title: Determination of sIgE to rPhl p 1 is sufficient to diagnose grass pollen allergy.
abstract: BACKGROUND
  New diagnostic tools such as the basophil activation test (BAT) and component-resolved diagnosis (CRD) are promising for Hymenoptera venom or food allergy. A clear benefit for inhalant allergens has not yet been shown. Our aim was to compare new and established tests for grass pollen allergy.
  
  
  METHODS
  Forty-nine patients with grass pollen allergy and 47 controls were prospectively enrolled in the study. A symptom score was calculated for each patient. Conjunctival provocation tests (CPT), skin prick tests (SPT), BAT, and sIgE determination including CRD were performed. Sensitivity and specificity were compared and results were correlated with the symptom score.
  
  
  RESULTS
  Single determination of sIgE to rPhl p 1 showed the best balance between sensitivity (98%) and specificity (92%). Use of additional components, such as rPhl p 2 and 5, did not increase sensitivity. Generally, sensitivity of tests was high: SPT 100%, ISAC-112 100%, sIgE to timothy grass 98%, BAT 98%, ISAC-103 84%, and CPT 83%. Specificity ranged from 79% (SPT) to 96% (CPT). All test results and calculated values (e.g. ratio sIgE/tIgE) did not correlate with symptom severity. Asymptomatic sensitization to timothy grass in controls was rare in the CAP (11%) and predominantly due to Phl p 1 sensitization.
  
  
  CONCLUSIONS
  rPhl p 1 was sufficient to diagnose grass pollen allergy, and sIgE patterns were the same in symptomatically and asymptomatically sensitized subjects. The testing of multiple components was of minor importance, and no test correlated with symptom severity.
authors.affiliation: Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Bokanovic
authors.forename: W
authors.initials: W
authors.lastname: Aberer
authors.forename: W
authors.initials: W
authors.lastname: Hemmer
authors.forename: A
authors.initials: A
authors.lastname: Heinemann
authors.forename: P
authors.initials: P
authors.lastname: Komericki
authors.forename: J
authors.initials: J
authors.lastname: Scheffel
authors.forename: G J
authors.initials: GJ
authors.lastname: Sturm
mesh_terms: D052179:Antigens, Plant / Q000008:administration & dosage / Q000276:immunology*; D001491:Basophils / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D007073:Immunoglobulin E / Q000096:biosynthesis* / Q000097:blood*; D031784:Phleum / Q000276:immunology; D010936:Plant Extracts / Q000008:administration & dosage / Q000276:immunology*; D011058:Pollen / Q000276:immunology*; D011446:Prospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D012882:Skin Tests / Q000379:methods*
chemical_list: D052179:Antigens, Plant; D010936:Plant Extracts; C451253:grass pollen extract, alum-adsorbed; D007073:Immunoglobulin E
keywords: basophil activation test; component-resolved diagnosis; conjunctival provocation test; grass pollen allergy; immuno solid-phase allergen chip (ISAC)