The performance of a component-based allergen-microarray in clinical practice.
BACKGROUND
Currently, the diagnosis of IgE-mediated allergy is based on allergen-specific history and diagnostic procedures using natural allergen extracts for in vivo and in vitro tests.


OBJECTIVE
The aim of the study was to comparatively analyse a new component-based allergen-microarray and the 'quasi-standard' ImmunoCAP for their clinical relevance in patients with allergic rhinoconjunctivitis to five aeroallergens [house dust mite (HDM), cat dander, birch, grass and mugwort pollen] in a prospective, double-centre study.


METHODS
We enrolled 120 subjects at the two study centres. Allergic patients were defined as having an allergen-specific history plus a concomitant positive skin-prick test (SPT) to natural allergen extracts and specific serum IgE was measured by both methods. Each allergen was analysed separately.


RESULTS
The microarray performed equally well in receiver-operating characteristic curve (ROC) analyses when compared with the CAP in cat (23 allergic vs 97 non-allergic, ROC area under the curve microarray 0.950 vs CAP 0.894, P = 0.211), birch (31/89, 0.908 vs 0.878, P = 0.483) and grass pollen (47/73, 0.923 vs 0.915, P = 0.770). It was slightly less sensitive in HDM-allergic subjects (26 allergic vs 94 non-allergic, ROC area microarray 0.808 vs CAP 0.911, P = 0.053) and displayed a reduced sensitivity in the mugwort pollen-allergic patients (17/103, 0.723 vs 0.879, P = 0.032).


CONCLUSIONS
Component-based testing and the whole-allergen CAP are equally relevant in the diagnosis of grass-, birch- and cat-allergic patients. Although slightly less sensitive, the microarray is sufficient for the diagnosis of HDM-allergic patients, but needs alternative and/or additional components for detecting mugwort allergy.
Wöhrl
S
S
Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University of Vienna, Vienna, Austria.
Vigl
K
K
Zehetmayer
S
S
Hiller
R
R
Jarisch
R
R
Prinz
M
M
Stingl
G
G
Kopp
T
T
D000328:Adult; D000485:Allergens / Q000276:immunology*; D000818:Animals; D019306:Artemisia / Q000276:immunology; D029662:Betula / Q000276:immunology; D002415:Cats; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D046228:Microarray Analysis / Q000295:instrumentation / Q000379:methods*; D006109:Poaceae / Q000276:immunology; D039981:Pyroglyphidae / Q000276:immunology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012882:Skin Tests
D000485:Allergens; D007073:Immunoglobulin E