4 research outputs found
Is the determination of specific IgE against components using ISAC 112 a reproducible technique?
The allergen microarray immunoassay, ISAC 112, is a repeatable and reproducible in vitro diagnostic tool for determination of sIgE beyond the own laborator
Is the determination of specific IgE against components using ISAC 112 a reproducible technique?
The allergen microarray immunoassay, ISAC 112, is a repeatable and reproducible in vitro diagnostic tool for determination of sIgE beyond the own laborator
Clinical management of plant food allergy in patients sensitized to lipid transfer proteins is heterogeneous: identifying the gaps
Background and objective: Patients sensitized to lipid transfer protein (LTP)
present a wide clinical variability. The lack of practical diagnostic and therapeutic
guidelines complicate their management. The aim of the study was to describe
the clinical approach of Spanish allergists to this pathology using a survey
designed by PICO method and subsequent Delphi approach validation.
Methods: Designed survey was answered by 224 allergists (75% women; 57.1%
with >20 years of professional experience). Homogeneity regarding clinical
practice on the main points of LTP allergy diagnosis was observed, except for
patients with suspected NSAID hypersensitivity (44.6% frequently include LTP
skin testing). Oral food challenges were not frequently performed (63.6%
occasionally to never), and they were generally (75.5%) used to confirm
tolerance. It was common to recommend fruit skins avoidance (77.2%) and
maintaining consumption of foods to which patients are sensitised but tolerant
(99.1%).
Results: There was heterogeneity on other dietary indications, modifications due
to co-factors, or traces avoidance. Peach sublingual immunotherapy (SLIT) was
considered very/quite effective by 55.9% of allergists. The majority (79.5%)
consider SLIT indicated in <25% of LTP allergic patients, based on severity
(95.2%), frequency of reactions (99.4%), allergy to multiple food families (97.4%),
and the quality of life/nutrition impairment (91.5%). There was different practice
on SLIT prescription based on co-factor involvement.
Conclusion: These data suggest that there is a need to increase evidence to
reduce the clinical practice heterogeneity in the management of LTP allergy
Is Microarray Analysis Really Useful and Sufficient to Diagnose Nut Allergy in the Mediterranean Area?
Background: Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been
evaluated in nut allergy.
Objective: To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut,
hazelnut, and walnut allergy.
Methods: sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently,
sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to
measure sIgE to Ara h 9, Cor a 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick
test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges.
Results: Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8,
80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic
patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in,
respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative
ISAC results. In the subgroup of peach LTP–sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC
(94.4% vs 72.2%, P<.05). Similar rates of Cor a 8 and Jug r 3 sensitization were detected by both techniques.
Conclusions: The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity
against Ara h 9 in ISAC needs to be improved.IntroducciĂłn: La utilidad clĂnica del diagnĂłstico por componentes no ha sido evaluada en el estudio de la alergia a frutos secos (FS).
Objetivo: Evaluar la capacidad diagnĂłstica de una micromatriz comercial de proteĂnas alergĂ©nicas en la alergia a cacahuete, avellana y nuez.
Métodos: Se determinó la sIgE en pacientes alérgicos a FS mediante la micromatriz ISAC 112, e ImmunoCAP en los pacientes con sIgE
negativa frente a los componentes de ISAC. Además, se realizó ImmunoCAP frente a Ara h 9, Cor a 8 y Jug r 3 en un subgrupo de pacientes
sensibilizados a LTP. La sIgE detectada por ImmunoCAP fue comparada con los rangos de ISAC.
Resultados: La mayorĂa de los alĂ©rgicos a cacahuete (66,7%), avellana (80,5%) y nuez (84%) estaba sensibilizados a su LTP. Sin embargo,
no se detectó sIgE frente a los componentes de ISAC en el 33,3% de alérgicos a cacahuete, 13,9% de alérgicos a avellana y 13,6% de
los alérgicos a nuez. El ImmunoCAP permitió detectar sIgE a Ara h 9 en 61,5%, Cor a 8 en 60% y Jug r 3 en 83,3% de los ISAC negativo.
En el subgrupo LTP, ImmunoCAP (94,4%) fue superior a ISAC (72,2%) en la detecciĂłn de sIgE a Ara h 9 (p<0,05). La sIgE frente a Cor a 8
y Jug r 3 fue detectada de forma similar por ambas técnicas.
Conclusiones: La micromatriz ISAC es adecuada para el diagnĂłstico de alergia a avellana y nuez. La sensibilidad del componente Ara h 9
de ISAC debe ser mejorada