Evaluation of the applicability of the Immuno-solid-phase allergen chip (ISAC) assay in atopic patients in Singapore

Clinical and Translational Allergy

Paul Lorenz Bigliardi⁴  De-Yun Wang⁵  Mei Bigliardi-Qi⁴  Amanda Chang¹  Hung Chew Wong²  Olaf Rotzschke³  Anand Kumar Andiappan³  Amelia Santosa² 

[1] Department of Pharmacy, National University Health System, Singapore, Singapore;Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore;SIgN (Singapore Immunology Network), A*STAR (Agency for Science, Technology and Research), Singapore, Singapore;IMB (Institute of Medical Biology), A*STAR (Agency for Science, Technology and Research), Singapore, Singapore;Department of Otolaryngology, National University of Singapore, Singapore, Singapore

关键词: Skin prick test;    Sensitization;    Atopy;    Specific IgE;    ISAC;   

Others  :  1133963
DOI  :  10.1186/s13601-015-0053-z

 received in 2015-01-17, accepted in 2015-02-19,  发布年份 2015

【 摘 要 】

Background/Objective

Molecular-based allergy diagnostics are gaining popularity in clinical practice. Our aim was to evaluate their role in the tropics, given the inherent genetic and environmental differences.

Methods

We recruited subjects with history of atopy and collected data on demographics and atopic symptoms using validated questionnaires. Subjects underwent a series of skin prick tests (SPT). Serum total and specific IgE levels were measured using ImmunoCAP FEIA and ImmunoCAP ISAC®, respectively. We describe their pattern of sensitization and agreement between test methods.

Results

A total of 135 subjects were recruited; mean ± SD age of 31.18 ± 12.72 years, 52.7% female. Allergic rhinitis (AR) was the most prevalent clinical manifestation of atopy (70.7%), followed by atopic dermatitis (AD) (50.5%) and asthma (26.2%). Polysensitization was seen in 51.1% of subjects by both SPT and ISAC. House dust mites (HDM) were the dominant allergen, with sensitization in 67.8% and 62% of subjects on SPT and ISAC, respectively. A group of subjects with monosensitization to B. tropicalis was identified. HDM sensitization was strongly associated with AR, while AD and asthma were not associated with sensitization to any allergen. Agreement between SPT and ISAC was mostly suboptimal. Greatest agreement was documented for the measurement of HDM sensitization with both methods (κ = 0.64). Sensitization to the bulk of the remaining allergens in the ISAC panel was infrequent.

Conclusion

Multiplex methods should not be used as a screening tool, especially in a population with lower rates of polysensitization and a dominant sensitizing allergen. There may be a role in adjusting the antigen spectrum in the ISAC panel to regional differences.

【 授权许可】

   
2015 Santosa et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Pawankar R, Bunnag C, Khaltaev N, Bousquet J: Allergic rhinitis and its impact on asthma in asia pacific and the ARIA update 2008. World Allergy Organ J 2012, 5(Suppl 3):S212-7. Epub 2012/12/27 BioMed Central Full Text
• [2]Wong GW, Leung TF, Ko FW: Changing prevalence of allergic diseases in the Asia-pacific region. Allergy Asthma Immunol Res 2013, 5(5):251-7. Epub 2013/09/05
• [3]Kilpelainen M, Terho EO, Helenius H, Koskenvuo M: Farm environment in childhood prevents the development of allergies. Clin Exp Allergy 2000, 30(2):201-8. Epub 2000/01/29
• [4]von Mutius E, Braun-Fahrlander C, Schierl R, Riedler J, Ehlermann S, Maisch S, et al.: Exposure to endotoxin or other bacterial components might protect against the development of atopy. Clin Exp Allergy 2000, 30(9):1230-4. Epub 2000/09/06
• [5]Ege MJ, Mayer M, Normand AC, Genuneit J, Cookson WO, Braun-Fahrlander C, et al.: Exposure to environmental microorganisms and childhood asthma. N Engl J Med 2011, 364(8):701-9. Epub 2011/02/25
• [6]Canonica GW, Ansotegui IJ, Pawankar R, Schmid-Grendelmeier P, van Hage M, Baena-Cagnani CE, et al.: A WAO - ARIA - GA(2)LEN consensus document on molecular-based allergy diagnostics. World Allergy Organ J 2013, 6(1):17. Epub 2013/10/05 BioMed Central Full Text
• [7]Inc. TFS. ImmunoCAP ISAC Multiplexing. 2012 [09/01/2014]; Available from: http://www.phadia.com/en/Products/Allergy-testing-products/ImmunoCAP-ISAC/.
• [8]Kim DS, Bae JM, Jee H, Lee H, Kim DY, Kim SM, et al. Analysis of Contact Allergens in Korean Polysensitized Patients by Patch Testing: A Pilot Study. Acta Dermato-Venereologica. 2013. Epub 2013/07/03.
• [9]Kidon MI, See Y, Bun CY, Goh A, Chay OM, Balakrishnan A: Bimodal skin reactivity to histamine in atopic children in Singapore: influence of specific sensitizations. Pediatr Allergy Immunol 2004, 15(6):545-50. Epub 2004/12/22
• [10]Kidon MI, See Y, Goh A, Chay OM, Balakrishnan A: Aeroallergen sensitization in pediatric allergic rhinitis in Singapore: is air-conditioning a factor in the tropics? Pediatr Allergy Immunol 2004, 15(4):340-3. Epub 2004/08/13
• [11]Khoo J, Shek L, Khor ES, Wang DY, Lee BW: Pattern of sensitization to common environmental allergens amongst atopic Singapore children in the first 3 years of life. Asian Pac J Allergy Immunol 2001, 19(4):225-9. Epub 2002/05/15
• [12]Andiappan AK, Puan KJ, Lee B, Nardin A, Poidinger M, Connolly J, et al.: Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites. Allergy 2014, 69(4):501-9. Epub 2014/01/25
• [13]Ciprandi G, Alesina R, Ariano R, Aurnia P, Borrelli P, Cadario G, et al.: Characteristics of patients with allergic polysensitization: the POLISMAIL study. Eur Ann Allergy Clin Immunol 2008, 40(3):77-83. Epub 2009/04/02
• [14]European Community Respiratory Health Survey IISC: The European Community Respiratory Health Survey II Eur Respir J 2002, 20(5):1071-9. Epub 2002/11/27
• [15]Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al.: Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008, 63(Suppl 86):8-160. Epub 2008/03/26
• [16]Bousquet J, Burney PG, Zuberbier T, Cauwenberge PV, Akdis CA, Bindslev-Jensen C, et al.: GA2LEN (Global Allergy and Asthma European Network) addresses the allergy and asthma ‘epidemic’. Allergy 2009, 64(7):969-77. Epub 2009/04/28
• [17]Phadia AB U, Sweden ImmunoCAP ISAC. 2008 [updated May 200909/01/2014]; Available from: http://www.phadia.com/Global/Corporate%20Allergy/Files/DfU/Assay%20Kit%20IgE/DfU-ImmunoCAP-ISAC-20-01-02-3-RUO.pdf.
• [18]Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977, 33(1):159-74. Epub 1977/03/01
• [19]Weghofer M, Thomas WR, Kronqvist M, Mari A, Purohit A, Pauli G, et al.: Variability of IgE reactivity profiles among European mite allergic patients. Eur J Clin Invest 2008, 38(12):959-65. Epub 2008/11/22
• [20]Wang DY, Goh DY, Ho AK, Chew FT, Yeoh KH, Lee BW: The upper and lower airway responses to nasal challenge with house-dust mite Blomia tropicalis. Allergy 2003, 58(1):78-82. Epub 2003/02/13
• [21]van Ree R, Antonicelli L, Akkerdaas JH, Garritani MS, Aalberse RC, Bonifazi F: Possible induction of food allergy during mite immunotherapy. Allergy 1996, 51(2):108-13. Epub 1996/02/01
• [22]Fernandes J, Reshef A, Patton L, Ayuso R, Reese G, Lehrer SB: Immunoglobulin E antibody reactivity to the major shrimp allergen, tropomyosin, in unexposed Orthodox Jews. Clin Exp Allergy 2003, 33(7):956-61. Epub 2003/07/16
• [23]Millon L, Roussel S, Rognon B, Quadroni M, Salamin K, Reboux G, et al.: Aspergillus species recombinant antigens for serodiagnosis of farmer’s lung disease. J Allergy Clin Immunol 2012, 130(3):803-5. 3. Epub 2012/05/23
• [24]Choi JS, Roh JY, Lee JR: Clinical availability of component-resolved diagnosis using microarray technology in atopic dermatitis. Ann Dermatol 2014, 26(4):437-46. Epub 2014/08/22