title: Performance of a component-based allergen-microarray in the diagnosis of cow's milk and hen's egg allergy.
abstract: BACKGROUND
  The food challenge test (FCT) is the gold standard for the diagnosis of food allergy. This procedure is time consuming, costly and can induce potentially severe symptoms. An ideal in vitro test should allow to avoid the FCT. Objective To assess the clinical performance of microarray for specific IgE (sIgE) detection in children with challenge-proven/excluded cow's milk (CM) or hen's egg (HE) allergy.
  
  
  METHODS
  One-hundred and four children with suspected IgE-mediated hypersensitivity to CM or HE were studied. In all patients, skin prick test, ImmunoCAP, microarray and FCT were performed.
  
  
  RESULTS
  The microarray components Bos d 8 for CM (27/58 patients) and Gal d 1 (20/46 patients) and Gal d 2 (24/46) for HE were the most frequently recognized allergens. Using the FCT results as the reference parameter, sIgE to Bos d 8 and Gal d 1 had the highest area under the curves. These were not significantly different from those obtained using the ImmunoCAP. Use of 95% clinical decision points (CDP) for sIgE to Bos d 8 and Gal d 1 resulted in higher negative predictive values (78% and 79%, respectively) than those obtained with the ImmunoCAP (57% and 59%).
  
  
  CONCLUSIONS
  Our results show that in children with suspected CM or HE allergy, the microarray has a good ability to predict the FCT results. In a clinical application perspective, the microarray could be used as a second-level assay, if the ImmunoCAP sIgE is <95% CDP. This approach would lead to a decrease in the number of the FCT to be performed, as well as of positive FCTs with a subsequent decrease in severe reaction risk.
authors.affiliation: Rheumatology Research Laboratory, IRCCS Children's Hospital Bambino Gesù, Rome, Italy.
authors.forename: L E
authors.initials: LE
authors.lastname: D'Urbano
authors.forename: K
authors.initials: K
authors.lastname: Pellegrino
authors.forename: M C
authors.initials: MC
authors.lastname: Artesani
authors.forename: S
authors.initials: S
authors.lastname: Donnanno
authors.forename: R
authors.initials: R
authors.lastname: Luciano
authors.forename: C
authors.initials: C
authors.lastname: Riccardi
authors.forename: A E
authors.initials: AE
authors.lastname: Tozzi
authors.forename: L
authors.initials: L
authors.lastname: Ravà
authors.forename: F
authors.initials: F
authors.lastname: De Benedetti
authors.forename: G
authors.initials: G
authors.lastname: Cavagni
mesh_terms: D000485:Allergens / Q000032:analysis* / Q000276:immunology; D000818:Animals; D019540:Area Under Curve; D002648:Child; D002675:Child, Preschool; D021181:Egg Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D040081:Protein Array Analysis / Q000379:methods*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012882:Skin Tests
chemical_list: D000485:Allergens; D007073:Immunoglobulin E