title: In vivo and in vitro testing with rAni s 1 can facilitate diagnosis of Anisakis simplex allergy.
abstract: BACKGROUND
  Traditional diagnostic tests such as skin prick tests (SPT) and specific IgE (slgE) against whole Anisakis simplex extract have low specificity. Consequently, allergy to A simplex is overdiagnosed.
  
  
  OBJECTIVE
  Our aim was to compare tests used in component-resolved diagnosis.
  
  
  METHODS
  We evaluated 34 patients with allergy to A simplex, 15 patients with acute urticaria who were sensitized to A simplex but had no clinical history of allergy to A simplex, and 10 patients allergic to seafood. SPT, slgE (ELISA and ISAC-I 12), and the basophil activation test (BAT) were performed with A simplex whole extract and the molecular components rAni s 1, rAni s 3, and nPen m 1. Sensitivity and specificity were calculated and compared with different cutoffs.
  
  
  RESULTS
  With the A simplex whole extract, SPT, slgE, and BAT yielded specificity values of 72%, 68%, and 70%, respectively, with a cutoff (wheal size) of 11.2 mm, an slgE value of 7.9 kUAIL, and a stimulation index of 1.9. Specificity increased to 100% using the molecular component rAni s 1 with SPT, slgE by ELISA, and ISAC-112. Neither rAni s 3 sensitization nor cross-reactivity with Pen m 1 was observed in patients sensitized to A simplex.
  
  
  CONCLUSIONS
  rAni s 1 is recognized by 100% of our patients and is able to distinguish between patients allergic to A simplex and patients with acute urticaria who are sensitized to A simplex but have no clinical history of allergy to this parasite.
authors: R M
authors: RM
authors: Martínez-Aranguren
authors: P M
authors: PM
authors: Gamboa
authors: E
authors: E
authors: García-Lirio
authors: J
authors: J
authors: Asturias
authors: M J
authors: MJ
authors: Goikoetxea
authors: M L
authors: ML
authors: Sanz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology*; D000818:Animals; D017163:Anisakis / Q000276:immunology*; D002135:Calcium-Binding Proteins / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015801:Helminth Proteins / Q000276:immunology*; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis*; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012882:Skin Tests
chemical_list: D000485:Allergens; D002135:Calcium-Binding Proteins; D015801:Helminth Proteins; C412511:troponin-like protein, Anisakis simplex; D007073:Immunoglobulin E