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.
Bernstein
David I
DI
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
Cartier
André
A
Côté
Johanne
J
Malo
Jean-Luc
JL
Boulet
Louis-Philippe
LP
Wanner
Mark
M
Milot
Joanne
J
L'Archevéque
Jocelyne
J
Trudeau
Carole
C
Lummus
Zana
Z
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