Accuracy of immunoblotting assay for detection of specific IgE compared with ImmunoCAP in allergic patients (original) (raw)
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Journal of Clinical Laboratory Analysis, 2016
Background: Our aim was to examine the performance of IMMULITE 2000 assay for specific IgE (sIgE) by comparing it with ImmunoCAP technology in light of a clinical background. Methods: Measurements of sIgE were done in a selected patient group (N = 569; varied sample size for each allergen) and in a random sample group (N = 100; 8 allergens). sIgE results were correlated with skin-prick test results (selected patients) and medical history (nonselected patients). Results: We have detected fair to excellent correlation and agreement between the results of both assays, despite their methodological differences, both in selected and nonselected patient group (qc = 0.431-0.976; qc = 0.390-0.972, respectively). Associations of sIgE levels with skin-prick test (SPT) levels and medical history have shown significant correlation for both assays for majority of tested allergens, where applicable (D. pteronyssinus, cat dander, egg white, milk, peanut, orchard grass, Alternaria tenuis, and common ragweed in selected patients; birch, cat dander, common ragweed, D. pteronyssinus, and orchard grass in nonselected; P < 0.05 for all). Conclusions: Laboratory testing for sIgE can be successfully accomplished by IMMULITE 2000 immunoanalyzer at a diagnostic accuracy relative to SPT, comparable to the results acquired by CAP technology but not fully comparable on the level of an individual patient. J.
World Allergy Organization Journal
Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.
Journal of Clinical Laboratory Analysis, 1997
A simple technique, checkerboard immunoblotting (CBIB), is described for simultaneous quantitation of specific IgE antibodies against several allergens in human sera. Using as little as 50 µl of each of the 20 sera examined against 20 different allergens, it was possible in a single run to achieve 400 tests. To guarantee high specificity and sensitivity of the assay, this new application of CBIB employs purified allergens, cyanogen bromide-activated nitrocellulose membrane, and Phosphorimager technology. Results are expressed both qualitatively (five classes) and quantitatively in kilo units per liter equilibrated against the World Health Organization (WHO) standard for IgE. There was excellent agreement between the results of CBIB and the results of Pharmacia Cap System, an alternative method widely used for measuring serum-specific IgE. The CBIB method certainly could be useful in any laboratory interested in allergy clinical research for easy screening and relative quantitation of allergen-specific human IgE.
Allergology International, 1999
A new method is described for the quantitative detection of IgE antibodies, based on IgE capture with a specific antibody, reaction with liquid-biotinylated allergens and biotinylated anti-IgE and immunoenzymatic development of the reaction (reverse enzyme allergosorbent test). Using a reference system based on the World Health Organization IgE International standard, this method determines total IgE in the range 2-100kU/L and specific IgE in the range 0.2-100 kU/L, from which the specific/total ratio, called 'specific IgE density', can be calculated. This procedure has been applied to the study of specific IgE in 23 sera from patients polysensitized to pollen and mite allergens: 11 with asthma and 12 with rhinitis. The sensitivity and reproducibility of the method were evaluted. Sera from asthmatic patients showed higher cumulative levels of specific IgE (mean density 57.7%) than sera from rhinitic patients (mean density 32.6%). The clinical significance of specific IgE density in patients with multiple sensitizations is discussed.
In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice
Primary care respiratory journal : journal of the General Practice Airways Group, 2006
The basis of any diagnosis of allergy requires a good history and examination, which should then provide a certain degree of confidence as to whether or not allergy is present. However, the diagnosis cannot be confirmed on the basis of symptoms alone, because both allergic and non-allergic conditions can present with similar symptoms. Based on prevalence figures, about half of the patients presenting with allergic symptoms in primary care may be non-allergic. Therefore, allergy testing in the form of specific IgE (sIgE) measurement and/or skin prick testing is an invaluable aid in demonstrating both the presence and severity of such an allergy. The usefulness of such tests extends beyond just the positive or negative result. Often, more information can be gleaned by using the test results in a form of a continuous variable in order to determine the likelihood that allergy can be attributed as an explanation for patients' symptoms and disease. In this review, we describe the rati...
Allergen-specific IgE: comparison between skin prick test and serum assay in real life
Allergologie select, 2019
Background: The most common sensitizing allergens in in the area of Liguria region (Northwestern Italy) are pollens, mainly Parietaria and cypress, house dust mites, i.e. Dermatophagoides, and pets. IgE assessment is a crucial step in allergy diagnosis. It may be performed by skin prick test (SPT) or serum IgE (sIgE) assay. Therefore, this study compared these two methods in a real-life setting. Methods: This retrospective study included 793 subjects, who were referred to the Allergy Department for respiratory allergy during 2014. Inclusion criteria were i) documented diagnosis of allergic rhinitis (AR), and/or allergic asthma, and/or allergic conjunctivitis. SPT and sIgE assay were performed for 5 allergens, such as Dermatophagoides pteronyssinus (D1), cat (E1), Parietaria officinalis (W19), cypress (T23), and dog (E5), as they are the most common in our geographic area. Results: Using a positive SPT result as the target condition, remarkably high and statistically significant values of AUC, ranging from 0.84 to 0.94, were found. On the basis of the Youden index the following optimal classification threshold values were also computed: D1 = 0.22, E1 = 0.26, W19 = 0.61, T23 = 0.25, E5 = 0.34. These values allowed to define a set of sensitivity/specifity estimates ranging from 0.75 to 0.93 and from 0.83 to 0.93, respectively. Conclusions: The present study shows that SPT and sIgE are two tests that are rather concordant, but with different sensitivity and specificity distinct for each allergen. In clinical practice, both tests should be used depending on clinical history features and obtained findings.
A further evaluation of the clinical use of specific IgE antibody testing in allergic diseases
Allergy, 2003
A further evaluation of the clinical use of specific IgE antibody testing in allergic diseases Testing for the presence of immunoglobulin E (IgE) antibodies has been used for years as a tool in the diagnosis of allergy diseases and identification of the relevant allergen (1-4). Patients with IgE mediated allergy are in most cases sensitized to several allergens. This may cause difficulties for the clinician in identifying the most relevant allergen(s) that is essential to avoid optimal treatment of the patient. The present communication test the hypothesis whether or not quantification of the specific IgE antibody levels to inhalant allergens may give an added value to the diagnosis of allergic diseases.
Quantitative IgE antibody assays in allergic diseases
Journal of Allergy and Clinical Immunology, 2000
During the past several years, immunoassays for specific IgE antibodies have been refined to permit reporting results in mass units. Thus quantitative immunoassays for IgE antibodies may be an adjunct to skin tests. In cases of food allergy among children with atopic dermatitis, cutoff values for IgE antibody concentrations to egg, milk, peanut, and fish have been derived to provide 95% positive and 90% negative predictive values. Food-specific IgE antibody determinations can also be used to predict which food allergies are resolving spontaneously. Elevated egg-specific IgE antibody levels in infancy are associated with significantly increased risk for development of inhalant allergies later in childhood. In cases of inhalant allergy, specific IgE antibody levels correlate closely with results of inhalation challenge studies in cat-sensitive persons. Also, mite-specific IgE antibody levels correlate significantly with the mite allergen contents of reservoir dust in the homes of mite-sensitive persons. Immunoassays for quantitation of specific IgE antibodies may be used to document aller-gen sensitization over time and to evaluate the risk of reaction on allergen exposure. However, immunoassays and skin tests are not entirely interchangeable, and neither will replace the other in appropriate circumstances. (J Allergy Clin Immunol 2000;105:1077-84.)
The use of IgE immunoblotting as a diagnostic tool in allergy
Journal of Allergy and Clinical Immunology, 1997
Background: The fish parasite Anisakis simplex is the etiologic agent of anisakiasis and induces IgE-mediated reactions. Skin prick tests (SPTs) and the measurement of specific IgE to A. simplex were, in our experience, not valid tools with which to discriminate between allergic and nonallergic patients because many control subjects also had positive results. Objective: The study was carried out to assess the usefulness of IgE immunoblotting in the diagnosis of allergy to A. simplex.