制设计的检测试剂盒可能能够降低特定患者群体的多重检测成本，而不会影响诊断价值。
