Abstract
BackgroundComponent-resolved diagnosis (CRD) allows to identify single molecular allergen components, and constitutes a routine practice in many allergy units. However, skin prick test (SPT) remains the technique of choice in many otorhinolaryngology departments, thus increasing the risk of using inadequate immunotherapies in patients with respiratory allergies. This study aimed to compare sensitization profiles determined by SPT and CRD in patients with respiratory allergy, and to explore the relationship between sensitization and type and severity of the respiratory disease.MethodsCross-sectional, multicenter study of patients admitted to the Otorhinolaryngology Department due to symptoms of respiratory allergy. Extracts from various house dust mites, pollens, and molds were tested by SPT, whereas IgE against the corresponding antigens were measured by CRD.ResultsThe analysis included 101 patients. The sensitization profile obtained by SPT had low agreement with that of CRD, particularly to dust mite allergens (Dermatophagoides sp.) and pollens (Plantago lanceolata, Olea europaea, and Cupressus sempervirens). While SPT did not show any significant relationship between sensitization and type/severity of the respiratory disease, CRD allowed to associate Der p 1, Der f 1 and Lep d 2 sensitizations with asthma, and Der p 2, Der f 2 and Lep d 2 sensitizations with more severe symptoms of allergic rhinitis.ConclusionsCompared with SPT, CRD enables to describe a more accurate sensitization profile and to identify associations between symptoms and specific antigens. The routine use of CRD in an otorhinolaryngology setting may benefit the management of patients with respiratory allergy.Trial registration IB 3108/15 (Retrospectively registered)
Highlights
Component-resolved diagnosis (CRD) allows to identify single molecular allergen components, and constitutes a routine practice in many allergy units
While CRD has been increasingly established as routine practice in many allergy units, skin prick test (SPT) remains the technique of choice in many otorhinolaryngology departments because of its lower cost, increasing the risk of using inadequate immunotherapies in patients with respiratory allergies [7, 13]
Either the type or severity of the disease significantly contributed to sensitization toall house dust mite allergens included in the analysis (Table 5). In this cross-sectional study, we found that the sensitization profile of patients with respiratory allergy obtained by the traditional SPT has low agreement with that of CRD, to dust mite allergens and pollens, such as P. lanceolata, O. europaea, and C. sempervirens
Summary
Component-resolved diagnosis (CRD) allows to identify single molecular allergen components, and constitutes a routine practice in many allergy units. Skin prick test (SPT) remains the technique of choice in many otorhinolaryngology departments, increasing the risk of using inadequate immunotherapies in patients with respiratory allergies. The diagnosis of allergic diseases has been traditionally based on patient anamnesis, supported by skin prick test (SPT) and/or the identification of serum IgE in whole allergen extracts Both methods are suitable for detecting reactivity against allergen extracts but fail to identify the specific disease-eliciting molecules. The development of the component-resolved diagnosis (CRD), known as molecular diagnosis, has allowed to identify single molecular allergen components responsible for sensitization [10] This feature, which allows to distinguish symptomeliciting allergens from those attributable to cross-reactivity, has become relevant since the advent of allergen-specific immunotherapy [10,11,12]. While CRD has been increasingly established as routine practice in many allergy units, SPT remains the technique of choice in many otorhinolaryngology departments because of its lower cost, increasing the risk of using inadequate immunotherapies in patients with respiratory allergies [7, 13]
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