Interleukin-4 enzyme-linked immunospot assay may be useful for diagnosing sensitization to house dust mite.
The skin prick test (SPT) is considered a standard test for identification of allergens, but it has some limitations in clinical practice. The multiple allergen simultaneous test (MAST), which measures allergen-specific immunoglobulin E in patients' serum, is a widely used alternative test, but is limited by its relatively low sensitivity and specificity. As a novel diagnostic test to identify allergens, we investigated the sensitivity and specificity of an interleukin-4 (IL-4) enzyme-linked immunospot (ELISpot) assay for Dermatophagoides farinae (Der f) and Dermatophagoides pteronyssinus (Der p).



Based on the symptoms and SPT results, 43 house dust mite (HDM) allergic rhinitis (AR) patients and 41 control subjects were included. Peripheral blood was drawn from each subject for IL-4 ELISpot assay and MAST. The receiver operating characteristic (ROC) curve analysis was conducted to determine the cutoff values. Sensitivity, specificity, and positive and neg predictive values were compared between the 2 tests.



The sensitivity, specificity, and areas under the ROC curve (AUCs) of the IL-4 ELISpot assay were 88.4%, 97.6%, and 0.939 for Der f, and 95.3%, 97.5%, and 0.971 for Der p, respectively. However, the sensitivity, specificity, and AUC of MAST were 76.7%, 73.2%, and 0.777 for Der f, and 69.8%, 75.6%, and 0.788 for Der p, respectively.



The IL-4 ELISpot assay showed higher sensitivity, specificity, and AUC than MAST, which indicates its clinical feasibility for diagnosing allergy for HDM. A further study is needed to determine the accuracy of the IL-4 ELISpot assay for other common allergens.
Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.|Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Dong-Yeop
DY
Chang
Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea.
Jino
J
Lee
Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea.
Sung-Won
SW
Choi
Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Hyeong Joo
HJ
Lee
Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Hyunmo
H
Kang
Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Seong Chul
SC
Yeo
Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Yeon-Hee
YH
Joo
Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.|Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Hyun-Jin
HJ
Cho
Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.|Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea.|Department of Otorhinolaryngology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
Sea-Yuong
SY
Jeon
Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju, Republic of Korea.
Rock Bum
RB
Kim
Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea. astroflower77@hanmail.net.|Department of Otorhinolaryngology, Gyeongsang National University Hospital, Jinju, Republic of Korea. astroflower77@hanmail.net.|Department of Otorhinolaryngology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea. astroflower77@hanmail.net.
Sang-Wook
SW
Kim
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology; D002648:Child; D040001:Dermatophagoides farinae / Q000276:immunology; D040002:Dermatophagoides pteronyssinus / Q000276:immunology; D058501:Enzyme-Linked Immunospot Assay / Q000379:methods*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D015847:Interleukin-4 / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D039981:Pyroglyphidae / Q000276:immunology; D065631:Rhinitis, Allergic / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D012680:Sensitivity and Specificity; D012882:Skin Tests; D055815:Young Adult
D000485:Allergens; D039741:Antigens, Dermatophagoides; C508598:IL4 protein, human; D015847:Interleukin-4; D007073:Immunoglobulin E
allergic rhinitis; allergy; enzyme-linked immunospot assay; house dust mites; interleukin-4