title: The additional values of microarray allergen assay in the management of polysensitized patients with respiratory allergy.
abstract: BACKGROUND
  The IgE response is directed against specific components from an allergenic source. The traditional diagnostic methods use whole extracts, containing allergenic, nonallergenic and cross-reactive molecules. This may pose diagnostic challenges in polysensitized patients. Microarray techniques detect specific IgE against multiple molecules, but their value in term of additional information and economic saving has not been yet defined.
  
  
  OBJECTIVE
  We assessed the additional diagnostic information provided by an allergen microarray in a large population of polysensitized subjects.
  
  
  METHODS
  In this multicentre study, allergists were required to carefully record diagnosis and treatment of consecutive patients referred for asthma/rhinitis, using the standard methodology (history, skin prick test, IgE assay). Then, a microarray allergen assay was carried out. Clinicians were required to review their diagnosis/treatment according to microarray results.
  
  
  RESULTS
  318 allergic patients (30% reporting also nonrespiratory symptoms) and 91 controls were enrolled. The clinicians reported at least one additional information from the microarray in about 60% of patients, this resulting in therapeutic adjustments. In 66% of patients IgE to pan-allergens were detectable, being this clinically relevant in 38% of patients with polysensitization to pollens.
  
  
  CONCLUSIONS
  Microarray IgE assay represents an advancement in allergy diagnosis, as a third-level approach in polysensitized subjects, when the traditional diagnosis may be problematic.
authors.affiliation: Allergy and Respiratory Diseases, IRCCS San Martino Hospital-University of Genoa-IST, Genoa, Italy. passalacqua@unige.it
authors.forename: G
authors.initials: G
authors.lastname: Passalacqua
authors.forename: G
authors.initials: G
authors.lastname: Melioli
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
authors.forename: S
authors.initials: S
authors.lastname: Bonini
authors.forename: E
authors.initials: E
authors.lastname: Maggi
authors.forename: G
authors.initials: G
authors.lastname: Senna
authors.forename: M
authors.initials: M
authors.lastname: Triggiani
authors.forename: E
authors.initials: E
authors.lastname: Nettis
authors.forename: R E
authors.initials: RE
authors.lastname: Rossi
authors.forename: A
authors.initials: A
authors.lastname: Vacca
authors.forename: G W
authors.initials: GW
authors.lastname: Canonica
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000145:classification / Q000276:immunology* / Q000378:metabolism; D000818:Animals; D000918:Antibody Specificity; D001249:Asthma / Q000145:classification / Q000175:diagnosis / Q000276:immunology; D002648:Child; D003429:Cross Reactions; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000096:biosynthesis* / Q000097:blood; D056656:Lab-On-A-Chip Devices; D008297:Male; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis / Q000191:economics / Q000379:methods* / Q000592:standards; D011446:Prospective Studies; D012130:Respiratory Hypersensitivity / Q000145:classification / Q000175:diagnosis* / Q000276:immunology*; D012220:Rhinitis / Q000145:classification / Q000175:diagnosis / Q000276:immunology; D055815:Young Adult
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: ISAC microarray; IgE assay; polysensitization; respiratory allergy; skin prick test