Comparison and evaluation of several Dermatophagoides pteronyssinus allergen extracts for skin prick test.
OBJECTIVE
To evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test (SPT) in patients allergic to Dermatophagoides pteronyssinus.


METHODS
Two hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen. Three kinds of house dust mite allergen extracts were used for SPT, including the Dermatophagoides pteronyssinus extract prepared by our laboratory (group A), standardized Dermatophagoides pteronyssinus extract (group B), and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae (group C). Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.


RESULTS
SPT results showed that the median wheal diameter of group A, group B, and group C was 0.43, 0.35, and 0.28 cm, respectively, with significant difference among three groups (P<0.05). The difference was significant between group A and B (P<0.01) as well as group A and C (P<0.01), but not between group B and C (P>0.05). There was no local urticaria or systemic allergic reactions following the procedure of SPT. Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A. As for group B and C, local reaction occurred in 3 cases and delayed reaction in 2 cases in each group. The area under ROC curve of SPT with extract in group A, group B, and group C was 0.765, 0.801, and 0.782, respectively. Based on the detection results of serum specific IgE, the sensitivity of SPT in diagnosis of Dermatophagoides pteronyssinus allergy with extract of group A, group B, and group C was 92.4%, 87.0%, and 81.5%, and the specificity was 60.6%, 73.2%, and 74.8%, respectively.


CONCLUSIONS
The Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts, and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.
Sun
Jin-lu
JL
Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China. sunjl5@yahoo.com
Wang
Rui-qi
RQ
Yin
Jia
J
Wang
Liang-lu
LL
Zhang
Hong-yu
HY
Li
Hong
H
Zhi
Yu-xiang
YX
Wen
Li-ping
LP
Guan
Kai
K
Gu
Jian-qing
JQ
He
Hai-juan
HJ
Zhao
Ying
Y
Zhang
Wei
W
Sun
Guo-qiang
GQ
D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology; D040002:Dermatophagoides pteronyssinus / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012882:Skin Tests / Q000379:methods*
D039741:Antigens, Dermatophagoides