Contribution of molecular diagnosis of allergy to the management of pediatric patients with allergy to pollen.
BACKGROUND
Component-resolved diagnosis based on recombinant allergens facilitates treatment of multiple sensitization and/or crossreactivity in allergic patients.


OBJECTIVE
To assess the usefulness of molecular diagnosis in childhood allergies.


METHODS
A total of 162 children aged 4-16 years diagnosed with allergic rhinitis or asthma/rhinitis caused by pollen were referred for recombinant allergen-based diagnosis in 2006. Specific immunoglobulin (Ig) E against pollen allergens and purified recombinant Phleum pratense pollen allergens were measured using an in vitro quantitative assay, and considering the recombinant allergens Phl p 1+Phl p 5 as P pratense--specific allergens and Phl p 7+Phl p 12 as cross-reacting allergens. Conditional probability was calculated to determine the relationship between values for specific IgE against major allergens and those for cross-reacting allergens.


RESULTS
Specific IgE antibodies against P pratense were detected in 99.4% of serum samples, and cross-reacting allergens in 46%. Multiple sensitization to pollen was documented in 38% of patients, with Plantago lanceolata as the main cause. Conditional probability calculations showed that patients with specific IgE values of 75-80 kU(A)/L to Phl p 1+Phl p 5 were 75% (95% confidence interval) more likely to present values > or = 2 kUA/L to Phl p 7+Phl p 12.


CONCLUSIONS
Our results show that recombinant DNA technology can help diagnose allergy in cases of multiple sensitization and crossreactivity, and is therefore a promising option for improving prognosis and management of allergic pediatric populations.
Service of Clinical Analysis and Biochemistry, León, Spain.
E
E
Casquete-Román
T
T
Rosado-Gil
I
I
Postigo
R
R
Pérez-Vicente
M
M
Fernández
H E
HE
Torres
J
J
Martínez-Quesada
D000293:Adolescent; D052179:Antigens, Plant / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003429:Cross Reactions; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D057089:Pathology, Molecular / Q000379:methods*; D031784:Phleum / Q000276:immunology; D011058:Pollen / Q000009:adverse effects / Q000276:immunology*; D011379:Prognosis; D011994:Recombinant Proteins / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology / Q000628:therapy
D052179:Antigens, Plant; D011994:Recombinant Proteins