title: Real-Life Study for the Diagnosis of House Dust Mite Allergy - The Value of Recombinant Allergen-Based IgE Serology.
abstract: BACKGROUND
  Dermatophagoides pteronyssinus is one of the most important perennial allergen sources worldwide. Molecular diagnostics using the commercially available major allergens (Der p 1 and Der p 2) in combination with Der p 10 do not detect house dust mite (HDM) sensitization in a number of cases when used alone. The objective was to evaluate the IgE reactivity profiles of these patients using an experimental immunoassay biochip.
  
  
  METHODS
  Sera of HDM-allergic patients (positive skin prick test, CAP class ≥1 for allergen extract, and positive intranasal provocation) were tested for IgE antibodies against Der p 1, Der p 2, and Der p 10 by ImmunoCAP fluorescence enzyme immunoassay. Negatively tested sera were examined by an experimental chip containing 13 microarrayed HDM allergens.
  
  
  RESULTS
  Of 97 patients tested, 16 showed negative results to Der p 1, Der p 2, and Der p 10. MeDALL chip evaluation revealed 5 patients monosensitized to Der p 23, and 11 patients were negative for all HDM MeDALL chip components. Seven sera were available for further testing, and 3 of them showed IgE reactivity to dot-blotted nDer p 1, and 2 reacted with high-molecular weight components (>100 kDa) in nitrocellulose-blotted HDM extract when tested with 125I-labeled anti-IgE in a RAST-based assay. The HDM extract-specific IgE levels of the 11 patients were <3.9 kU/l.
  
  
  CONCLUSIONS
  Recombinant allergen-based IgE serology is of great value when conventional IgE diagnostics fails. Der p 23 is an important HDM allergen, especially when major allergens are negative. Therefore, it would be desirable to have Der p 23 commercially available. Further research concerning the prevalence and clinical significance of different HDM allergens is needed.
authors: Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
authors: Sven
authors: S
authors: Becker
authors: Thomas
authors: T
authors: Schlederer
authors: Matthias F
authors: MF
authors: Kramer
authors: Mareike
authors: M
authors: Haack
authors: Susanne
authors: S
authors: Vrtala
authors: Yvonne
authors: Y
authors: Resch
authors: Christian
authors: C
authors: Lupinek
authors: Rudolf
authors: R
authors: Valenta
authors: Moritz
authors: M
authors: Gröger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology; D002648:Child; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D039981:Pyroglyphidae / Q000276:immunology*; D012698:Serologic Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; D007073:Immunoglobulin E