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Jung, Oh, Lee, Kim, Kim, Kim, and Park: Usefulness of Total IgE in Predicting Positive Allergen Specific IgE Tests in Korean Subjects
Original Article

Korean J Leg Med 2010;30(6):660-667.

Published online: 14 January 2010

DOI: https://doi.org/10.3343/kjlm.2010.30.6.660

Usefulness of Total IgE in Predicting Positive Allergen Specific IgE Tests in Korean Subjects

Seoung Won Jung, M.D.1, Eun-Jee Oh, M.D.1, Jehoon Lee, M.D.1, Yonggoo Kim, M.D.1, Soo-Young Kim, M.D.1, Yeongsic Kim, M.D.1, Yong Jin Park, M.D.2

1Departments of Laboratory Medicine and Otorhinolaryngology, Seoul, Korea

2The Catholic University of Korea College of Medicine, Seoul, Korea

Corresponding author: Yeongsic Kim, M.D. Department of Laboratory Medicine, The Catholic University of Korea College of Medicine, St. Vincent's Hospital, 93-6 Ji-dong, Paldal-gu, Suwon 442-723, Korea Tel: +82-31-249-7665, Fax: +82-31-249-7645 E-mail: yeongsik@catholic.ac.kr

∗ This work was supported by “Development of Core Components in Bio-robot System (10024719)” under the ‘Industrial Source Technology Development Programs’ of the Ministry of Knowledge Economy (MKE) of Korea.

      Revised 14 April 201026 August 2010       Accepted 14 October 2010

Copyright © 2010 Korean Society for Legal Medicine

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:

Total IgE levels in allergic patients tend to be higher than those in healthy individuals. We evaluated the usefulness of total IgE levels in predicting positive results of allergen specific IgEs in multiple allergen simultaneous tests.

Methods:

A total of 133 patients with allergic symptoms were evaluated. Allergen specific IgEs were detected using 3 different kits: Allergy screen (R-biopharm, Germany), AdvanSure Allergy Screen (LG Life Science, Korea) and Polycheck allergy (Biocheck Co., Germany). Total IgE was measured by turbidoimmunometric assay (LX-2200, Eiken Chemical Co., Japan). The patients were divided into high (≥170 IU/mL) and low (<170 IU/mL) groups of total IgE level, and the positive rates and number of positive allergen specific IgEs were evaluated in each group. Positive concordance rates among different kits were also evaluated.

Results:

High total IgE group showed significantly higher positive rates and number of positive allergen specific IgEs in all of the 3 test kits used compared to low total IgE group. Only two of the allergens, Dermatophagoides farinae and Dermatophagoides pteronyssinus had positive concordance rates of ≥50%. Allergen specific IgEs to these two allergens showed good correlation with total IgE (correlation coefficients >0.5).

Conclusions:

Total IgE appears to be useful in predicting positive results in allergen specific IgE tests to common allergens. The specific IgEs to D. farinae and D. pteronyssinus showed good correlation with total IgE. However, for other allergens, significant differences were observed among different test kits, and the standardization of allergens in multiple allergen simultaneous tests is needed.

Keywords: Total IgE, Multiple allergen simultaneous test, Specific IgE

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Fig. 1.
Correlation between total IgE measured by immunoturbidometric assay and specific IgE class against Dermatophagoides farinae and Dermatophagoides pteronyssinus determined by Allergy Screen (A, B), Advansure Allergy screen (C, D), and Polycheck Allergy (E, F).
kjlm-30-660f1.tif
Table 1.
Total IgE concentration according to age
Age Total N Total IgE (IU/mL) P value∗
Male Female
N Mean±SD N Mean±SD
2-10 27 15 279.3±467.6 12 274.3±495.2 0.79
11-20 16 10 467.6±397.2 6 202.5±191.8 <0.05
21-30 21 12 180.9±195.6 9 114.2±88.8 <0.05
31-40 17 9 447.1±455.5 8 88.8±41.3 <0.05
41-50 19 7 95±78.4 12 76.8±43.7 <0.05
51-60 24 7 367.3±458.2 17 96.4±83.9 <0.05
>60 9 2 196±217.7 7 57.7±24.3 <0.05
Total 133 62 350.4±514.3 71 164.3±431.8 <0.05

∗ Statistical significance of difference of total IgE between male and female was evaluated by Student's t-test.

Total IgE was significantly decreased as a function of age (r=-0.26, P=0.003). Spearman correlation test was used.

Table 2.
Positive rates of allergen specific IgE in high and low total IgE groups
Assays Positive allergen specific IgE Total IgE (IU/mL) P value∗
≤170 >170
AS None (N=55) 51 (56.7%) 4 (9.3%) <0.001
  ≥1 (N=78) 39 (43.3%) 39 (90.7%)  
AA None (N=40) 39 (43.3%) 1 (2.3%) <0.001
  ≥1 (N=93) 51 (56.7%) 42 (97.7%)  
PA None (N=29) 28 (33.7%) 1 (2.9%) <0.001
  ≥1 (N=89) 55 (66.2%) 34 (97.1%)  

∗ P values were obtained by Pearson's chi square test for comparing positive rates of allergen specific IgE between high and low total IgE group.

Abbreviations: AS, Allergy Screen; AA, Advansure Allergy; PA, Polycheck Allergy.

Table 3.
Number of positive allergen specific IgEs in high and low total IgE groups
Assays Total IgE (IU/mL) P value∗
≤170 >170
AS 2.1±4.6 5.1±4.8 <0.001
AA 2.7±4.4 6.1±5.2 <0.001
PA 4.1±5.7 8.9±8.8 0.003

Abbreviations: AS, Allergy Screen; AA, Advansure Allergy; PA, Polycheck Allergy.

Table 4.
Positive rates of allergen specific IgEs in three different multiple allergen simultaneous tests
Types of allergen Positive rate in each panel assay % (N of positive results/N tested)
AS AA PA
House dust 6.0 (8/133) 43.6 (58/133) 61.0 (72/118)
D. farinae 30.1 (40/133) 38.3 (51/133) 41.5 (49/118)
D. pteronyssinus 30.1 (40/133) 36.1 (48/133) 31.4 (37/118)
Dog 2.3 (3/133) 33.1 (44/133) 27.1 (32/118)
Cat 4.5 (6/133) 28.6 (38/133) 26.3 (31/118)
Cockroach 6.0 (8/133) 18.8 (25/133) 13.6 (16/118)
Cladosporium 12.0 (16/133) 11.3 (15/133) 12.7 (15/118)
Bermudar grass 15.0 (20/133) 10.5 (14 /133) 25.4 (30/118)
Alternaria alternata 16.5 (21/133) 9.0 (12/133) 5.1 (6/118)
Ox-eye-dasy 13.5 (18/113) 1.5 (2/113) 6.8 (8/118)
Timothy grass 13.5 (18/133) 8.3 (11/133) 11.9 (14/118)
Sycamore mix 12.0 (16/133) 1.5 (2/133) 5.9 (7/118)
Orchard grass 12.0 (16/133) 5.3 (7/133) 11.0 (13/118)
Ragweed 12.0 (16/133) 6.0 (8/133) 11.9 (14/118)
Mugwart 11.3 (15/133) 8.3 (11/133) 10.2 (12/118)
Pine 10.2 (14/133) 9.0 (12/133) 0.0 (0/118)
Golden rod 9.0 (12/133) 6.8 (9/133) 6.8 (8/118)
Dandelion 8.3 (11/133) 5.3 (7/133) 11.0 (13/118)
Oak white 6.8 (9/133) 0.0 (0/133) 10.2 (14/118)
Pigweed 6.8 (9/133) 7.5 (10/133) 12.7 (15/118)
Sallow 6.0 (8/133) 3.8 (5/133) 0.0 (0/118)
Reed 4.5 (6/133) 15.0 (20/133) NA
Russian thistle 6.0 (8/133) 6.8 (9/133) 22.9 (27/118)
Acacia 5.3 (7/133) 3.8 (5/133) 5.9 (7/118)
Ash mix 5.3 (7/133) 0.0 (0/133) 8.5 (10/118)
Milk 5.3 (7/133) 8.3 (11/133) 7.6 (9/118)
Cedar, Japan 5.3 (7/133) 2.3 (3/133) 19.5 (23/118)
Poplar mix 3.8 (5/133) 3.8 (5/133) 0.0 (0/118)
Aspergillus 3.0 (4/133) 5.3 (7/133) 10.2 (14/118)
Birch-Alder mix 3.0 (4/133) 0.8 (1/133) 21.2 (25/118)
Egg, white 2.3 (3/133) 3.0 (4/133) 0.8 (1/118)
Penincillium 2.3 (3/133) 8.3 (11/133) 7.6 (9/118)
Sweet vernal grass 8.3 (11/133) 9.0 (12/133) 0.0 (0/118)
Crab 3.0 (4/133) 6.0 (8/133) 5.1 (6/118)
Rye 3.0 (4/133) 2.3 (3/133) 17.8 (21/118)
Shrimp 2.3 (3/133) 2.3 (3/133) 3.4 (4/118)
Hezelnut 1.5 (2/133) 1.5 (2/133) 18.8 (22/118)
Peach 1.5 (2/133) 3.8 (5/133) 6.8 (8/118)
Soybean 1.5 (2/133) 6.8 (9 /133) 3.4 (4/118)
Willow NA 3.8 (5/133) NA
Japanese hop NA 1.5 (2/133) NA
Mackerel NA 0.0 (0/133) NA
T. putrescantiae NA NA 14.4 (19/118)
Redtop.pol NA NA 13.6 (18/118)
Lilac.pol NA NA 11.0 (15/118)
Latex NA NA 8.5 (11/118)
Fescue.meado NA NA 5.3 (7/118)

Abbreviations: AS, Allergy Screen; AA, Advansure Allergy; PA, Polycheck Allergy; D. farinae, Dermatophagoides farinae; D. pteronyssinus, Dermatophagoides pteronyssinus; NA, Allergens not included in each inhalant panel; T. putrescentiae, Tyrophagus putrescentiae.

Table 5.
Positive concordance rates for 34 common allergens: comparison of three different multiple allergen simultaneous tests
Types of allergen Positive concordance rate % (N of positive agreement results/N of positive results in any of two tests)
AS vs. AA AA vs. PA PA vs. AS
Soybean 22.2 (2/9) 50.0 (4/8) 12.5 (1/8)
Milk 42.9 (6/14) 23.5 (4/17) 13.3 (2/15)
Egg white 40.0 (2/5) 33.3 (2/6) 33.3 (2/6)
Crab 25.0 (2/8) 50.0 (3/6) 50.0 (5/10)
Shrimp 20.0 (1/5) 50.0 (2/4) 40.0 (2/5)
Peach 40.0 (2/5) 50.0 (5/10) 20.0 (2/10)
Acacia 42.9 (6/14) 44.4 (4/9) 55.6 (5/9)
Ash mix 0.0 (0/7) 0.0 (0/10) 54.5 (6/11)
Birch-Alder mix 25.0 (1/4) 4.0 (1/25) 11.5 (3/26)
Hazelnut 33.3 (1/3) 9.1 (2/22) 9.1 (2/22)
Cedar, Japan 11.1 (1/9) 8.3 (2/24) 3.6 (1/27)
Oak white 0.0 (0/9) 0.0 (0/14) 23.5 (4/17)
Sycamore mix 6.3 (1/16) 12.5 (1/8) 21.1 (4/19)
Bermudar grass 47.6 (10/21) 31.3 (10/32) 37.8 (14/37)
Ochard grass 37.5 (6/16) 18.8 (3/16) 61.1 (11/18)
Timothy grass 38.1 (8/21) 35.0 (7/20) 45.8 (11/24)
Rye 75.0 (3/4) 14.3 (3/21) 19.0 (4/21)
Goldenrod 41.2 (7/17) 54.5 (6/11) 25.0 (4/16)
Pigweed 26.7 (4/15) 19.0 (4/21) 33.3 (6/18)
Russian thistle 41.7 (5/12) 24.0 (6/25) 25.9 (7/27)
Dandelion 28.6 (4/14) 25.0 (4/16) 60.0 (9/15)
Mugwort 31.6 (6/19) 31.3 (5/16) 68.8 (13/19)
Ragweed, short 33.3 (6/18) 31.3 (6/19) 60.0 (12/20)
Alternaria alternata 13.3 (4/30) 30.8 (4/13) 26.3 (6/23)
Aspergillus 0.0 (0/11) 26.7 (4/15) 0.0 (0/16)
Cladosporium 19.2 (5/26) 55.6 (5/9) 19.2 (5/26)
Penicillium 0.0 (0/14) 26.7 (4/15) 0.0 (0/12)
Cat 12.8 (5/39) 51.2 (23/45) 12.9 (4/31)
Dog 6.8 (3/44) 43.1 (22/51) 9.4 (3/32)
Cockroach 17.2 (4/23) 16.7 (7/42) 27.8 (5/18)
Housedust 13.6 (8/59) 53.7 (47/88) 8.0 (4/50)
D. farinae 76.9 (37/48) 64.3 (32/50) 64.0 (37/58)
D. pteronyssinus 57.9 (33/57) 53.7 (31/58) 80.0 (37/46)
Ox-eye-dasy 11.1 (2/18) 9.1 (1/11) 36.8 (7/19)

Abbreviations: AS, Allergy Screen; AA, Advansure Allergy; PA, Polycheck Allergy; D. farinae, Dermatophagoides farinae; D. pteronyssinus, Dermatophagoides pteronyssinus.

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