背景:ALEX多重平台最近已商业化,但其作为ImmunoCAP-singleplex作为参考方法的定量技术的临床实用性尚未在患有坚果过敏和对不同坚果共致敏的患者中得到证实。
方法:通过ALEX多重和ImmunoCAP单一技术平行测定了来自地中海人群的坚果过敏患者的58份血清样本。根据临床症状和皮肤点刺试验(SPT)阳性对患者进行诊断。两种技术之间比较了以下整个提取物:核桃,榛子,花生,杏仁,开心果和向日葵种子;除了重组Prup3。进行了定性和定量研究。
结果:两种技术对核桃整体提取物的敏感性相似,榛子和花生以及Prup3(p>0.05)。然而,对于杏仁的整个提取物,开心果和向日葵种子ALEX获得的敏感性远低于ImmunoCAP(分别为9.09%vs88.63%;14.81vs70.37%;和8.51%vs88.88%)。两种技术之间的一致性显示,对于Prup3(k=0.791)仅有实质性的协议;榛子和花生的中等协议(分别为k=0.550和k=0.544);核桃的公平协议(k=0.386)和杏仁的不良协议,开心果和葵花籽(k<0.2)。定量分析表明,ImmunoCAP对核桃,花生和葵花籽的平均值高于ALEX。除杏仁外,所有特异性IgE水平的关系均显着,开心果和葵花籽。
结论:ALEX平台适用于地中海地区坚果过敏患者,但杏仁过敏患者除外,开心果和葵花籽。
BACKGROUND: ALEX multiplex platform has been recently commercialized but its clinical utility as quantitative technique respect to
ImmunoCAP-singleplex as the reference method has not yet been confirmed on patients suffering from nut allergy and co-sensitization to different nuts.
METHODS: 58 serum samples from patients with nut allergy from a Mediterranean population were assayed in parallel by ALEX-multiplex and
ImmunoCAP-singleplex techniques. Patients were diagnosed based on clinical symptoms and positive skin prick tests (SPTs). The following whole extracts were compared between both techniques: walnut, hazelnut, peanut, almond, pistachio and sunflower seed; besides the recombinant Pru p 3. A qualitative and quantitative study was carried out.
RESULTS: Both techniques had similar sensitivities respect to whole extracts from walnut, hazelnut and peanut as well as to Pru p 3 (p > 0.05). However for whole extracts from almond, pistachio and sunflower seed the sensitivity obtained by ALEX was much lower than
ImmunoCAP (9.09 % vs 88.63 %; 14.81 vs 70.37 %; and 8.51 % vs 88.88 %; respectively). The concordance between both techniques showed only a substantial agreement for Pru p 3 (k = 0.791); moderate agreement for hazelnut and peanut (k = 0.550 and k = 0.544, respectively); fair agreement for walnut (k = 0.386) and poor agreement for almond, pistachio and sunflower seed (k < 0.2). Quantitative analysis showed that
ImmunoCAP for walnut, peanut and sunflower seed had higher mean values than ALEX. Relationships were significant for all specific IgE levels except to for almond, pistachio and sunflower seed.
CONCLUSIONS: ALEX platform is a suitable technique to patients with nut allergy from the Mediterranean area except to for those suffering from allergy to almond, pistachio and sunflower seed.