title: Is Microarray Analysis Really Useful and Sufficient to Diagnose Nut Allergy in the Mediterranean Area?
abstract: BACKGROUND
  Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been evaluated in nut allergy.
  
  
  OBJECTIVE
  To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut, hazelnut, and walnut allergy.
  
  
  METHODS
  sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently, sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to measure sIgE to Ara h 9, Cora 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges.
  
  
  RESULTS
  Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8, 80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in, respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative ISAC results. In the subgroup of peach LTP-sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC (94.4% vs 72.2%, P < .05). Similar rates of Cora 8 and Jug r 3 sensitization were detected by both techniques.
  
  
  CONCLUSIONS
  The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity against Ara h 9 in ISAC needs to be improved.
authors.forename: M J
authors.initials: MJ
authors.lastname: Goikoetxea
authors.lastname: D'Amelio C M
authors.forename: R
authors.initials: R
authors.lastname: Martínez-Aranguren
authors.forename: P
authors.initials: P
authors.lastname: Gamboa
authors.forename: B E
authors.initials: BE
authors.lastname: Garcia
authors.forename: F
authors.initials: F
authors.lastname: Gómez
authors.lastname: Fernández J
authors.forename: J
authors.initials: J
authors.lastname: Bartra
authors.forename: A
authors.initials: A
authors.lastname: Parra
authors.forename: M I
authors.initials: MI
authors.lastname: Alvarado
authors.forename: M I
authors.initials: MI
authors.lastname: Alonso
authors.forename: E
authors.initials: E
authors.lastname: González
authors.forename: S
authors.initials: S
authors.lastname: Terrados
authors.forename: C
authors.initials: C
authors.lastname: Moya
authors.forename: N
authors.initials: N
authors.lastname: Blanca
authors.forename: F
authors.initials: F
authors.lastname: Feo-Brito
authors.forename: M
authors.initials: M
authors.lastname: Villalba
authors.forename: A
authors.initials: A
authors.lastname: Díaz-Perales
authors.forename: M L
authors.initials: ML
authors.lastname: Sanz
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D031211:Corylus / Q000276:immunology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007428:Intradermal Tests; D031324:Juglans / Q000276:immunology*; D008297:Male; D019083:Mediterranean Region; D008875:Middle Aged; D021184:Nut Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D009754:Nuts / Q000276:immunology*; D021183:Peanut Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D010940:Plant Proteins / Q000276:immunology*; D011237:Predictive Value of Tests; D040081:Protein Array Analysis; D013030:Spain; D055815:Young Adult
chemical_list: D000485:Allergens; D015415:Biomarkers; D010940:Plant Proteins; D007073:Immunoglobulin E