RESUMEN
Based on the current urgent need for an in vitro quantitative detection system for allergens in most hospitals in China, we introduced a novel allergen-specific immunoglobulin E detection system that employs a solid phase enzyme-linked immunoassay and evaluated its clinical performance. The system uses a special reaction component (innovative patents) to reduce the reaction time to 12 min, achieving point-of-care testing for allergy management, which is impressive compared to the 3-18 h testing time for all other systems. In addition, the AILEX system has excellent consistency with the ImmunoCAP reference method system; therefore, we recommend the introduction of the AILEX system for clinical auxiliary diagnosis in medical units.
Asunto(s)
Hipersensibilidad , Inmunoglobulina E , Alérgenos , Bioensayo , Humanos , Técnicas para InmunoenzimasRESUMEN
BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) is an airway disease caused by Aspergillus (mainly Aspergillus fumigatus). OBJECTIVE: To evaluate the diagnostic performance of four fungal-related allergen-specific immunoglobulin E (sIgE) detection systems. METHODS: A total of 99 patients with ABPA and 30 control patients admitted to the First Affiliated Hospital of Guangzhou Medical University from 2017 to 2019 were included in the study. Four allergen detection systems were used to detect Aspergillus-related sIgE. RESULTS: The 99 patients were divided into two groups based on the total IgE. Fluorescence immunoassay for fungal mixtures detected positive rates of 100% and 81% in the Confirmed and Probable groups, respectively. For Aspergillus fumigatus, the positive rates were 90.2% and 87.9%, respectively. In the detection of sIgE of fungal mixtures in all ABPA patients, the sensitivity of System 1 was 90.9%, which was higher than for the other three systems (System 2, 38.4%; System 3, 44.4%; System 4, 52.5%), All four systems have excellent specificity ( > 90.0%) and had higher consistency in the Confirmed group than in the Probable group (P < 0.05). Consistency for the Aspergillus mixture and Aspergillus fumigatus detected by fluorescence immunoassay was 90.2% and 86.2% in the Confirmed and Probable groups, respectively. CONCLUSIONS: Despite the many methods used to detect fungal-related sIgE, the ImmunoCAP system has the best clinical diagnostic performance. It is recommended that this method be used to detect fungal (mixtures or Aspergillus fumigatus) sIgE in order to reduce the missed diagnosis rate of ABPA.
RESUMEN
INTRODUCTION: The impact of furry animal allergens on house dust mite (HDM)-induced allergic rhinitis (AR) is unclear. OBJECTIVE: We aimed to investigate the co-sensitization and cross-sensitization of furry animal allergens and assess their clinical relevance with HDM-induced AR. METHODS: We enrolled 268 patients with HDM-induced AR who were diagnosed with skin prick tests positive for dogs and/or cats. Specific immunoglobulin E (sIgE) for dogs (e1) and cats (e2), their components (Can f 1-5 and Fel d 1-2), and other uncommon furry animal extracts were measured. Symptoms and quality of life were assessed with a visual analog scale (VAS). RESULTS: The VAS scores for the AR and asthma (AS; n = 166), moderate-to-severe persistent-AR (n = 132), and e1P (positive)-e2P (n = 89) groups were higher than those for single AR (n = 102), other AR classifications, and other AR sensitization profiles, respectively. The IgE positivity rates for components such as Can f 1-3 and Fel d 2 and those for rats, sheep, mice, cows, and horses were highest in e1P-e2P patients. Can f 1-4, Fel d 1, Fel d 2, or the combined allergens were positively correlated with VAS scores. AR combined with AS and sensitization to Can f 4, Fel d 1, or mice were risk factors for HDM-induced AR with VAS scores ≥5. CONCLUSIONS: Extensive cross-sensitization or co-sensitization was found between Can f 1-3, Fel d 2, or rat, sheep, mouse, cow, and horse extracts. Higher sIgE levels for Can f 1-4 and Fel d 1-2 or a higher number of furry animal allergens lead to more severe symptoms and a reduced quality of life. Combined with AS, sensitization to Can f 4, Fel d 1, or mice were risk factors for moderate-to-severe HDM-induced AR.