Ann Dermatol.  2014 Aug;26(4):437-446. 10.5021/ad.2014.26.4.437.

Clinical Availability of Component-Resolved Diagnosis Using Microarray Technology in Atopic Dermatitis

• Choi JS
• Roh JY
• Lee JR

• KMID: 2265583
• DOI: http://doi.org/10.5021/ad.2014.26.4.437

Abstract

BACKGROUND
Various allergens play a role in the elicitation or exacerbation of eczematous skin lesions in atopic dermatitis (AD), and much research effort has been focused on improving diagnostic tests to identify causative allergens.
OBJECTIVE
The purpose of this study was to evaluate the diagnostic effectiveness of a newly introduced microarray-based specific immunoglobulin E detection assay, ImmunoCAP ISAC, for use in AD patients.
METHODS
The serum samples of 25 AD patients were tested by using ISAC and a multiple allergen simultaneous test-enzyme immunoassay (MAST-EIA). In addition, 10 of the 25 patients underwent skin prick testing (SPT). The positive reaction rates to allergens in each test and the agreements, sensitivities, and specificities of ISAC and MAST-EIA were evaluated versus the SPT results.
RESULTS
For ISAC versus SPT, the overall results were as follows: sensitivity, 90.0%; specificity, 98.2%; positive predictive value (PPV), 90.0%; and negative predictive value (NPV), 98.2%. The total agreement and kappa value for ISAC versus SPT were 96.9% and 0.882, respectively. For MAST-EIA versus SPT, the sensitivity was 80.0%, specificity 92.7%, PPV 66.7%, and NPV 96.2%. The total agreement and kappa value for MAST-EIA versus SPT were 90.8% and 0.672, respectively. The overall agreement between the ISAC and MAST-EIA results was 88%.
CONCLUSION
The ISAC results in AD correlated well with the SPT results, and compared favorably to the MAST-EIA results. This study demonstrates the potential of ISAC as a convenient allergic diagnostic method in AD patients.

Keyword

Atopic dermatitis; Microarray-based specific IgE detection assay

MeSH Terms

Allergens
Dermatitis, Atopic*
Diagnosis*
Diagnostic Tests, Routine
Humans
Immunoassay
Immunoglobulin E
Immunoglobulins
Skin
Allergens
Immunoglobulin E
Immunoglobulins

Reference

1. Scalabrin DM, Bavbek S, Perzanowski MS, Wilson BB, Platts-Mills TA, Wheatley LM. Use of specific IgE in assessing the relevance of fungal and dust mite allergens to atopic dermatitis: a comparison with asthmatic and nonasthmatic control subjects. J Allergy Clin Immunol. 1999; 104:1273–1279.

2. Garcia-Marcos L, Sanchez-Solis M, Martinez-Torres AE, Lucas Moreno JM, Hernando Sastre V. Phadiatop compared to skin-prick test as a tool for diagnosing atopy in epidemiological studies in schoolchildren. Pediatr Allergy Immunol. 2007; 18:240–244.

3. Shin JW, Jin SP, Lee JH, Cho S. Analysis of MAST-CLA results as a diagnostic tool in allergic skin diseases. Ann Dermatol. 2010; 22:35–40.

4. Park DS, Cho JH, Lee KE, Ko OS, Kim HR, Choi SI, et al. Detection rate of allergen-specific IgE by multiple antigen simultaneous test-immunoblot assay. Korean J Lab Med. 2004; 24:131–138.

5. Lee JH, Park KH, Kim HS, Kim KW, Sohn MH, Kim CH, et al. Specific IgE measurement using AdvanSure® system: comparison of detection performance with ImmunoCAP® system in Korean allergy patients. Clin Chim Acta. 2012; 413:914–919.

6. Ferrer M, Sanz ML, Sastre J, Bartra J, del Cuvillo A, Montoro J, et al. Molecular diagnosis in allergology: application of the microarray technique. J Investig Allergol Clin Immunol. 2009; 19:Suppl 1. 19–24.

7. Sastre J. Molecular diagnosis in allergy. Clin Exp Allergy. 2010; 40:1442–1460.

8. Hanifin JM, Rajka RG. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980; 60:Suppl 92. 44–47.

9. Lucas JM. Microarrays: molecular allergology and nanotechnology for personalised medicine (I). Allergol Immunopathol (Madr). 2010; 38:153–161.

10. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33:159–174.

11. Mari A, Scala E, Alessandri C. The IgE-microarray testing in atopic dermatitis: a suitable modern tool for the immunological and clinical phenotyping of the disease. Curr Opin Allergy Clin Immunol. 2011; 11:438–444.

12. Lim HS, Kim HS, Oh H. Current status of serum allergen tests in Korea. Korean J Lab Med. 2008; 28:124–129.

13. Kniker WT. Is the choice of allergy skin testing versus in vitro determination of specific IgE no longer a scientific issue? Ann Allergy. 1989; 62:373–374.

14. Sampson HA. Improving in-vitro tests for the diagnosis of food hypersensitivity. Curr Opin Allergy Clin Immunol. 2002; 2:257–261.

15. Valenta R, Vrtala S. Recombinant allergens for specific immunotherapy. Allergy. 1999; 54:Suppl 56. 43–44.

16. Treudler R. Update on in vitro allergy diagnostics. J Dtsch Dermatol Ges. 2012; 10:89–97.

17. Sampson HA, McCaskill CC. Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr. 1985; 107:669–675.

18. Lee EJ, Piao YJ, Kim KH, Suhr KB, Lee JH, Park JK. The relationship among the clinical evaluation, total ige, and allergen-specific IgE of MAST-CLA in atopic dermatitis. Korean J Dermatol. 2003; 41:197–206.

19. Kim HD, Cho MK, Lee SY, Lee JS, Park YL, Whang KU, et al. Evaluation of the MAST CLA allergy system for measuring total and allergen specific IgE in child and adult atopic dermatitis. Korean J Dermatol. 2007; 45:413–421.

20. Chun TJ, Lee KS, Seo SJ, Kim MN, Hong CK, Ro BI. A comparison study of prick test and chemiluminescent assay. Korean J Dermatol. 1999; 37:1450–1456.

21. Garcia-Marcos L, Sanchez-Solis M, Martinez-Torres AE, Lucas Moreno JM, Hernando Sastre V. Phadiatop compared to skin-prick test as a tool for diagnosing atopy in epidemiological studies in schoolchildren. Pediatr Allergy Immunol. 2007; 18:240–244.

22. Contin-Bordes C, Petersen A, Chahine I, Boralevi F, Chahine H, Taïeb A, et al. Comparison of ADVIA Centaur and Pharmacia UniCAP tests in the diagnosis of food allergy in children with atopic dermatitis. Pediatr Allergy Immunol. 2007; 18:614–620.

23. Lee IW, Kim TH, Ahn SK, Choi EH. Comparison of MAST chemiluminescent assay (MAST-CLA) with skin prick, test in patients with atopic dermatitis. Korean J Dermatol. 1999; 37:297–304.

24. Jang WR, Nahm CH, Kim JH, Lim DH, Jang TY, Moon YS, et al. Allergen specific IgE measurement with Polycheck Allergy: comparison of three multiple allergen simultaneous tests. Korean J Lab Med. 2009; 29:465–472.

25. Jeon HJ, Bang HD, Kim KH, Park CW, Kim KJ, Lee CH. A study of food allergy in atopic dermatitis using CAP-RAST FEIA and open food challenge test. Korean J Dermatol. 2003; 41:1034–1040.

26. Jin C, Hantusch B, Hemmer W, Stadlmann J, Altmann F. Affinity of IgE and IgG against cross-reactive carbohydrate determinants on plant and insect glycoproteins. J Allergy Clin Immunol. 2008; 121:185–190.

27. Resch Y, Weghofer M, Seiberler S, Horak F, Scheiblhofer S, Linhart B, et al. Molecular characterization of Der p 10: a diagnostic marker for broad sensitization in house dust mite allergy. Clin Exp Allergy. 2011; 41:1468–1477.

28. Frati F, Incorvaia C, David M, Scurati S, Seta S, Padua G, et al. Requirements for acquiring a high-quality house dust mite extract for allergen immunotherapy. Drug Des Devel Ther. 2012; 6:117–123.

29. Zuidmeer L, van Ree R. Lipid transfer protein allergy: primary food allergy or pollen/food syndrome in some cases. Curr Opin Allergy Clin Immunol. 2007; 7:269–273.

30. Lombardero M, García-Sellés FJ, Polo F, Jimeno L, Chamorro MJ, García-Casado G, et al. Prevalence of sensitization to Artemisia allergens Art v 1, Art v 3 and Art v 60 kDa. Crossreactivity among Art v 3 and other relevant lipid-transfer protein allergens. Clin Exp Allergy. 2004; 34:1415–1421.

31. Gadermaier G, Harrer A, Girbl T, Palazzo P, Himly M, Vogel L, et al. Isoform identification and characterization of Art v 3, the lipid-transfer protein of mugwort pollen. Mol Immunol. 2009; 46:1919–1924.

32. Knol EF, Knulst AC. Application of multiplexed immunoglobulin E determination on a chip in component-resolved diagnostics in allergy. Clin Exp Allergy. 2010; 40:190–192.