Diagnostik von berufsbedingten Typ-I-Allergien – Vergleich von Haut-Pricktestlösungen verschiedener Hersteller für ausgewählte Berufsallergene

Abstract

Reactivity in the skin prick test (SPT) is related to the potency of the SPT solution used. The aim of this study was to compare SPT solutions from different manufacturers for selected occupational allergens. All patients suffered from work-related allergic complaints like rhinitis, conjunctivis or asthmatic complaints. 125 bakers and 21 subjects exposed to natural rubber latex (NRL) were examined with four flour SPT solutions and two NRL SPT solutions, respectively. By means of the maximum test efficiency (gold standard: specific IgE), the optimal cut-off was determined. Using this cut-off, sensitivities and specificities of the flour and NRL SPT solutions were calculated. Additionally, five SPT solutions for TYROPHAGUS PUTRESCENTIAE (Tp) were tested in two farmers. All SPT solutions were analysed IN-VITRO for protein and antigen content. IN-VITRO analyses resulted in differences for all SPT solutions depending on the manufacturer. The optimal cut-off for the flour and NRL SPT solutions was a wheal >or= 1.5 mm. Sensitivities of flour SPT solutions ranged from 38 % to 95 %, specificities from 77 % to 98 %. Both NRL SPT solutions reached a sensitivity of 100 % and a specificity of 92 %. SPT results with the different Tp SPT solutions were variable. While both NRL SPT solutions exhibited a fairly good quality, the flour and Tp SPT solutions showed differences between manufacturers. As a rule solutions with higher protein and antigen contents gave better results.