Clinical & Experimental Allergy

A clinical evaluation in children of the Pharmacia ImmunoCAP system for inhalant allergens

Authors

  • M. GLEESON,

    Corresponding author
    1. Hunter Immunology Unit, Hunter Area Pathology Service, Royal Newcastle Hospital, Newcaslle, New South Wales, Australia
      Dr M. Gleeson, Hunter Immunology Unit, Royal Newcastle Hospital, PO Box 664J, Newcastle, NSW 2300. Australia.
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  • A. W. CRIPPS,

    Corresponding author
    1. Faculty of Applied Science, University of Canberra, Belconnen, Australian Capital Territory, Australia
      Dr M. Gleeson, Hunter Immunology Unit, Royal Newcastle Hospital, PO Box 664J, Newcastle, NSW 2300. Australia.
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  • M. J. HENSLEY,

    1. Faculty of Medicine and Health Sciences, John Hunter Hospital, New Lambton, New South Wales, Australia
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  • J. H. WLODARCZYK,

    1. Newcastle Environmental Toxicology Research Unit, Royal Newcastle Hospital, Newcastle, New South Wales, Australia
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  • R. L. HENRY,

    1. Newcastle Environmental Toxicology Research Unit, Royal Newcastle Hospital, Newcastle, New South Wales, Australia
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  • R. L. CLANCY

    1. Faculty of Medicine and Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
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Dr M. Gleeson, Hunter Immunology Unit, Royal Newcastle Hospital, PO Box 664J, Newcastle, NSW 2300. Australia.

Summary

Background The Pharmacia ImmunoCAP system (CAP) for assaying serum IgE specific antibodies was evaluated in a clinical setting against skin-prick test (SPT) perfonncd using Dome/Hollister-Steir allergen extracts. The five cotnmon inhalant allergens D. pteronyssinus. D. farinae, mould mix, grass mix and cat epithelium were tested concurrently by both methods in 167 children aged 7.5–12 years. The specific SPT for D. pteronyssinus and D. farinae were also tested against the CAP house dust mite (HDM) mix.

Objective The purpose of the study was to determine the sensitivity and specificity of the Pharmacia ImmunoCAP system Tor detecting serum IgE specific antibodies to inhalant allergens in a clinical setting, using the SPT result as the ‘gold standard’.

Methods The SPTs were performed using Dome/Hollister-Steir allergen extracts. The serum IgE specific antibodies were quantitated using the radioimmunoassay version of the Pharmacia ImmunoCAP system. A history of allergic disease was assessed using a validated questionnaire.

Results SPT gave more positive reactions than CAP with the exception of cat epithelium. The concordance between SPT and CAP results was 91% over all the tests. The concordance with SPT was slightly higher for the specific CAP for D. pteronyssinus and D. farinae (93% and 95% respectively) than for the CAP HDM mix (86% and 90% respectively). There was a higher proportion of positive results for both SPT and CAP in the 115 children defined as having a history of allergic disease. Using SPT defined allergy as the gold standard, the sensitivity of the CAP system was 87% for the two specific house dust mites but was lower for cat epithelium (67%), mould mix (59%) and grass mix (46%). The sensitivity of the CAP system improved for D. pteronyssinus (96%) and the HDM mix (91%) when tested in subjects defined as having a history of allergy associated disease. The specificity of the CAP system showed less variation between allergens and ranged from 90–99%.

Conclusion The results of this study of children aged 7.5–12 years demonstrate that, for the inhalent allergens tested, the Pharmacia ImmunoCAP system perfoms well in the setting of known allergic disease.

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