The sensitivity of the RAST using anti-IgE in 125I-labelled IgG fractions of sheep antiserum was compared to that using anti-IgE purified by immunosorbent techniques in tests with three allergens (grass pollens, Aspergillus fumigatus and the detergent enzyme ‘Alcalase’) on sera from 248 workers in a detergent factory. Both anti-IgE reagents measure the same antibody but the RAST procedure using the crude anti-IgE reagent is less sensitive than that using the immunosorbent-purified anti-IgE in its ability to detect circulating IgE in subjects with positive skin-prick tests. In general the agreement between positive RAST and positive skin test was improved when only skin tests equal to or greater than 3 mm were considered positive. With Alcalase, antigen non-specific binding by the crude anti-IgE reagent may give false positive results. Optimal conditions for the preparation of allergosorbents with this allergen are defined. Predictive equations relating the results of RAST and skin test show that the hitherto arbitrary definition of a positive RAST result is statistically valid.
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