Detection of Allergen Specific IgE by AdvanSure Allergy Screen Test

Eun-Jee Oh; Sun-Ah Lee; Jihyang Lim; Yeon-Joon Park; Kyungja Han; Yonggoo Kim

doi:10.3343/kjlm.2010.30.4.420

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Oh, Lee, Lim, Park, Han, and Kim: Detection of Allergen Specific IgE by AdvanSure Allergy Screen Test

Original Article

Korean J Leg Med 2010;30(4):420-431.

Published online: 14 January 2010

DOI: https://doi.org/10.3343/kjlm.2010.30.4.420

Detection of Allergen Specific IgE by AdvanSure Allergy Screen Test

Eun-Jee Oh, M.D., Sun-Ah Lee, M.D., Jihyang Lim, M.D., Yeon-Joon Park, M.D., Kyungja Han, M.D., Yonggoo Kim, M.D.

Department of Laboratory Medicine, School of Medicine, the Catholic University of Korea, Seoul, Korea

Corresponding author: Yonggoo Kim, M.D. Department of Laboratory Medicine, Seoul St. Mary's Hospital, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel: +82-2-2258-1642, Fax: +82-2-2258-1719 E-mail: yonggoo@catholic.ac.kr

^∗ This work was supported by the Industrial Core Technology Development Program funded by the Ministry of Knowledge Economy (No. 10033183).

Revised 29 April 201028 July 2010 Accepted 23 July 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

In vitro serum allergen-specific IgE tests have been routinely used in the clinical diagnosis of allergic diseases. We evaluated the clinical usefulness of a newly introduced multiple antigen screen test, Advansure Allergy Screen (LG Life Science, Korea) (LG-Screen) for the detection of allergen specific IgE.

Methods:

A total of 180 sera (80 for inhalant and 100 for food panels) were tested by LG-Screen and RIDA Allergy Screen (R-biopharm, Germany) (RIDA-Screen) assays. According to the 58-60 specific allergens or allergen groups, the positive rates and agreement rates were analyzed using the cut off levels of class 2. For the quantitation of total IgE and specific IgE, nephelometry and ImmunoCAP test were performed in the sera showing discrepant results between the two allergy screen assays.

Results:

The agreement rate and kappa value (k) of total IgE between the two allergy screen assays was 73.9% and 0.333. LG-Screen showed higher agreement rate with nephelometry than RIDA-Screen. The positive rates to common outdoor inhalant and food allergens were significantly higher in RIDA-Screen. Overall agreement rate of specific IgE between the two allergy screen assays for 58 allergens was 86.7% (6,086/7,020) (k, 0.293). In samples showing discrepant results between the two allergy screen assays, concordance rate of allergy screen assay with ImmunoCAP assay was 70.9% (449/633) for LG-Screen (k, 0.585) and 29.1% (184/633) for RIDA-Screen (k, −0.303).

Conclusions:

LG-Screen showed a favorable agreement with RIDA-Screen and ImmunoCAP assays, and it could be used for the detection of allergen specific IgE in the clinical laboratory.

Keywords: Allergens, Specific IgE assay, Allergy screen test, ImmunoCAP assay

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Fig. 1.

Quantitative results of total IgE in 34 sera showing discrepant results between the two allergy screen assays.

Fig. 2.

Positive rates of allergen-specific IgE in LG-Screen and RIDA-Screen assays. Numbers of sera tested according to different allergens were 180(∗), 100(^†) and 80(^‡).

Table 1.

Tested allergens in LG-Screen, RIDA-Screen and ImmunoCAP assays

Panel	LG-Screen		RIDA-Screen			ImmunoCAP
Panel	Code	Allergens	Code		Allergens	Code		Allergens
Inhalant	F17	Hazelnut		∗			∗
	G1	Sweet vernal grass		∗			∗
	G2	Bermuda grass		∗			∗
	G3	Orchard grass		∗			∗
	G6	Timothy grass		∗			∗
	G7	Reed		∗			∗
	M1	Penicillium notatum		∗				∗
	T11	Sycamore mix	T1		Sycamore maple	T11		Sycamore mix
	T12	Sallow willow		∗			∗
	T14	Poplar mix		∗			∗
	T15	Ash mix		∗			∗
	T16	Pine		∗			∗
	T17	Japanese cedar	T24		Cedar	T17		Japanese cedar
	T19	Acacia	T36		Acacia	T19		Acacia
	W11	Russian thistle		∗			∗
	W12	Goldenrod		∗			∗
	W14	Pigweed		∗			∗
	W7	Oxeye daisy		∗			∗
	W8	Dandelion		∗			∗
Food	D70	Acarus siro		∗				∗
	F11	Buck-wheat		∗			∗
	F13	Peanut		∗			∗
	F25	Tomato		∗			∗
	F26	Pork		∗			∗
	F27	Beef		∗			∗
	F3	Codfish		∗				NT
	F4	Wheat flour		∗			∗
	F40	Tuna		∗			∗
	F41	Salmon		∗				NT
	F45	Yeast, bakers	M44		Yeast, bakers	F45		Yeast, bakers
	F47	Garlic		∗			∗
	F48	Onion		∗			∗
	F6	Barley meal		∗			∗
	F81	Cheddar cheese		∗			∗
	F83	Chicken		∗			∗
	F9	Rice		∗			∗
	Fx	Citrus mix	Kofx		Citrus mix			NT
	M5	Candida albicans		∗				∗
Common	D1	D. pteronyssinus		∗				∗
	D2	D. farinae		∗				∗
	H1	House dust	Hx		House dust	H1		House dust
	E1	Cat		∗			∗
	E2/E5	Dog epithelium	E5		Dog	E2		Dog epithelium
	F1	Egg white		∗			∗
	F14	Soy bean		∗			∗
	F2	Milk		∗			∗
	F206	Mackerel		∗	NT			NT
	F23	Crab		∗			∗
	F24	Shrimp		∗			∗
	F95	Peach	F53		Peach		∗
	G12	Rye pollens		∗		G5		Rye-grass
	I6	Cockroach		∗			∗
	M2	Cladosporium		∗				∗
	M3	Aspergillus fumigatus		∗				∗
	M6	Alternaria alternata		∗				∗
	T7	Oak white		∗			∗
	Tx	Birch-alder mix	TxKo		Birch-alder mix	T2, T3		Grey alder, common silver birch
	W2	Ragweed, short	W2		Ragweed, short	W1		Common ragweed
	W22	Japanese hop			NT			NT
	W6	Mugwort		∗			∗

^∗ same code and allergen as LG-Screen.

Abbreviations: NT, not tested.

Table 2.

Comparison of the test results between LG-Screen and RIDA-Screen assays

Allergens	N	LG-Screen +	+	-	-	Agreement % (kappa value)
Allergens	N	RIDA-Screen +	-	+	-	Agreement % (kappa value)
D. pteronyssinus (d1)	180	40	16	26	98	76.7 (0.481)
D. farinae (d2)	180	44	36	8	92	75.6 (0.487)
Acarus siro (d70)	100	4	2	14	80	84.0 (0.267)
House dust (h1, hx)	180	8	12	22	138	81.1 (0.215)	79.3 (0.443)∗
Cat (e1)	180	6	39	15	120	70.0 (0.027)
Dog (e2, e5)	180	7	33	1	139	81.1 (0.235)	75.6 (0.123)
Egg white (f1)	180	6	0	9	165	95.0 (0.550)
Buck-wheat (f11)	100	6	1	18	75	81.0 (0.313)
Peanut (f13)	100	4	2	5	89	93.0 (0.497)
Soy bean (f14)	180	1	1	11	167	93.3 (0.126)
Hazelnut (f17)	80	1	0	3	76	96.3 (0.388)
Milk (f2)	180	0	1	37	142	78.9 (-0.011)
Crab (f23)	180	5	3	18	154	88.3 (0.275)
Shrimp (f24)	180	2	1	1	176	98.9 (0.661)
Tomato (f25)	100	6	2	10	82	88.0 (0.440)
Pork (f26)	100	0	1	23	76	76.0 (-0.020)
Beef (f27)	100	2	1	18	79	81.0 (0.128)
Codfish (f3)	100	0	0	0	100	100 (NaN)
Wheat flour (f4)	100	0	0	25	75	75.0 (0.000)
Tuna (f40)	100	0	1	0	99	99.0 (0.000)
Salmon (f41)	100	0	0	0	100	100 (NaN)
Yeast, Baker (f45, M44)	100	0	6	0	94	94.0 (0.000)
Garlic (f47)	100	0	10	1	89	89.0 (-0.019)
Onion (f48)	100	3	3	2	92	95.0 (0.519)
Peach (f95, f53)	180	7	1	22	150	87.2 (0.332)
Barley meal (f6)	100	3	2	3	92	95.0 (0.519)
Cheddar cheese (f81)	100	0	0	35	65	65.0 (0.000)
Chicken (f83)	100	0	1	0	99	99.0 (0.000)
Rice (f9)	100	4	0	16	80	84.0 (0.286)
Citrus mix (fx)	100	2	2	3	93	95.0 (0.419)	89.5 (0.220)
Sweet vernal grass (g1)	80	3	1	4	72	93.8 (0.515)
Rye pollens (g12)	180	18	5	13	144	90.0 (0.609)
Bermuda grass (g2)	80	5	0	17	58	78.8 (0.299)
Orchard grass (g3)	80	1	0	14	65	82.5 (0.104)
Timothy grass (g6)	80	3	0	19	58	76.3 (0.186)
Reed (g7)	80	4	0	6	70	92.5 (0.538)	85.6 (0.403)
Cockroach (i6)	180	10	4	12	154	91.1 (0.509)
Penicillium notatum (m1)	80	3	1	7	69	90.0 (0.385)
Cladosporium (m2)	180	1	3	24	152	85.0 (0.032)
Aspergillus fumigatus (m3)	180	1	3	4	172	96.1 (0.203)
Candida albicans (m5)	100	0	2	5	93	93.0 (-0.029)
Alternaria alternata (m6)	180	3	5	12	160	90.6 (0.215)	90.9 (0.264)
Sycamore mix (t11, t1)	80	1	0	23	56	71.3 (0.057)
Sallow willow (t12)	80	0	0	17	63	78.8 (0.000)
Poplar mix (t14)	80	0	1	6	73	91.3 (-0.022)
Ash mix (t15)	80	1	0	6	73	92.5 (0.233)
Pine (t16)	80	1	1	5	73	92.5 (0.221)
Japanese cedar (t17, t24)	80	0	0	4	76	95.0 (0.000)
Acacia (t19, t36)	80	0	0	9	71	88.8 (0.000)
Oak white (t7)	180	9	1	19	151	88.9 (0.427)
Birch-alder mix (tx)	180	6	0	37	137	79.4 (0.198)	86.5 (0.186)
Russian thistle (w11)	80	2	0	13	65	83.8 (0.200)
Goldenrod (w12)	80	1	0	18	61	77.5 (0.078)
Pigweed (w14)	80	2	2	8	68	87.5 (0.231)
Ragweed, short (w2)	180	13	2	25	140	85.0 (0.421)
Mugwort (w6)	180	9	1	24	146	86.1 (0.364)
Oxeye daisy (w7)	80	0	0	14	66	82.5 (0.000)
Dandelion (w8)	80	1	1	13	65	82.5 (0.085)	83.6 (0.263)
Total	7,020	259	210	724	5,827	86.7 (0.293)

^∗ Agreement between LG-Screen and RIDA-Screen results according to the allergen group specific IgE.

Abbreviations: NaN, not a number.

Table 3.

Specific allergens according to the agreement between LG-Screen and RIDA-Screen assay results

	Agreement between LG-Screen and RIDA-Screen assay
	<70%	70-80%	80-90%	90-100%
Allergens	Cat	D. farinae	Dog	Penicillium notatum
	Cheddar cheese	D. pteronyssinus	House dust	Alternaria alternata
		Wheat	Acarus siro	Cockroach
		Pork	Cladosporium	Candida albicans
		Milk	Buck-wheat	Aspergillus fumigatus
		Sycamore mix	Beef	Peanut
		Timothy grass	Rice	Soy bean
		Goldenrod	Peach	Yeast, bakers
		Bermuda grass	Tomato	Egg white
		Sallow willow	Crab	Onion
		Birch-alder mix	Garlic	Barley meal
			Orchard grass	Citrus mix
			Oxeye daisy	Hazelnut
			Dandelion	Shrimp
			Russian thistle	Tuna
			Ragweed, short	Chicken
			Mugwort	Rye pollens
			Pigweed	Poplar mix
			Acacia	Reed
			Oak white	Pine
				Ash mix
				Sweet vernal grass
				Japanese cedar
				Codfish
				Salmon

Table 4.

Analysis of discrepant results between LG-Screen and RIDA-Screen assays compared with ImmunoCAP assay (N=633)

Allergens	LG-Screen	+	+	+	+	Agreement % (kappa value) between ImmunoCAP &
N RIDA-Screen	-	-	-	-
		ImmunoCAP -	-	-	-		LG		RIDA
D. pteronyssinus(d1)	27	2 (7.4)∗	8 (29.6)	2 (7.4)	15 (55.6)	37.0		63.0
D. farinae (d2)	31	3 (9.7)	21 (67.7)	3 (9.7)	4 (12.9)	77.4		22.6
Acarus siro (d70)	13	(0.0)	1 (7.7)	5 (38.5)	7 (53.8)	46.2		53.8
House dust (hx, h1)	28	4 (14.3)	6 (21.4)	8 (28.6)	10 (35.7)	50.0	54.5 (0.127)^†	50.0	46.5 (-0.138)
Cat (e1)	36	18 (50.0)	9 (25.0)	8 (22.2)	1 (2.8)	47.2		52.8
Dog (e2,e5)	22	15 (68.2)	6 (27.3)	1 (4.5)	(0.0)	31.8	41.4 (0.094)	68.2	58.6 (-0.172)
Egg white (f1)	6	(0.0)	(0.0)	5 (83.3)	1 (16.7)	83.3		16.7
Buck-wheat (f11)	9	(0.0)	(0.0)	5 (55.6)	4 (44.4)	55.6		44.4
Peanut (f13)	3	(0.0)	1 (33.3)	1 (33.3)	1 (33.3)	66.7		33.3
Soy bean (f14)	7	(0.0)	(0.0)	1 (14.3)	6 (85.7)	14.3		85.7
Hazelnut (f17)	3	(0.0)	(0.0)	3 (100)	(0.0)	100		0.0
Milk (f2)	24	(0.0)	(0.0)	22 (91.7)	2 (8.3)	91.7		8.3
Crab (f23)	16	2 (12.5)	1 (6.3)	12 (75.0)	1 (6.3)	81.3		18.8
Shrimp (f24)	2	(0.0)	1 (50.0)	(0.0)	1 (50.0)	50.0		50.0
Tomato (f25)	6	(0.0)	(0.0)	2 (33.3)	4 (66.7)	33.3		66.7
Pork (f26)	15	(0.0)	(0.0)	15 (100)	(0.0)	100		0.0
Beef (f27)	13	(0.0)	(0.0)	13 (100)	(0.0)	100		0.0
Wheat flour (f4)	17	(0.0)	(0.0)	6 (35.3)	11 (64.7)	35.3		64.7
Tuna (f40)	1	(0.0)	1 (100)	(0.0)	(0.0)	100		0.0
Yeast, Bakers (f45, M44)	5	3 (60.0)	2 (40.0)	(0.0)	(0.0)	40.0		60.0
Garlic (f47)	9	1 (11.1)	8 (88.9)	(0.0)	(0.0)	88.9		11.1
Onion (f48)	5	(0.0)	3 (60.0)	(0.0)	2 (40.0)	60.0		40.0
Peach (f95, f53)	18	(0.0)	(0.0)	11 (61.1)	7 (38.9)	61.1		38.9
Barley meal (f6)	3	(0.0)	1 (33.3)	2 (66.7)	(0.0)	100		0.0
Cheddar cheese (f81)	24	(0.0)	(0.0)	24 (100)	(0.0)	100		0.0
Chicken (f83)	1	1 (100)	(0.0)	(0.0)	(0.0)	0.0		100
Rice (f9)	9	(0.0)	(0.0)	3 (33.3)	6 (66.7)	33.3	73.0 (0.271)	66.7	27.0 (-0.160)
Sweet vernal grass (g1)	5	(0.0)	1 (20.0)	3 (60.0)	1 (20.0)	80.0		20.0
Rye pollens (g12, g5)	6	1 (16.7)	2 (33.3)	3 (50.0)	(0.0)	83.3		16.7
Bermuda grass (g2)	6	(0.0)	(0.0)	6 (100)	(0.0)	100		0.0
Orchard grass (g3)	13	(0.0)	(0.0)	11 (84.6)	2 (15.4)	84.6		15.4
Timothy grass (g6)	17	(0.0)	(0.0)	17 (100)	(0.0)	100		0.0
Reed (g7)	5	(0.0)	(0.0)	4 (80.0)	1 (20.0)	80.0	90.4 (0.496)	20.0	9.6 (-0.117)
Cockroach (i6)	13	1 (7.7)	2 (15.4)	3 (23.1)	7 (53.8)	38.5		61.5
Penicillium notatum (m1)	7	1 (14.3)	(0.0)	5 (71.4)	1 (14.3)	71.4		28.6
Cladosporium (m2)	15	3 (20.0)	(0.0)	11 (73.3)	1 (6.7)	73.3		26.7
Aspergillus fumigatus (m3) 3	1 (33.3)	(0.0)	2 (66.7)	(0.0)	66.7		33.3
Candida albicans (m5)	3	(0.0)	(0.0)	3 (100)	(0.0)	100		0.0
Alternaria alternata (m6)	8	2 (25.0)	1 (12.5)	5 (62.5)	(0.0)	75.0	75.0 (0.069)	25.0	25.0 (-0.025)
Sycamore mix (t11, t1)	22	(0.0)	(0.0)	22 (100)	(0.0)	100		0.0
Sallow willow (t12)	7	(0.0)	(0.0)	6 (85.7)	1 (14.3)	85.7		14.3
Poplar mix (t14)	7	1 (14.3)	(0.0)	5 (71.4)	1 (14.3)	71.4		28.6
Pine (t16)	6	1 (16.7)	(0.0)	5 (83.3)	(0.0)	83.3		16.7
Japanese cedar (t17, t24)	2	(0.0)	(0.0)	2 (100)	(0.0)	100		0.0
Acacia (t19, t36)	4	(0.0)	(0.0)	4 (100)	(0.0)	100		0.0
Oak white (t7)	14	(0.0)	(0.0)	10 (71.4)	4 (28.6)	71.4		28.6
Birch-alder mix (tx, t2, t3)	18	(0.0)	(0.0)	12 (66.7)	6 (33.3)	66.7	82.5 (-0.045)	33.3	17.5 (0.009)
Russian thistle (w11)	13	(0.0)	(0.0)	12 (92.3)	1 (7.7)	92.3		7.7
Goldenrod (w12)	17	(0.0)	(0.0)	17 (100)	(0.0)	100		0.0
Pigweed (w14)	9	1 (11.1)	(0.0)	8 (88.9)	(0.0)	88.9		11.1
Ragweed (w2, w1)	17	(0.0)	(0.0)	15 (88.2)	2 (11.8)	88.2		11.8
Mugwort (w6)	17	(0.0)	(0.0)	11 (64.7)	6 (35.3)	64.7		35.3
Oxeye daisy (w7)	13	(0.0)	(0.0)	9 (69.2)	4 (30.8)	69.2		30.8
Dandelion (w8)	13	1 (7.7)	(0.0)	11 (84.6)	1 (7.7)	84.6	83.8 (-0.037)	15.4	16.2 (0.007)
Total	633	62 (9.8)	75 (11.8)	374 (59.1)	12 (19.3)		70.9 (0.585)		29.1 (-0.303)

^∗ Number of cases(%);

^† Agreement between LG-Screen and RIDA-Screen results according to the allergen group specific IgE.

Abbreviations: +, positive; -, negative, NaN, not a number.

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