Cell-Based Functional IgE Assays Are Superior to Conventional Allergy Tests for Shrimp Allergy Diagnosis.

Wai, CYY ; Leung, NYH ; et al.

In: The journal of allergy and clinical immunology. In practice, Jg. 9 (2021), Heft 1, S. 236-244.e9

academicJournal

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 < .0001).

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.

Titel:	Cell-Based Functional IgE Assays Are Superior to Conventional Allergy Tests for Shrimp Allergy Diagnosis.
Autor/in / Beteiligte Person:	Wai, CYY ; Leung, NYH ; Leung, ASY ; Shum, Y ; Leung, PSC ; Chu, KH ; Kwan, YW ; Lee, QU ; Wong, JSC ; Lam, ICS ; Li, PF ; Xu, KJY ; Lam, CY ; Sun, J ; Wong, GWK ; Leung, TF
Zeitschrift:	The journal of allergy and clinical immunology. In practice, Jg. 9 (2021), Heft 1, S. 236-244.e9
Veröffentlichung:	New York, NY : Elsevier Inc., [2013]-, 2021
Medientyp:	academicJournal
ISSN:	2213-2201 (electronic)
DOI:	10.1016/j.jaip.2020.08.057
Schlagwort:	Allergens Animals Humans Immunoglobulin E Skin Tests Tropomyosin Food Hypersensitivity diagnosis
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Language: English [J Allergy Clin Immunol Pract] 2021 Jan; Vol. 9 (1), pp. 236-244.e9. <i>Date of Electronic Publication: </i>2020 Sep 12. MeSH Terms: Food Hypersensitivity* / diagnosis ; Allergens ; Animals ; Humans ; Immunoglobulin E ; Skin Tests ; Tropomyosin Contributed Indexing: Keywords: Basophil activation test; CCR3; CD63; DBPCFC; IgE crosslinking–induced luciferase expression test; Shrimp allergy; Tropomyosin Substance Nomenclature: 0 (Allergens) ; 0 (Tropomyosin) ; 37341-29-0 (Immunoglobulin E) Entry Date(s): Date Created: 20200915 Date Completed: 20210521 Latest Revision: 20210521 Update Code: 20231215

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