Abstract
BackgroundCat allergy is of great importance, and its prevalence is increasing worldwide. Cat allergens and house dust mite allergens represent the major indoor allergens; however, they are ubiquitous. Cat sensitization and allergy are known risk factors for rhinitis, bronchial hyperreactivity and asthma. Thus, the diagnosis of sensitization to cats is important for any allergist.Methods70 patients with positive skin prick tests for cats were retrospectively compared regarding their skin prick test results, as well as their specific immunoglobulin E antibody profiles with regard to their responses to the native cat extract, rFel d 1, nFel d 2 and rFel d 4. 35 patients were allergic to cats, as determined by positive anamnesis and/or nasal provocation with cat allergens, and 35 patients exhibited clinically non-relevant sensitization, as indicated by negative anamnesis and/or a negative nasal allergen challenge.ResultsNative cat extract serology testing detected 100% of patients who were allergic to cats but missed eight patients who showed sensitization in the skin prick test and did not have allergic symptoms. The median values of the skin prick test, as well as those of the specific immunoglobulin E antibodies against the native cat extract, were significantly higher for allergic patients than for patients with clinically non-relevant sensitization. Component based diagnostic testing to rFel d 1 was not as reliable. Sensitization to nFel d 2 and rFel d 4 was seen only in individual patients.ConclusionExtract based diagnostic methods for identifying cat allergy and sensitization, such as the skin prick test and native cat extract serology, remain crucial in routine clinical practice. In our study, component based diagnostic testing could not replace these methods with regard to the detection of sensitization to cats and differentiation between allergy and sensitization without clinical relevance. However, component resolved allergy diagnostic tools have individual implications, and future studies may facilitate a better understanding of its use and subsequently may improve the clinical management of allergic patients.
Highlights
Cat allergy is of great importance, and its prevalence is increasing worldwide
There is a trend toward costly component resolved analysis, which has been described as the beginning of new era in the diagnosis of allergies [20, 21], compared to standard diagnostic approaches, such as the extract based Skin prick test (SPT) and serology against native extract
Total immunoglobulin E (IgE) and specific IgE antibodies to native cat extract and to the allergen components rFel d 1, nFel d 2, and rFel d 4 were measured
Summary
Cat allergy is of great importance, and its prevalence is increasing worldwide. Cat allergens and house dust mite allergens represent the major indoor allergens; they are ubiquitous. There is a trend toward costly component resolved analysis, which has been described as the beginning of new era in the diagnosis of allergies [20, 21], compared to standard diagnostic approaches, such as the extract based SPT (skin prick test) and serology against native extract. These standard tools are more cost effective because the extract usually contains all of the allergenic components within one test; the increased regulatory demands within the European Union for any allergen solution used for diagnostic tests, such as SPT or provocation tests, have driven the use of component resolved analysis [22]
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