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  • Component-resolved diagnosi...
    Bublin, Merima, PhD; Pfister, Marina, MD; Radauer, Christian, PhD; Oberhuber, Christina, PhD; Bulley, Sean, PhD; DeWitt, Åsa Marknell, PhD; Lidholm, Jonas, PhD; Reese, Gerald, PhD; Vieths, Stefan, PhD; Breiteneder, Heimo, PhD; Hoffmann-Sommergruber, Karin, PhD; Ballmer-Weber, Barbara K., MD

    Journal of allergy and clinical immunology, 03/2010, Letnik: 125, Številka: 3
    Journal Article

    Background Kiwifruit is one of the most common causes of food allergic reactions. Component-resolved diagnostics may enable significantly improved detection of sensitization to kiwifruit. Objective To evaluate the use of individual allergens for component-resolved in vitro diagnosis of kiwifruit allergy. Methods Thirty patients with a positive double-blind placebo-controlled food challenge to kiwifruit, 10 atopic subjects with negative open provocation to kiwifruit, and 5 nonatopic subjects were enrolled in the study. Specific IgE to 7 individual allergens (nAct d 1-5 and rAct d 8-9) and allergen extracts was measured by ImmunoCAP. Results The diagnostic sensitivities of the commercial extract and of the sum of single allergens were 17% and 77%, respectively, whereas diagnostic specificities were 100% and 30%. A combination of the kiwi allergens Act d 1, Act d 2, Act d 4, and Act d 5 gave a diagnostic sensitivity of 40%, whereas diagnostic specificity remained high (90%). Exclusion of the Bet v 1 homolog recombinant (r) Act d 8 and profilin rAct d 9 from this allergen panel reduced sensitivity to 50% but increased specificity to 40%. Kiwifruit-monosensitized patients reacted more frequently ( P < .001) with Act d 1 than polysensitized patients, whereas the latter group reacted more frequently with rAct d 8 ( P = .004). Conclusion Use of single kiwifruit allergen ImmunoCAP increases the quantitative test performance and diagnostic sensitivity compared with the commercial extract. Bet v 1 homolog and profilin are important allergens in pollen-related kiwifruit allergy, whereas actinidin is important in monoallergy to kiwifruit, in which symptoms are often more severe.