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. 2023 Aug;37(15-16):e24960.
doi: 10.1002/jcla.24960. Epub 2023 Aug 28.

Would the choice of multiplex platform impact the management of the allergic patient? A first approach focusing on LTPs

Carmen Maria Cabrera  1   2 , Moisés Labrador Horrillo  3   4 , Francisco Feo Brito  5 , Alberto Palacios-Cañas  5
Affiliations

Would the choice of multiplex platform impact the management of the allergic patient? A first approach focusing on LTPs

Carmen Maria Cabrera et al. J Clin Lab Anal. 2023 Aug.

Abstract

Background: In the Mediterranean area, patients with LTP syndrome who are sensitized to multiple allergens are often tested for sIgE using multiplex platforms. The results obtained from different commercial platforms are not interchangeable, so it is important to compare and validate the platform selected for use. The objective of this study is to compare and validate the performance of the ImmunoCAP ISAC E112i and the macroarray ALEX2 in our daily practice.

Methods: From August 2021 to March 2022, we tested 20 random serum samples from polysensitized patients using the ALEX2 test (MADx) and ImmunoCAP tIgE and ISAC E112i (Thermo Fisher Scientific). We compared the total IgE (tIgE) and sIgE levels for shared allergens.

Results: The heatmap generally showed more intense results for ISAC. The overall correlation was good, but some exceptions were noted. The main discrepancies were found for Ole e 7, which was positive for 11 patients in ISAC but negative for all patients in ALEX2, and for nut LTPs, for which ISAC showed a threefold higher detection rate for Ara h 9 and a fivefold higher detection rate for Cor a 8 and Jug r 3 compared to ALEX2. The regression model showed no interchangeability of tIgE results.

Conclusions: Despite our small sample size and the complexity of comparing a quantitative and a semi-quantitative platform, our results suggest that patient diagnosis and management can be influenced by the platform used. Therefore, our findings must be taken into consideration when choosing a platform to use for some profiles of LTP-polysensitized patients, even though more data is needed.

Keywords: ALEX2; ISAC; LTP; clinical impact; comparison.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
(A) Heatmap corresponding to the sensitization profiles of the 20 study patients according to ALEX and ImmunoCAP ISAC. The heatmap displays only allergens shared between both platforms with at least a positive result in either of the two platforms. Allergens are grouped by protein families. (B) Heatmap corresponding to the sensitization profiles of the 20 study patients according to ALEX and ImmunoCAP ISAC. The heatmap displays only allergens shared between both platforms with at least a positive result in either of the two platforms. Allergens are grouped by protein families.
See this image and copyright information in PMC

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