Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;77(10):3028-3040.
doi: 10.1111/all.15329. Epub 2022 May 9.

Real-life evaluation of molecular multiplex IgE test methods in the diagnosis of pollen associated food allergy

Luisa Diem  1 , Bellinda Neuherz  1 , Johanna Rohrhofer  1 , Larissa Koidl  1 , Riccardo Asero  2 , Knut Brockow  3 , Araceli Diaz Perales  4   5 , Margaretha Faber  6 , Julia Gebhardt  3 , María José Torres  7 , Erika Jensen-Jarolim  1   8   9 , Sonja Zehetmayer  10 , Eva Untersmayr  1
Affiliations

Real-life evaluation of molecular multiplex IgE test methods in the diagnosis of pollen associated food allergy

Luisa Diem et al. Allergy. 2022 Oct.

Abstract

Background: Diagnosis of food allergies is challenging, as combining information from specific IgE (sIgE)-sensitization pattern and skin prick tests (SPTs) with clinical history is necessary for a personalized management of allergic patients. The aim of this study was to compare two molecular tests, the ImmunoCAP ISAC (ISAC) and the Allergy Explorer, version 2 (ALEX2 ) in the context of pollen food syndrome (PFS) diagnosis in a real-life scenario, to assess the benefit of multiplex testing in PFS patients.

Methods: Diagnosis of food allergy was performed in 53 patients. Allergen-sIgE concentrations were measured with ISAC and ALEX2 . Results for sIgE were statistically compared with each other, with SPT results and with clinical presentation of the patients.

Results: Using ISAC as reference test for sIgE measurements, the average sensitivity of ALEX2 for PR-10 allergens was 83.2% and the average specificity 88.0%. If only low sIgE concentrations were included, the sensitivity was 60.8% and the specificity 91.1%. Apple and hazelnut sensitizations were confirmed in most patients by concordance of sIgE and SPT results. Significant correlations were shown between clinical symptoms and Mal d 1- and Gly m 4-sIgE levels measured by both tests and for Cor a 1-sIgE levels measured by ALEX2 . In eight patients, profilin related symptoms were supported by Hev b 8-sensitization.

Conclusion: Multiplex testing is beneficial to understand patient-specific individual sensitization profiles and to providing personalized management recommendations. In the future, custom-designed test kits might enable reducing costs of multiplex testing for specific patient groups without compromising the diagnostic value.

Keywords: food allergy; molecular diagnosis; multiplex testing; pollen food syndrome.

PubMed Disclaimer

Conflict of interest statement

KB has received honoraria for talks and controlling webinar contents from ThermoFisher. The other authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

FIGURE 1
FIGURE 1
Comparison of measured allergen‐sIgE concentrations by scatterplots and Spearman's correlation coefficient (rs). p‐values were <.0001 in all cases. (A) Mal d 1‐sIgE, (B) Api g 1‐sIgE, (C) Cor a 1‐sIgE, (D) Ara h 8‐sIgE, (E) Gly m 4‐sIgE, (F) Hev b 8‐sIgE. Values are indicated in ISU‐E and kUA/ml
FIGURE 2
FIGURE 2
Numbers of patients with positive or negative results in SPT in comparison to sIgE titers measured by ISAC (left panel) and ALEX2 (right panel). (A) Mal d 1‐sIgE and SPT with apple extract, (B) Api g 1‐sIgE and SPT with celery extract, (C) Cor a 1‐sIgE and SPT with hazelnut extract, (D) Ara h 8‐sIgE and SPT with peanut extract, (E) Gly m 4‐sIgE and SPT with soy extract. Color coding: green—negative; yellow—low IgE concentration; orange—moderate to high IgE concentration; red—very high IgE concentration
FIGURE 3
FIGURE 3
Clinical symptoms of patients and allergen‐sIgE levels measured by ISAC (left panel) and ALEX2 (right panel). (A) Mal d 1‐sIgE in correlation with symptoms upon apple ingestion, (B) Api g 1‐sIgE in correlation with symptoms upon celery ingestion, (C) Cor a 1‐sIgE in correlation with symptoms upon hazelnut ingestion, (D) Ara h 8‐sIgE in correlation with symptoms upon peanut ingestion, (E) Gly m 4‐sIgE in correlation with symptoms upon soy ingestion. Color coding: blue—no symptoms; green—OAS; yellow—local (gastrointestinal symptoms); orange—systemic (urticaria/dyspnea); red—anaphylaxis
See this image and copyright information in PMC

References

    1. Hamilton RG, Hemmer W, Nopp A, Kleine‐Tebbe J. Advances in IgE testing for diagnosis of allergic disease. J Allergy Clin Immunol Pract. 2020;8(8):2495‐2504. - PubMed
    1. De Martinis M, Sirufo MM, Suppa M, Ginaldi L. New perspectives in food allergy. Int J Mol Sci. 2020;21(4):1474. - PMC - PubMed
    1. Persaud Y, Memon RJ, Savliwala MN. Allergy Immunotherapy, in StatPearls. StatPearls Publishing Copyright © 2021, StatPearls Publishing LLC; 2021. - PubMed
    1. Alessandri C, Ferrara R, Bernardi ML, et al. Molecular approach to a patient's tailored diagnosis of the oral allergy syndrome. Clin Transl Allergy. 2020;10:22. - PMC - PubMed
    1. Foong RX, Santos AF. Biomarkers of diagnosis and resolution of food allergy. Pediatr Allergy Immunol. 2021;32(2):223‐233. - PubMed

Publication types