The Relationship among the Clinical Evaluation, Total IgE, and Allergen-Specific IgE of MAST-CLA in Atopic Dermatitis

Lee, Eun Ju; Piao, Young Jun; Kim, Kyung Ho; Suhr, Ki Beom; Lee, Jeung Hoon; Park, Jang Kyu

Abstract

BACKGROUND
Even though the cause of atopic dermatitis is still unknown, it is considered an allergic reaction whose onset is frequently and strongly associated with both hereditary and environmental factors. The multiple allergosorbent test-chemiluminescent assay(MAST-CLA) is a new assay for serum allergen-specific IgE, and allows up to 35 allergens to be tested simultaneously. Furthermore, the MAST-CLA has shown good sensitivity, specificity, and a correlation with the RAST and skin prick test. OBJECTIVE: The purpose of this study was to find total IgE and allergen-specific IgE and to evaluate the correlations between clinical status and abnormal immunologic findings in MAST-CLA on atopic dermatitis patients. METHODS: Our study was designed by analyzing outpatients with atopic dermatitis via physical examination, questionnaires and the MAST-CLA with a total IgE and 35 allergen-specific IgE in 100 patients. RESULTS: The results were as follows; 1. Among the subjects(mean age=11.6 years, mean age of onset=28.7 months olds), 87% of patients showed elevated serum total IgE levels(more than class level 2) and 72% revealed at least more than one allergen-specific IgE by MAST-CLA. 2. The positive allergens rate, in descending order, were D. farinae 58%, D. pteronyssynus 54%, house dust 43%(aeroallergens), egg white 31%, milk 30%, and crab 22%(food allergens). 3. Good correlation was obtained between total IgE levels and number of positive allergen-specific IgE in MAST-CLA, with 0.497 correlation coefficient(p<0.05). The relationship between the clinical severity(SCORAD scores) and total IgE and allergen-specific IgE did not show statistical significance. 4. While age was significantly increased to positive of total IgE, over 12 year-old group was the highest(100%)(p<0.05). The highest rate of positive allergen-specific IgE was shown in the 7-12 year-old group(9.2+/-9.6), the difference of other groups was statistically significant(p<0.05). The relation of clinical status and result of MAST-CLA did not show statistical significancy but also correlation coefficient was low. 5. The 0-2 year-old group showed only food allergens and no aeroallergens, the positive rate of aeroallergens were 3-6 year-old group 80.2%, 7-12 years group 63.5%, over 12 years old group 73.7%. 6. Both total IgE level and allergen-specific IgE were significantly increased in patient groups with atopic personal history(p<0.05). But, there was not a significant difference in patient groups with or without family history. Also, the relationship among the clinical status, total IgE level, and number of positive allergen-specific IgE in patient groups with or without atopic personal or family history did not show significant difference(p>0.05). CONCLUSION: Our data suggested that MAST-CLA is a sensible and useful method to investigate the causative allergen-specific IgE and to evaluate in patients with atopic dermatitis with additional benefit of a non-isotopic technique and therefore not very expensive