title: Allergy testing in children with persistent asthma: comparison of four diagnostic methods.
abstract: BACKGROUND
  Multiple allergic sensitizations are common in persistent childhood asthma, and thorough assessment of allergy is crucial for optimal care of these children. Microarray testing offers opportunities for improved sIgE characterization, which has been projected to be useful in the management of multisensitized patients.
  
  
  OBJECTIVE
  The aim of this study was to investigate the accuracy and information obtained by two microarray platforms applied on a well-characterized pediatric asthma cohort.
  
  
  METHODS
  Seventy-one children were recruited from a nationwide Swedish study on severe childhood asthma. Severe (n = 40) and controlled (n = 31) asthmatics were assessed for allergic sensitization by two microarray systems (Microtest and ISAC) and by two standard diagnostic methods (ImmunoCAP and skin prick test). Data on clinical history, physical examination, spirometry, asthma control test, and doctor's diagnosis were collected. Results from the four diagnostic methods were analyzed and compared.
  
  
  RESULTS
  A high prevalence of allergic sensitization was observed in this cohort. The pairwise concordance between two methods was 90-92% independently of methods compared. The sensitivity of the four methods against doctor's diagnosis was 0.77-0.88, and the specificity was 0.97-0.99. Microarray methods provided new information in 47% of the sensitized children in comparison with results obtained by standard diagnostic methods.
  
  
  CONCLUSIONS
  The high prevalence of food and respiratory sensitization supports the clinical guideline recommendation that allergies should be evaluated in all children with suspected asthma. The microarray platforms studied here demonstrated acceptable accuracy and provided refined IgE characterization in 47% of the patients compared to standard extract-based methods.
authors.affiliation: Microtest Dx, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Önell
authors.affiliation: Department of Clinical Neuroscience, Karolinska institutet, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Whiteman
authors.affiliation: Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.|Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Nordlund
authors.affiliation: Microtest Dx, London, UK.
authors.forename: F
authors.initials: F
authors.lastname: Baldracchini
authors.affiliation: Microtest Dx, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Mazzoleni
authors.affiliation: Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.|Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Hedlin
authors.affiliation: Department of Clinical Neuroscience, Karolinska institutet, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Grönlund
authors.affiliation: Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.|Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.|Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: J R
authors.initials: JR
authors.lastname: Konradsen
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology*; D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D002648:Child; D019468:Disease Management; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D007118:Immunoassay / Q000379:methods / Q000592:standards; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D040081:Protein Array Analysis / Q000379:methods* / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012882:Skin Tests / Q000379:methods
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: allergen component; microarray; multiplex; pediatric asthma; sIgE