Component-Resolved in Vitro Diagnosis in Peach-Allergic Patients

Abstract

BACKGROUND: The in vitro diagnosis of pollen-related food allergy presents low specifi city and reproducibility with many conventional extracts. This can be improved using natural purifi ed allergens, recombinant purifi ed allergens, or both. OBJECTIVE: We compared specifi c immunoglobulin (Ig) E determination (sIgE), the basophil activation test (BAT), the histamine release test (HRT), and the cellular allergen stimulation test (CAST) using natural and recombinant allergens in the diagnosis of peach allergy. METHODS: Thirty-two peach allergic patients were studied. Skin prick tests were performed with commercial peach and extract with Mal d 1, nPru p 3, and profi lin (nPho d 2). sIgE, BAT, CAST, and HRT were determined using rPru p 3, rMal d 3, rBet v 1, rMal d 1, and rMal d 4. RESULTS: Agreement between the techniques was good with all the allergens, except HRT with rMal d 1 and rMal d 4. With rPru p 3, sIgE, CAST, BAT, and HRT showed sensitivity values of 88%, 81%, 72%, and 69% and specifi city values of 100%, 93%, 97%, and 83%, respectively. In patients with systemic symptoms or contact urticaria, the values were 100%, 85%, 81%, and 81%. In patients with oral allergy syndrome, sensitivity to profi lins or homologues of Bet v 1 was detected in 100% of the cases by all the techniques, except by HRT with rMal d 1, which detected 66% of the cases. CONCLUSIONS: The use of single allergens in the in vitro diagnosis of peach allergy by specifi c IgE determination, BAT, and CAST offers high specifi city and sensitivity, with better results than the HRT