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).
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Fig. 1.
Quantitative results of total IgE in 34 sera showing discrepant results between the two allergy screen assays.
![kjlm-30-420f1.tif](/upload/SynapseXML/0039kjlm/thumb/kjlm-30-420f1.gif)
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(‡).
![kjlm-30-420f2.tif](/upload/SynapseXML/0039kjlm/thumb/kjlm-30-420f2.gif)
Table 1.
Tested allergens in LG-Screen, RIDA-Screen and ImmunoCAP assays
Panel | LG-Screen | RIDA-Screen | ImmunoCAP | |||||
---|---|---|---|---|---|---|---|---|
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 | ∗ | ∗ |
Table 2.
Comparison of the test results between LG-Screen and RIDA-Screen assays
Allergens | N | LG-Screen + | + | - | - | Agreement % (kappa value) | |
---|---|---|---|---|---|---|---|
RIDA-Screen + | - | + | - | ||||
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) |
Table 3.
Specific allergens according to the agreement between LG-Screen and RIDA-Screen assay results
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) |