PMID- 12974191
OWN - NLM
STAT- MEDLINE
DCOM- 20050331
LR  - 20191210
IS  - 1088-5412 (Print)
IS  - 1088-5412 (Linking)
VI  - 24
IP  - 4
DP  - 2003 Jul-Aug
TI  - In vitro diagnostic evaluation of patients with inhalant allergies: summary of 
      probability outcomes comparing results of CLA- and CAP-specific immunoglobulin E 
      test systems.
PG  - 253-8
AB  - For the diagnosis of allergy, presence of allergen-specific immunoglobulin E 
      (IgE) usually is established either by allergen skin tests or by in vitro 
      allergen-specific IgE measurements. However, in vitro assays of specific IgE 
      often are modified as manufacturers improve allergens or change reagents to 
      optimize test performance, affecting the diagnostic performance of in vitro 
      allergen-specific IgE assays. This investigation compares the diagnostic outcomes 
      of the Hitachi Chemical Diagnostics chemiluminescent assay (CLA) and Pharmacia, 
      capsulated hydrophilic carrier polymer (CAP) in vitro allergen-specific IgE test 
      methods in patients with inhalant allergy to a panel of selected allergens. Sera 
      were obtained from 60 consecutive patients who had a clinical history suggesting 
      inhalant allergy and were evaluated by allergen skin-prick test (SPT). Only 
      patients with clinical findings of allergic asthma or rhinoconjunctivitis were 
      included. Sera from patients with at least one positive SPT, which clinically 
      correlated with the case history, were used for specific IgE measurements. 
      Sensitivity and specificity were defined as conditional probabilities describing 
      performances of the CAP system and the CLA system in reference to a standard 
      composed of a combination of allergen-specific symptoms and a positive SPT. A 
      test concordance of 79% was found between the CLA and CAP test results with a 
      correlation coefficient of 0.8. Allergen-specific IgE assay sensitivity of the 
      CLA and CAP systems was similar and allergen dependent, ranging from 67 to 100%. 
      Assay specificity ranged from 39 to 86% for the CLA system and from 36 to 81% for 
      the CAP system. When comparing the specific IgE results with allergen SPTs, 75% 
      (+/- 3%) of CLApositive patients had a positive SPT, and 92% (+/- 4%) of 
      CAPpositive patients had a positive SPT. Eighty-four percent (+/- 4%) of 
      CLAnegative patients had a negative SPT, whereas 69% (+/- 5%) of CAPnegative 
      patients had a negative SPT. The overall concordance between skin tests and in 
      vitro tests was 76% for CLA and 67% for CAP. CLA and CAP score values showed good 
      correlation and both tests may be useful when skin tests cannot be performed to 
      identify subjects with IgE-mediated allergy. The CLA and CAP assays for 
      allergen-specific IgE may be useful as part of an initial allergy evaluation 
      because of the high negative predictive value of negative test results. For the 
      majority of allergens the sensitivity was high. However, the specificity of both 
      in vitro tests was low, indicating that positive in vitro test results should be 
      evaluated carefully in conjunction with clinical symptoms and allergen-specific 
      skin tests to determine the clinical relevance of the allergen sensitization.
FAU - Nepper-Christensen, Steen
AU  - Nepper-Christensen S
AD  - Asthma and Allergy Unit, Department of Internal Medicine, Bispebjerg University 
      Hospital, Copenhagen, Denmark.
FAU - Backer, Vibeke
AU  - Backer V
FAU - DuBuske, Lawrence M
AU  - DuBuske LM
FAU - Nolte, Hendrik
AU  - Nolte H
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Allergy Asthma Proc
JT  - Allergy and asthma proceedings
JID - 9603640
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adult
MH  - Allergens/immunology
MH  - Humans
MH  - Hypersensitivity/*diagnosis
MH  - Immunoglobulin E/*blood
MH  - Inhalation Exposure
MH  - Luminescent Measurements
MH  - Sensitivity and Specificity
MH  - Serologic Tests/*methods
MH  - Skin Tests
EDAT- 2003/09/17 05:00
MHDA- 2005/04/01 09:00
CRDT- 2003/09/17 05:00
PHST- 2003/09/17 05:00 [pubmed]
PHST- 2005/04/01 09:00 [medline]
PHST- 2003/09/17 05:00 [entrez]
PST - ppublish
SO  - Allergy Asthma Proc. 2003 Jul-Aug;24(4):253-8.