Diisocyanate antigen-stimulated monocyte chemoattractant protein-1 synthesis has greater test efficiency than specific antibodies for identification of diisocyanate asthma.
We previously reported that diisocyanate-human serum albumin (DIISO-HSA) stimulated production of monocyte chemoattractant protein-1 (MCP-1) by peripheral blood mononuclear cells is significantly associated with a clinical diagnosis of diisocyanate asthma (DA). Others have reported that antibodies for DIISO-HSA are specific but insensitive markers of DA. This study was performed to evaluate test characteristics of the in vitro MCP-1 assay compared with DIISO-HSA-specific immunoglobulin (Ig) G and IgE in identifying workers with DA. MCP-1 was quantitated in peripheral blood mononuclear cell supernatants 48 hours after incubation with DIISO-HSA antigens. Assay results were compared with outcomes of specific inhalation challenge (SIC) testing. Nineteen of 54 (35%) workers assayed for antibodies and MCP-1 stimulation had SIC-confirmed DA. Mean MCP-1 produced by SIC-positive workers was greater than SIC-negative workers (p < or = 0.001). Diagnostic sensitivity, specificity, and test efficiency for specific IgG were 47%, 74%, and 65%, respectively, and for specific IgE were 21%, 89%, and 65%, respectively. Sensitivity, specificity, and test efficiency of the MCP-1 test were 79%, 91%, and 87%, respectively. This study indicates that the MCP-1 stimulation assay has greater sensitivity and specificity than the specific antibody assays in correctly identifying DA.
Department of Internal Medicine, Division of Immunology, College of Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0563, USA. bernstdd@email.uc.edu
David I
DI
Bernstein
André
A
Cartier
Johanne
J
Côté
Jean-Luc
JL
Malo
Louis-Philippe
LP
Boulet
Mark
M
Wanner
Joanne
J
Milot
Jocelyne
J
L'Archevéque
Carole
C
Trudeau
Zana
Z
Lummus
D000328:Adult; D001249:Asthma / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis* / Q000276:immunology; D001985:Bronchial Provocation Tests / Q000379:methods / Q000592:standards; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007118:Immunoassay / Q000379:methods* / Q000592:standards; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D017953:Isocyanates / Q000009:adverse effects*; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D009784:Occupational Diseases / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis* / Q000276:immunology; D016273:Occupational Exposure / Q000009:adverse effects*; D012680:Sensitivity and Specificity
D018932:Chemokine CCL2; D007074:Immunoglobulin G; D017953:Isocyanates; D007073:Immunoglobulin E