Asia Pac Allergy.  2018 Oct;8(4):e39. 10.5415/apallergy.2018.8.e39.

Evaluation of skin prick test to screen dust mite sensitization in chronic respiratory diseases in Southern Vietnam

• Chu HT
• Godin I
• PhÆ°Æ¡ng N
• Nguyen LH
• Hiep TT
• Xuan NM
• Corazza F
• Michel O

• KMID: 2423990
• DOI: http://doi.org/10.5415/apallergy.2018.8.e39

Abstract

BACKGROUND
In the view of the epidemic growth of sensitization to indoor allergens in Southern Vietnam, there is a requirement to screen large population.
OBJECTIVE
To evaluate skin prick tests (SPTs) as predictors of positive specific IgE (sIgE) to dust allergens, among patients with chronic respiratory diseases (CRDs).
METHODS
The sensitization to Blomia tropicalis (Blo t), Dermatophagoides pteronissinus (Der p), and Blattella germanica allergens (Bla g) were evaluated among 610 CRD, both SPT (≥4 mm) and sIgE by immuno-CAP (≥0.7 kUA/L).
RESULTS
Based on sIgE, 45%, 32%, and 33% of patients with CRD were sensitized to Blo t, Der p, and Bla g, respectively, compared to 19%, 18%, and 13% by SPT. The association between SPT and sIgE was statistically significant, though the Kappa factor was fair (i.e., 0.39 to 0.23). While the specificity of SPT to detect sensitization (compared to sIgE) was >90% among the whole population, the sensitivity was only 34%, 41%, and 24% for Bo t, Der p, and Bla g, suggesting that SPT was not enough sensitive to screen the indoor allergen sensitization. Though, among the < 10 pack-year (PY) smokers, the sensitivity was 43% for Blo t, 52% for Der p, and 61% for Blo t and/or Der p, compared to 27%, 30%, and 35% among the ≥10 PY smokers. The sensitivity/specificity was not associated with the diagnosis of asthma compared to chronic obstructive pulmonary disease.
CONCLUSION
In the present circumstance, SPT to dust mites allergens can be used to detect a sensitization among CRD population in Southern Vietnam.

Keyword

Skin test; Immunoglobulin E; Allergen; Chronic respiratory diseases; Vietnam

MeSH Terms

Allergens
Asthma
Diagnosis
Dust*
Humans
Immunoglobulin E
Mites*
Pulmonary Disease, Chronic Obstructive
Pyroglyphidae
Sensitivity and Specificity
Skin Tests
Skin*
Vietnam*
Allergens
Dust
Immunoglobulin E

Figure

• 

  Fig. 1. Prevalence of allergen sensitization. (A) Prevalence of positive skin prick test (SPT). (B) Prevalence of positive sIgE. The black bars indicate a cutoff of 0.35 kU A/L and the white bares show a cutoff of 0.70 kU A/L specific IgE (sIgE). Blo t, Blomia tropicalis; Der p, Dermatophagoides pteronyssinus; Bla g, Blattella germanica; Bla a, Blattella americana; Bla o, Blattella orientalis.

Reference

References

1. World Health Organization. Programmes: chronic respiratory diseases [Internet]. Geneva (Switzerland): World health organization;c2017. [cited 2017 Jul 4]. Available from:. http://www.who.int/respiratory/about_topic/en/.

2. Bousquet J, Kiley J, Bateman ED, Viegi G, Cruz AA, Khaltaev N, Aït Khaled N, Baena-Cagnani CE, Barreto ML, Billo N, Canonica GW, Carlsen KH, Chavannes N, Chuchalin A, Drazen J, Fabbri LM, Gerbase MW, Humbert M, Joos G, Masjedi MR, Makino S, Rabe K, To T, Zhi L. Prioritised research agenda for prevention and control of chronic respiratory diseases. Eur Respir J. 2010; 36:995–1001.

3. Burney P, Jarvis D, Perez-Padilla R. The global burden of chronic respiratory disease in adults. Int J Tuberc Lung Dis. 2015; 19:10–20.

4. Wong GW, Leung TF, Ko FW. Changing prevalence of allergic diseases in the Asia-pacific region. Allergy Asthma Immunol Res. 2013; 5:251–7.

5. Li J, Sun B, Huang Y, Lin X, Zhao D, Tan G, Wu J, Zhao H, Cao L, Zhong N. China Alliance of Research on Respiratory Allergic Disease. A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China. Allergy. 2009; 64:1083–92.

6. Yuenyongviwat A, Koonrangsesomboon D, Sangsupawanich P. Recent 5-year trends of asthma severity and allergen sensitization among children in southern Thailand. Asian Pac J Allergy Immunol. 2013; 31:242–6.

7. Andiappan AK, Puan KJ, Lee B, Nardin A, Poidinger M, Connolly J, Chew FT, Wang DY, Rotzschke O. Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites. Allergy. 2014; 69:501–9.

8. Lâm HT, Ekerljung L, Bjerg A, Văn T Tng N, Lundbäck B, Rönmark E. Sensitization to airborne allergens among adults and its impact on allergic symptoms: a population survey in northern Vietnam. Clin Transl Allergy 2014;4:6.

9. Chu HT, Godin I, Phuong NT, Nguyen LH, Hiep TT, Michel O. Allergen sensitization among chronic respiratory diseases in urban and rural areas of the South of VietNam. Int J Tuberc Lung Dis. 2018; 22:221–9.

10. Global Initiative for Asthma [Internet]. [place unknown]: Global Initiative for Asthma;c2016. [cited 2017 Jul 4]. Available from:. http://www.ginasthma.org/.

11. Global Initiative for Chronic Obstructive Lung Disease [Internet]. [place unknown]: Global Initiative for Chronic Obstructive Lung Disease;c2016. [cited 2017 Jul 4]. Available from:. http://goldcopd.org/.

12. Brand PL, Kerstjens HA, Jansen HM, Kauffman HF, de Monchy JG. Interpretation of skin tests to house dust mite and relationship to other allergy parameters in patients with asthma and chronic obstructive pulmonary disease. The Dutch CNSLD Study Group. J Allergy Clin Immunol. 1993; 91:560–70.

13. Lee-Wong M, Chou V, Silverberg JI. A study of IgE sensitization and skin response to histamine in Asian-Pacific American adults. Allergy Asthma Proc. 2012; 33:341–7.

14. Kanceljak-Macan B, Macan J, Plavec D, Klepac T, Milković-Kraus S. The 3 mm skin prick test (SPT) threshold criterion is not reliable for Tyrophagus putrescentiae: the reevaluation of SPT criterion to dust mites. Allergy. 2002; 57:1187–90.

15. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33:159–74.

16. Plebani M, Borghesan F, Basso D, Faggian D. Receiver-operating characteristic (ROC) curves: a fundamental tool for improving the clinical usefulness of in vitro IgE tests. Allergy. 1996; 51:407–11.

17. Lâm HT, Tu'ò'ng NV, Lundbäck B, Rönmark E. Storage mites are the main sensitizers among adults in northern Vietnam: results from a population survey. Allergy. 2011; 66:1620–1.

18. Roos A, Wurmser C, Kokou C, Vrtala S, Valenta R, Pauli G. Reconnaissance des allergènes moléculaires des acariens en Afrique équatoriale. Rev Fr Allergio. 2017; 57:236.

19. Soh WT, Le Mignon M, Suratannon N, Satitsuksanoa P, Chatchatee P, Wongpiyaboron J, Vangveravong M, Rerkpattanapipat T, Sangasapaviliya A, Nony E, Piboonpocanun S, Ruxrungtham K, Jacquet A. Mite Allergy Research Cohort (MARC) Study Team. The house dust mite major allergen Der p 23 displays O-Glycan-Independent IgE reactivities but no chitin-binding activity. Int Arch Allergy Immunol. 2015; 168:150–60.

20. Casset A, Mari A, Purohit A, Resch Y, Weghofer M, Ferrara R, Thomas WR, Alessandri C, Chen KW, de Blay F, Valenta R, Vrtala S. Varying allergen composition and content affects the in vivo allergenic activity of commercial Dermatophagoides pteronyssinus extracts. Int Arch Allergy Immunol. 2012; 159:253–62.

21. Lee AJ, Thalayasingam M, Lee BW. Food allergy in Asia: how does it compare? Asia Pac Allergy. 2013; 3:3–14.

22. Chauveau A, Dalphin ML, Mauny F, Kaulek V, Schmausser-Hechfellner E, Renz H, Riedler J, Pekkanen J, Karvonen AM, Lauener R, Roduit C, Vuitton DA, von Mutius E, Dalphin JC. PASTURE Study Group. Skin prick tests and specific IgE in 10-year-old children: Agreement and association with allergic diseases. Allergy. 2017; 72:1365–73.

23. Ponte JC, Junqueira SB, Veiga RV, Barreto ML, Pontes-de-Carvalho LC, Alcântara-Neves NM. A study on the immunological basis of the dissociation between type I-hypersensitivity skin reactions to Blomia tropicalis antigens and serum anti-B. tropicalis IgE antibodies. BMC Immunol. 2011; 12:34.

24. Visitsunthorn N, Sripramong C, Bunnag C, Jirapongsananuruk O. Comparison between specific IgE levels and skin prick test results of local and imported American cockroach, dog, cat, dust mites and mold allergen extracts. Asian Pac J Allergy Immunol. 2017; 35:60–5.

25. Nam YH, Lee SK. Comparison between skin prick test and serum immunoglobulin E by CAP system to inhalant allergens. Ann Allergy Asthma Immunol. 2017; 118:608–13.