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J Allergy Clin Immunol. 2010 Mar;125(3):687-94, 694.e1. doi: 10.1016/j.jaci.2009.10.017. Epub 2010 Jan 12.

Component-resolved diagnosis of kiwifruit allergy with purified natural and recombinant kiwifruit allergens.

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  • 1Department of Pathophysiology, Medical University of Vienna, Vienna, Austria.

Abstract

BACKGROUND:

Kiwifruit is one of the most common causes of food allergic reactions. Component-resolved diagnostics may enable significantly improved detection of sensitization to kiwifruit.

OBJECTIVE:

To evaluate the use of individual allergens for component-resolved in vitro diagnosis of kiwifruit allergy.

METHODS:

Thirty patients with a positive double-blind placebo-controlled food challenge to kiwifruit, 10 atopic subjects with negative open provocation to kiwifruit, and 5 nonatopic subjects were enrolled in the study. Specific IgE to 7 individual allergens (nAct d 1-5 and rAct d 8-9) and allergen extracts was measured by ImmunoCAP.

RESULTS:

The diagnostic sensitivities of the commercial extract and of the sum of single allergens were 17% and 77%, respectively, whereas diagnostic specificities were 100% and 30%. A combination of the kiwi allergens Act d 1, Act d 2, Act d 4, and Act d 5 gave a diagnostic sensitivity of 40%, whereas diagnostic specificity remained high (90%). Exclusion of the Bet v 1 homolog recombinant (r) Act d 8 and profilin rAct d 9 from this allergen panel reduced sensitivity to 50% but increased specificity to 40%. Kiwifruit-monosensitized patients reacted more frequently (P < .001) with Act d 1 than polysensitized patients, whereas the latter group reacted more frequently with rAct d 8 (P = .004).

CONCLUSION:

Use of single kiwifruit allergen ImmunoCAP increases the quantitative test performance and diagnostic sensitivity compared with the commercial extract. Bet v 1 homolog and profilin are important allergens in pollen-related kiwifruit allergy, whereas actinidin is important in monoallergy to kiwifruit, in which symptoms are often more severe.

PMID:
20061012
[PubMed - indexed for MEDLINE]
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