|
Background:
Traditional
diagnostic tests
such as skin prick
tests (SPT) and
specific IgE (sIgE)
against whole
Anisakis simplex
extract have low
specificity.
Consequently,
allergy to A
simplex is
overdiagnosed.
Objective:
Our aim was to
compare tests used
in
component-resolved
diagnosis.
Methods: We
evaluated 34
patients with
allergy to A
simplex, 15
patients with acute
urticaria who were
sensitized to A
simplex but had no
clinical history of
allergy to A
simplex, and 10
patients allergic to
seafood. SPT, sIgE
(ELISA and
ISAC-112), and the
basophil activation
test (BAT) were
performed with A
simplex whole
extract and the
molecular components
rAni s 1, rAni s 3,
and nPen m 1.
Sensitivity and
specificity were
calculated and
compared with
different cutoffs.
Results: With
the A simplex
whole extract, SPT,
sIgE, and BAT
yielded specificity
values of 72%, 68%,
and 70%,
respectively, with a
cutoff (wheal size)
of 11.2 mm, an sIgE
value of 7.9 kUA/L,
and a stimulation
index of 1.9.
Specificity
increased to 100%
using the molecular
component rAni s 1
with SPT, sIgE by
ELISA, and ISAC-112.
Neither rAni s 3
sensitization nor
cross-reactivity
with Pen m 1 was
observed in patients
sensitized to A
simplex.
Conclusion:
rAni s 1 is
recognized by 100%
of our patients and
is able to
distinguish between
patients allergic to
A simplex and
patients with acute
urticaria who are
sensitized to A
simplex but have
no clinical history
of allergy to this
parasite.
Key words:
Anisakis simplex
allergy. Acute
urticaria. Ani s 1.
Component-resolved
diagnosis. In vitro
test. BAT. ISAC.
ELISA. |
