Journal List > Allergy Asthma Respir Dis > v.3(3) > 1059098

Choi, You, Yi, Jeong, Song, Yang, Hwang, Lee, and Baek: Component-resolved diagnosis using microarray for diagnosing hypersensitivity to raw fruits in birch pollen sensitized children

Abstract

Purpose

Recently, component-resolved diagnosis (CRD) using microarray technology has been introduced to the field of clinical allergy. This study was aimed to investigate the clinical usefulness of microarray-based IgE detection for diagnosing clinical raw fruit allergy in birch pollen-sensitized children.

Methods

Thirty-one children with allergic disease who had been sensitized to pollen were studied. A pollen-sensitized patient was defined as having an allergen-specific history with concomitant positive skin-prick tests (SPTs) to natural allergen extracts or positive allergen-specific IgE. All subjects underwent SPTs for pollen and fruit. In all subjects, specific IgE to pollen and fruit were measured by ImmunoCAP. Specific IgE antibodies to allergen components were determined by a customized allergen microarray (ISAC).

Results

Thirteen of the 31 patients (41.9%) had a history of fruit hypersensitivity with positive SPTs. Measuring IgE to allergen components by ISAC, all the 13 patients with fruit hypersensitivity were positive to at least one of Mal d 1, Pru p 1, Pru p 3, Act d 8, and Act d 2 compared to 12 of the 13 patients (92.3%) who had at least 1 positive IgE to fruits (apple, peach, and kiwi) using ImmunoCAP. The sensitivity of ISAC microarray was 100.0% for the diagnosis of fruit hypersensitivity, but its specificity was 27.7% (5/18). The sensitivity of ImmunoCAP was 92.3%, and its specificity was 83.3%.

Conclusion

The sensitivity of allergen components tested using microarray for the diagnosis of clinical fruit hypersensitivity in children with pollen allergy was high; however, its specificity was low.

Figures and Tables

Fig. 1

Results of the study subject.

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Fig. 2

Correlations of specific IgE to Bet v 1 with birch (A), IgE to Mal d 1 with apple (B), and specific IgE to Pru p 1 with peach (C). P-value was applied by Pearson correlation. sIgE, specific IgE; ISA, ISAC standardized units. ISAC (Phadia AB, Uppsla, Sweden), ImmunoCAP (Phadia AB, Uppsala, Sweden).

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Fig. 3

Receiver operating characteristic curve for IgE levels by microarray and IgE levels by immunoCAP for diagnosing raw fruit hypersensitivity. AUC, area under curve; SE, standard error; CI, confidence interval. ISAC (Phadia AB, Uppsla, Sweden), ImmunoCAP (Phadia AB, Uppsala, Sweden).

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Table 1

Clinical characteristics and specific IgE by ImmunoCAP, skin prick test, allergen components microarray of subjects

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Patients No. Sex Age (yr) Manifestation Total IgE (kU/L) Specific IgE by ImmunoCAP (kU/L) Skin test ISAC microarray (ISU)
Birch Apple Peach Kiwi Birch Apple Peach Kiwi Bet v 1 Bet v 2 Mal d 1 Pru p 1 Pru p 3 Act d 8 Act d 2
1 M 9 OAS 1,434.0 88.44 < 0.01 6.11 < 0.01 + - + - 10.11 0 2.90 1.78 0 0 0
2 M 11 AU & angioedema 548.1 85.50 3.22 40.60 < 0.01 + + + - 28.22 0 18.89 21.13 1.05 0 0
3 M 7 OAS 562.8 32.30 1.43 2.92 < 0.01 + + - - 27.36 0.72 12.71 9.34 0 0 0
4 M 9 OAS 385.9 71.30 0.43 7.66 0.44 + + + + 16.20 0.00 7.63 3.54 0 1.34 0
5 M 8 OAS, AU 307.6 12.60 < 0.01 < 0.01 < 0.01 + - - - 56.20 6.12 20.00 7.59 0 0 0
6 M 12 OAS 210.0 3.42 3.76 < 0.01 < 0.01 + + + + 16.80 0 13.60 6.97 0 4.09 0
7 M 14 OAS 194.3 66.00 11.90 26.40 < 0.01 + + + - 175.00 0 137.80 54.20 0 0 0
8 M 6 OAS, AU 808.0 36.00 7.91 32.30 < 0.01 + + + - 37.00 0 28.00 27.00 0 0 0
9 M 6 OAS 592.5 25.20 6.42 8.00 < 0.01 + + + - 23.80 0 22.20 9.79 0 0 0
10 F 6 OAS 761.2 17.40 2.88 3.43 < 0.01 + - + - 14.00 3.19 22.90 14.70 0 0 0
11 F 6 OAS 529.4 9.43 5.96 3.88 < 0.01 + + + - 17.10 0 4.23 3.37 0 0 0
12 M 7 OAS 506.0 35.00 2.98 4.03 < 0.01 + + + - 34.00 0 15.00 15.00 0 4.40 0
13 M 3 OAS, AU 801.3 14.50 < 0.01 1.69 < 0.01 + + + + 89.79 15.46 40.46 20.74 2.46 0 2.21

OAS, orall allergy syndrome; AU, acute urticarial.

Table 2

Predictive capacity of ImmunoCAP and IgE to allergen component by ISAC for clinical raw fruit hypersensitivity

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Sensitivity (%) Specificity (%) PPV (%) NPV (%)
ImmunoCap 92.3 83.3 80.0 93.7
ISAC microarray 100 27.7 50.0 100

PPV, positive predictive value; NPV, negative predictive value.

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