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The Measure of Specific IgE to Whole-Allergen Extracts May Not be Useful for Primary Sensitization Diagnosis in Children with Atopic Dermatitis and Asthma
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Lukasz Blazowski, MD PhD, Ryszard Kurzawa
Rationale:

Children with atopic dermatitis and asthma are mainly polysensitized thus use of specific IgE to allergen extracts in sensitization diagnosis may lead to misdiagnosis. In this cross-sectional, prospective study the degree of cross-reactivity using component resolved diagnostics (CRD) was analyzed.

Methods:

Serum specific IgE to 112 allergen components were measured by using multiplex microarray (ISAC) in 297 sensitized children (aged 1-18 years) with atopic dermatitis (mAD-moderate, sAD-severe, objective SCORAD index 15-40 and >40 respectively), asthma (A1-episodic, A2-mild persistent or A3-moderate) or both. Sensitization to 7 main cross-reactive allergen families (C-RAF) and specific IgE to cross-reactive carbohydrate determinants (CCD) was identified and evaluated depending on clinical diagnosis and age.

Results:

IgE reactivity to C-RAF and CCD was found in 81,1%  of children (52,9%, 17,5%, 14,8%, 4,7%, 52,2%,  21,6%,  14,5%  and 9,4%  in pathogenesis-related class 10 proteins, non-specific transfer lipid proteins, profilins,  polcalcins,  lipokalins, serum albumins, tropomyosins  and CCD respectively. Depending on clinical diagnosis IgE to C-RAF was found in 75,3% children with asthma (57,9%, 78,9% and 85,0% in A1, A2 and A3 respectively), in 76,0% with atopic dermatitis (61,1% in mAD and 87,3% in sAD) and in 92,6% children with both atopic dermatitis and asthma. IgE reactivity to C-RAF was different depending on age: in 60,8%, 84,1% and 92,8%  of children at age 1-2, 3-6 and 7-18 years respectively.

Conclusions: In children with atopic dermatitis and/or asthma CRD is essential to  due to widespread sensitization to C-RAF and high cross-reactivity to components within each family.