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Malucelli M, Farias R, Mello RG, Prando C. Biomarkers associated with persistence and severity of IgE-mediated food allergies: a systematic review. J Pediatr (Rio J) 2023; 99:315-321. [PMID: 36977497 PMCID: PMC10373149 DOI: 10.1016/j.jped.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE The prevalence of food allergies (FA) has increased worldwide over the last few decades. Milk, eggs, and peanuts are among the most common allergens and can cause anaphylaxis. Therefore, we aimed to identify biomarkers that could predict the persistence and/or severity of IgE-mediated allergies to milk, eggs, and peanuts via a systematic review. METHODS This systematic review proceeded according to a protocol registered in the International Prospective Register of Systematic Reviews. Two independent authors extracted studies of interest from PubMed, SciELO, EMBASE, Scopus, and Ebsco databases and assessed their quality using the Newcastle-Ottawa Scale. RESULTS We selected 14 articles describing 1,398 patients. Among eight identified biomarkers, total IgE, specific IgE (sIgE), and IgG4 were the most often cited biomarkers of persistent allergies to milk, eggs, and peanuts. Skin prick tests, endpoint tests, and sIgE cutoff levels may predict positive responses to challenges with these foods. The basophil activation test is a biomarker for the severity and/or threshold of allergic reactions to milk and peanuts. CONCLUSION Only a few publications identified possible prognostic indicators of the persistence or severity of FA and outcomes of oral food challenges, indicating that more accessible biomarkers are needed to determine the likelihood of having a severe food allergic reaction.
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Affiliation(s)
- Mariana Malucelli
- Faculdades Pequeno Príncipe, Pós-Graduação em Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Hospital Pequeno Príncipe, Serviço de Alergia e Imunologia Pediátrica, Curitiba, PR, Brazil; Complexo Hospital de Clinicas - Ebserh, UFPR, Curitiba, PR, Brazil.
| | - Roque Farias
- Faculdades Pequeno Príncipe, Curso de Medicina, Curitiba, PR, Brazil
| | - Rosiane Guetter Mello
- Faculdades Pequeno Príncipe, Pós-Graduação em Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Faculdades Pequeno Príncipe, Curso de Medicina, Curitiba, PR, Brazil
| | - Carolina Prando
- Faculdades Pequeno Príncipe, Pós-Graduação em Biotecnologia Aplicada à Saúde da Criança e do Adolescente, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Hospital Pequeno Príncipe, Serviço de Alergia e Imunologia Pediátrica, Curitiba, PR, Brazil; Faculdades Pequeno Príncipe, Curso de Medicina, Curitiba, PR, Brazil
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Pascal M, Moreno C, Dávila I, Tabar AI, Bartra J, Labrador M, Luengo O. Integration of in vitro allergy test results and ratio analysis for the diagnosis and treatment of allergic patients (INTEGRA). Clin Transl Allergy 2021; 11:e12052. [PMID: 34582103 PMCID: PMC9082998 DOI: 10.1002/clt2.12052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/05/2021] [Accepted: 07/30/2021] [Indexed: 01/09/2023] Open
Abstract
The introduction of molecular diagnosis into routine clinical practice has substantially improved the diagnosis and management of allergic patients by allowing clinicians to precisely identify the allergenic molecule responsible for immunoglobulin E (IgE)‐mediated allergies. However, it can be challenging to accurately interpret the results of molecular assays, partly due to the limited evidence base. In this context, a panel of experts with extensive experience in interpreting in vitro measures of total and serum specific IgE reviewed the available scientific evidence. After this review, the panel selected a series of representative case studies to demonstrate how determination of specific and total IgE values and the relationship between them (ratio analysis) can add value to the diagnostic process by more precisely defining the patient’s sensitization profile. Finally, the experts developed a series of recommendations on the clinical application of ratio analysis to optimize and complement the classical approach to allergy diagnosis.
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Affiliation(s)
- Mariona Pascal
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,ARADyAL Network, Health Institute Carlos III, Madrid, Spain
| | - Carmen Moreno
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Hospital Universitario Reina Sofía, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
| | - Ignacio Dávila
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Department of Biomedical and Diagnostic Sciences and Institute for Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Ana I Tabar
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Hospital Complex of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Cooperative Health Research Thematic Networks (RETICs) for Asthma, Madrid, Spain
| | - Joan Bartra
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Pneumology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Moisés Labrador
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Internal Medicine Department, Hospital Universitari Vall d´Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Olga Luengo
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Internal Medicine Department, Hospital Universitari Vall d´Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona. Barcelona, Spain
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Schulze J, Leberkuehne L, Salzmann-Manrique E, Schubert R, Zielen S, Rosewich M. Comparison of two different assays and the predictive value of allergen components in house dust mite allergy. Immunotherapy 2018; 9:1253-1262. [PMID: 29130795 DOI: 10.2217/imt-2017-0084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
AIM In house dust mite (HDM) allergy diagnostics, the IMMULITE, ImmunoCAP and assays for allergen components (nDer p 1 and rDer p 2) are available. METHODS Serum sIgE levels were compared and the predictive values for the detection of an early asthmatic response (EAR) were calculated with receiver operating characteristics and a log-logistic regression model. RESULTS sIgE levels of IMMULITE and ImmunoCAP were similar (Dermatophagoides pteronyssinus [D. pter.] 47.3 ± 35.7 and 42.9 ± 34.4 kU.l-1; p = 0.23). ImmunoCAP slgEs exhibited similar accuracy in detecting an EAR, area under the curves (AUCs): D. pter. (0.76); Dermatophagoides farinae (0.79); nDer p 1 (0.69); and rDer p 2 (0.72). At low sIgE concentrations (3.5 kU.l-1), rDer p 2 was more specific and better predicted an EAR (probability rDer p 2: 62%; D. pter.: 19%).
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Affiliation(s)
- Johannes Schulze
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | | | - Emilia Salzmann-Manrique
- Institute of Biostatistics & Mathematical Modeling, Department of Medicine, Goethe University, Frankfurt, Germany
| | - Ralf Schubert
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Stefan Zielen
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Martin Rosewich
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
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Savage J, Sicherer S, Wood R. The Natural History of Food Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 4:196-203; quiz 204. [DOI: 10.1016/j.jaip.2015.11.024] [Citation(s) in RCA: 166] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/06/2015] [Accepted: 11/10/2015] [Indexed: 02/01/2023]
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