Single sIgE for Dermatophagoides pteronyssinus (Dp) is a good screening tool for atopic sensitisation

Abstract

Background: Limited publications evaluated the Phadiatop application for aeroallergen screen in allergic respiratory diseases (ARD) in Chinese. Our retrospective cohort studied the Phadiatop versus total IgE use in aeroallergen workups, and local aeroallergen sensitisation profiles by reviewing aeroallergen sIgE. We aimed to derive a cost-effective algorithm for ARD workup. Methods: The Phadiatop tests from 694 patients with ARD in 2010–2019 were retrospectively identified. Other associated workups including total IgE, and/or allergen specific sIgE (sIgE), if available, were retrieved and analysed. Besides, a further review was performed on 53 consecutive samples collected during January 2021, for aeroallergen screening. Cost effectiveness of the existing protocol (Phadiatop screening followed by individual aeroallergen characterisation) was compared with a new testing algorithm, which started with dust mite (Dermatophagoides pteronyssinus, Dp) allergy detection. Results: Positivity of Phadiatop and total IgE were 67.3% (n=694) and 66.7% (n=366), with overall agreement being 73.5% (269/366). 34.9% to 45.6% of asthmatic patients had elevated total IgE than Phadiatop. Dp was the most prevalent aeroallergen (> 90%), and its sIgE level correlated best with the Phadiatop sIgE level (R=0.99, p < 0.001). Conclusions: Screening by Dp sIgE is as sensitive as Phadiatop in aeroallergen screen but of lower running cost. It should be the approach in our locality. Reference 1. Vidal C, Boquete O, Fernández-Merino MC, et al. Evaluation of the phadiatop test in the diagnosis of allergic sensitization in a general adult population. J Investig Allergol Clin Immunol 2005; 15: 124–130. 2. Zeng G, Haisheng H, Zheng P, et al. The practical benefit of Phadiatop test as the first-line in vitro allergen-specific immunoglobulin E (sIgE) screening of aeroallergens among Chinese asthmatics: a validation study. Ann Translational Med 2018; 6: 151. 3. Sterner T, Uldahl A, Svensson A, et al. IgE sensitization in a cohort of adolescents in southern Sweden and its relation to allergic symptoms. Clin Molec Allergy 2019; 17: 6.