Component-resolved diagnosis of pollen allergy based on skin testing with profilin, polcalcin and lipid transfer protein pan-allergens.

Abstract

BACKGROUND:

Allergy diagnosis needs to be improved in patients suffering from pollen polysensitization due to the existence of possible confounding factors in this type of patients.

OBJECTIVE:

To evaluate new diagnostic strategies by comparing skin responses to pan-allergens and conventional allergenic extracts with specific IgE (sIgE) to purified allergen molecules.

METHODS:

One thousand three hundred and twenty-nine pollen-allergic patients were diagnosed by a combination of an in vitro method with a panel of 13 purified allergens, including major allergens and pan-allergens, using a high-capacity screening technology (ADVIA-Centaur) and skin prick test (SPT) to pan-allergens and conventional extracts.

RESULTS:

There was a high concordance (kappa index) between in vitro (sIgE to major allergens) and in vivo (SPT to conventional extracts) methods in patients who were not sensitized to pan-allergens, but SPT with conventional extracts failed to diagnose patients with sensitization to pan-allergens. In patients who were simultaneously sensitized to polcalcins and profilins, there was a duplication both in the number of sensitizations to major allergens and in the years of disease evolution. There was a statistical association between sensitization to profilins and/or lipid transfer proteins and food allergy (P<0.0001).

CONCLUSION:

The novel diagnostic strategy has proven to be a valuable tool in daily clinical practice. Introduction of routine SPT to pan-allergens is a simple and feasible way of improving diagnostic efficacy. Patients sensitized to pan-allergens should be tested by an adequate panel of allergenic molecules in order to identify the allergens that are responsible for the allergic disease.

• Authors: D Barber, F de la Torre, M Lombardero, I Antépara, C Colas, I Dávila, A I Tabar, C Vidal, M Villalba, G Salcedo, R Rodríguez
• Journal: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology (Clin Exp Allergy) Vol. 39 Issue 11 Pg. 1764-73 (Nov 2009) ISSN: 1365-2222 [Electronic] England
• PMID: 19877313 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens, Plant
• Carrier Proteins
• Plant Proteins
• Profilins
• lipid transfer proteins, plant
• Immunoglobulin E

Topics

• Adolescent
• Adult
• Antigens, Plant (immunology, pharmacology)
• Carrier Proteins
• Child
• Female
• Humans
• Immunoglobulin E (immunology)
• Male
• Plant Proteins
• Profilins (immunology, pharmacology)
• Rhinitis, Allergic, Seasonal (diagnosis, epidemiology, immunology)
• Skin Tests
• Spain (epidemiology)