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Cell-Based Functional IgE Assays Are Superior to Conventional Allergy Tests for Shrimp Allergy Diagnosis
- Source :
- The journal of allergy and clinical immunology. In practice. 9(1)
- Publication Year :
- 2020
-
Abstract
- Background The diagnosis of shellfish allergy currently relies on patient history, skin prick test (SPT), and serum specific IgE (sIgE) quantification. These methods lack sufficient diagnostic accuracy, whereas the gold standard of oral food challenges is risky and burdensome. Markers of reactivity and severity of allergic reactions to shellfish will improve clinical care of these patients. Objectives This study compared the diagnostic performance of SPT, sIgE, basophil activation test (BAT), and IgE crosslinking–induced luciferase expression (EXiLE) test for shrimp allergy. Methods Thirty-five subjects with documented history of shrimp allergic reactions were recruited and grouped according to results of double-blind, placebo-controlled food challenge (DBPCFC). In addition to routine diagnostics, BAT (Flow CAST) and EXiLE test with shrimp extract and tropomyosin were performed. Results Of 35 subjects, 15 were shrimp allergic with pruritus, urticaria, and itchy mouth on DBPCFC, whereas 20 were tolerant to shrimp. Tropomyosin only accounted for 53.3% of sensitization among subjects with challenge-proven shrimp allergy. BAT using shrimp extract as stimulant showed the highest area under curve value (0.88), Youden Index (0.81), likelihood ratio (14.73), odds ratio (104), and variable importance (4.27) when compared with other assays and tropomyosin diagnosis. Results of BAT significantly correlated with those of EXiLE (r = 0.664, P Conclusions BAT is a more accurate diagnostic marker for shrimp allergy than SPT and shrimp sIgE, whereas the EXiLE test based on an IgE crosslinking assay is a good alternative to BAT. Tropomyosin may not be the most important shrimp allergen in Chinese, which warrants further investigation to search for other major allergens and diagnostic markers.
- Subjects :
- Allergy
animal structures
Tropomyosin
Immunoglobulin E
medicine.disease_cause
03 medical and health sciences
0302 clinical medicine
Allergen
medicine
Immunology and Allergy
Animals
Humans
030212 general & internal medicine
SCORAD
Skin Tests
biology
medicine.diagnostic_test
business.industry
fungi
Shellfish allergy
Gold standard (test)
Allergens
medicine.disease
Shrimp
Basophil activation
030228 respiratory system
Immunology
biology.protein
business
Food Hypersensitivity
Subjects
Details
- ISSN :
- 22132201
- Volume :
- 9
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The journal of allergy and clinical immunology. In practice
- Accession number :
- edsair.doi.dedup.....5afcc2e22062324b93ce60d54b4191e7