Components in soy allergy diagnostics: Gly m 2S albumin has the best diagnostic value in adults

Authors

  • R. J. B. Klemans,

    Corresponding author
    1. Department of (Paediatric) Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
    • Correspondence

      Rob J. B. Klemans, MD, Department of Dermatology and Allergology (G02.124), University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.

      Tel.: +31 88 755 73 88

      Fax: +31 88 755 54 04

      E-mail: R.J.B.Klemans-3@umcutrecht.nl

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  • E. F. Knol,

    1. Department of (Paediatric) Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
    2. Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
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  • A. Michelsen-Huisman,

    1. Department of (Paediatric) Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
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  • S. G. M. A. Pasmans,

    1. Department of (Paediatric) Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
    2. Center for Paediatric Allergology, Wilhelmina Children's Hospital, University Medical Center Utrecht
    3. Department of Paediatric Dermatology, Children's Hospital Erasmus University Medical Center-Sophia, Erasmus University Medical Center
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  • W. de Kruijf-Broekman,

    1. Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
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  • C. A. F. M. Bruijnzeel-Koomen,

    1. Department of (Paediatric) Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
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  • E. van Hoffen,

    1. Department of (Paediatric) Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
    2. NIZO Food Research, Ede, the Netherlands
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  • A. C. Knulst

    1. Department of (Paediatric) Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Edited by: Reto Crameri

Abstract

Background

Thus far, four soy allergens have been characterized. Their diagnostic value was assessed only using a case-control design with controls not suspected of soy allergy or in a soy-allergic population without controls. Our objective was to analyze the diagnostic value of specific immunoglobulin E (sIgE) to Gly m 2S albumin, Gly m 4, 5, and 6, and their possible relation with severity or culprit soy product.

Methods

Adult patients suspected of soy allergy were included (n = 46). Allergy was confirmed by challenge (n = 19) or history (n = 16) and excluded by challenge in 11 patients. Soy components were analyzed by ImmunoCAP. Diagnostic value was assessed in the challenged patient group by an area under receiver operating characteristic (ROC) curve (AUC).

Results

Specific immunoglobulin E to Gly m 2S albumin had the highest AUC (0.79), comparable to skin prick test (SPT) and sIgE to soy extract (0.76 and 0.77, respectively). All patients were sensitized to either soy extract or Gly m 4 (sIgE ≥ 0.35 kU/l). sIgE to soy extract, Gly m 5, and Gly m 6 was significantly higher in patients with mild symptoms (= 0.04, 0.02 and 0.02, respectively). Patients only reacting to soy milk had higher sIgE levels to Gly m 4 (median 9.8 vs 1.1 kU/l, = 0.01).

Conclusion

Specific immunoglobulin E to Gly m 2S albumin had the best accuracy in diagnosing soy allergy. Gly m 5 and 6 were related to mild symptoms. Higher levels of Gly m 4 were related to allergy to soy milk.

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