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Trouche-Estival B, Vitte J, Martin-Blondel A, Michelet M, Gruzelle V, Didier A, Guilleminault L, Mailhol C, Rivera SM, De Lima Correia A, Taurus C, Blancher A, Goret J, Klingebiel C, Apoil PA. NOVEOS and ImmunoCAP Have Similar Performances for Diagnosing Food Allergies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1605-1613.e5. [PMID: 38458433 DOI: 10.1016/j.jaip.2024.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 02/15/2024] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND The clinical significance of newly available platforms for specific IgE measurement must be evaluated. However, data are lacking for NOVEOS (Hycor), especially for food allergens. OBJECTIVE We compared the technical and clinical performance of two platforms (ImmunoCAP and NOVEOS) to measure specific IgE to 10 food allergens. METHODS Sera from 289 clinically characterized patients were tested for IgE specific for six food allergen extracts (egg white, cow's milk, peanut, hazelnut, fish, and shrimp) and four molecular allergens (Gal d 1, Bos d 8, Ara h 2, and Cor a 14). Specific IgE measurements were carried out using ImmunoCAP and NOVEOS methods. Food allergy diagnoses were established according to international guidelines. RESULTS A strong correlation (ρ > 0.9) was present between the two platforms whereas specific IgE concentrations measured with NOVEOS were consistently lower (mean, -15%) than with ImmunoCAP. NOVEOS and ImmunoCAP provided similar overall odds ratios and relative risks for food allergy diagnosis with both allergen extracts and molecular allergens. When all 10 allergens were considered, NOVEOS provided better receiver operating characteristic curves (P = .04). Finally, we found that the most discordant results were observed with hazelnut and peanut extracts and were related to cross-reactive carbohydrate determinants for these two with ImmunoCAP. CONCLUSIONS Specific IgE determination by either ImmunoCAP or NOVEOS (odds ratios of allergy, 25.1 or 33.0, respectively) is highly informative regarding the risk of allergy in the selected population. The NOVEOS platform presents the advantage of being less affected by unwanted reactivity owing to carbohydrate determinant-specific IgE while requiring a 10-fold lower test sample volume.
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Affiliation(s)
| | - Joana Vitte
- INSERM UMR-S 1250, University of Reims-Champagne Ardenne, Reims, France
| | - Audrey Martin-Blondel
- Pneumologie and Allergologie, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - Marine Michelet
- Pneumologie and Allergologie, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - Vianney Gruzelle
- Pneumologie and Allergologie, Hôpital des Enfants, CHU de Toulouse, Toulouse, France
| | - Alain Didier
- Pneumo-Allergologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France; INSERM INFINITy, U1291, Toulouse, France
| | - Laurent Guilleminault
- Pneumo-Allergologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France; INSERM INFINITy, U1291, Toulouse, France
| | - Claire Mailhol
- Pneumo-Allergologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | | | | | - Camille Taurus
- Institut Fédératif de Biologie, CHU de Toulouse, Toulouse, France
| | - Antoine Blancher
- Institut Fédératif de Biologie, CHU de Toulouse, Toulouse, France
| | - Julien Goret
- Laboratoire d'Immunologie, CHU de Bordeaux, Bordeaux, France
| | | | - Pol André Apoil
- Institut Fédératif de Biologie, CHU de Toulouse, Toulouse, France; INSERM INFINITy, U1291, Toulouse, France.
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Giusti D, Guemari A, Perotin JM, Fontaine JF, Tonye Libyh M, Gatouillat G, Tabary T, Pham BN, Vitte J. Molecular allergology: a clinical laboratory tool for precision diagnosis, stratification and follow-up of allergic patients. Clin Chem Lab Med 2024; 0:cclm-2024-0305. [PMID: 38815141 DOI: 10.1515/cclm-2024-0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024]
Abstract
Identification of the molecular culprits of allergic reactions leveraged molecular allergology applications in clinical laboratory medicine. Molecular allergology shifted the focus from complex, heterogeneous allergenic extracts, e.g. pollen, food, or insect venom, towards genetically and immunologically defined proteins available for in vitro diagnosis. Molecular allergology is a precision medicine approach for the diagnosis, stratification, therapeutic management, follow-up and prognostic evaluation of patients within a large range of allergic diseases. Exclusively available for in vitro diagnosis, molecular allergology is nonredundant with any of the current clinical tools for allergy investigation. As an example of a major application, discrimination of genuine sensitization from allergen cross-reactivity at the molecular level allows the proper targeting of the culprit allergen and thus dramatically improves patient management. This review aims at introducing clinical laboratory specialists to molecular allergology, from the biochemical and genetic bases, through immunological concepts, to daily use in the diagnosis and management of allergic diseases.
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Affiliation(s)
- Delphine Giusti
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, EA7509 IRMAIC, Reims, France
| | - Amir Guemari
- Univ Montpellier, Desbrest Institute of Epidemiology and Public Health (IDESP), INSERM, Montpellier, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, INSERM UMR 1250, Reims, France
| | | | - Marcelle Tonye Libyh
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
| | - Gregory Gatouillat
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
| | - Thierry Tabary
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
| | - Bach-Nga Pham
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, EA7509 IRMAIC, Reims, France
| | - Joana Vitte
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, INSERM UMR 1250, Reims, France
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Potapova E, Panetta V, Grabenhenrich L, Icke K, Grübl A, Müller C, Zepp F, Schuster A, Wahn U, Lau S, Keil T, Matricardi PM. A singleplex IgE test to a mixture of molecules from multiple airborne allergen sources: Innovating in vitro screening of respiratory allergies. Pediatr Allergy Immunol 2022; 33:e13867. [PMID: 36433848 DOI: 10.1111/pai.13867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/12/2022] [Accepted: 09/24/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND In vitro immunoglobulin E (IgE) tests can be better standardized if based on molecules rather than extracts. However, singleplex screening tests for respiratory or food allergies are still based on extracts only. TARGET To validate a novel singleplex IgE screening test for respiratory allergies, based on a mix of major allergenic molecules Der p 1, Der p 2, Fel d 1, Can f 1, Can f 2, Can f 3, Can f 5, Bet v 1, Phl p 1, and Art v 1 (Molecular SX01, NOVEOS, HYCOR, USA), and requiring only four microliters (μl) of serum. METHODS We examined six subsets of sera from participants of the German Multicenter Allergy Study (MAS) birth cohort enrolling 1314 newborns during 1990: (1) monosensitized (n = 58); (2) polysensitized (n = 24); (3) nonsensitized, with total IgE levels above (n = 24) or (4) below (n = 24) 300 kU/L; (5) sensitized to milk and/or egg but not to airborne allergens (n = 24); and (6) sera of children aged ≤5 years at their earliest IgE monosensitization to airborne allergens (n = 41). Sera were analyzed with the novel molecular SX01 test (NOVEOS) and with three categories of comparators: ImmunoCAP Phadiatop SX01, extracts, and molecules of D. pteronyssinus, cat, dog, grass, and birch. Sensitivity, specificity, positive and negative predictive values were calculated. Quantitative interrelationships were determined using Spearman's rank-order correlation coefficient and Bland-Altmann plots. RESULTS The molecular SX01 test predicted the outcome of IgE tests based on molecules, extracts, or Phadiatop in 188 (96.4%), 171 (87.7%), and 171 (87.7%) of the 195 sera, respectively. Accordingly, sensitivity was 93.5%, 89.0%, and 82.4%, whereas specificity was 100%, 97.6%, and 96.1% when compared with molecular, extract, and Phadiatop tests, respectively. Inconsistent outcomes were largely confined to sera with IgE-Ab levels around the cutoff value of 0.35 kU/L, except for 5/195 (2.5%) sera, containing high levels of IgE to Phl p 5 and/or Alt a 1 only. IgE levels measured by the molecular SX01 test and with IgE tests to molecules, extracts, and Phadiatop were highly correlated (rho 0.90; p < .001), (rho 0.87, p < .001), (rho 0.84, p < .001), respectively. The novel molecular SX01 test detected IgE-Ab in 27/28 (sensitivity 96.4%) of the sera of preschool children at their earliest IgE sensitization to the same molecules. DISCUSSION Our study validates the prototype of a novel category of IgE test, based on molecular mixes. The test's rather good precision and accuracy in early screening IgE sensitization to airborne allergens in German children may be further improved by adding a few other molecules, such as Phl p 5 and Alt a 1.
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Affiliation(s)
- Ekaterina Potapova
- Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Valentina Panetta
- L'altrastatistica srl, Consultancy & Training, Biostatistics office, Rome, Italy
| | - Linus Grabenhenrich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Katja Icke
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Armin Grübl
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Christoph Müller
- Department of Pediatrics, Allergy Working Group, University Clinic Freiburg, Freiburg, Germany
| | - Fred Zepp
- Department of Pediatrics and Adolescent Medicine, University Medicine Mainz, Mainz, Germany
| | - Antje Schuster
- Department of Pediatrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ulrich Wahn
- Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Susanne Lau
- Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Keil
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,State Institute of Health, Bavarian Health and Food Safety Authority, Erlangen, Germany
| | - Paolo Maria Matricardi
- Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Potapova E, Bauersachs D, Villella V, Meneguzzi G, Scala E, Sfika I, Tripodi S, Panetta V, Dramburg S, Skevaki C, Matricardi PM. Validation study of a new chemiluminescent singleplex IgE assay in a set of Italian allergic rhinitis patients. Clin Exp Allergy 2020; 51:604-613. [DOI: 10.1111/cea.13785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/04/2020] [Accepted: 10/08/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Ekaterina Potapova
- Division of Pneumonology, Immunology and Intensive Medicine Department of Pediatrics Charité – Universitätsmedizin Berlin Germany
| | - Daniel Bauersachs
- Institute of Laboratory Medicine Universities of Giessen and Marburg Lung Center (UGMLC) German Center for Lung Research (DZL) Philipps University Marburg Marburg Germany
| | | | - Giorgia Meneguzzi
- Allergy Unit Istituto dermopatico dell'Immacolata (IDI)‐IRCCS Roma Italy
| | - Enrico Scala
- Allergy Unit Istituto dermopatico dell'Immacolata (IDI)‐IRCCS Roma Italy
| | - Ifigenia Sfika
- Pediatric Allergy Unit Sandro Pertini Hospital Rome Italy
| | | | | | - Stephanie Dramburg
- Division of Pneumonology, Immunology and Intensive Medicine Department of Pediatrics Charité – Universitätsmedizin Berlin Germany
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine Universities of Giessen and Marburg Lung Center (UGMLC) German Center for Lung Research (DZL) Philipps University Marburg Marburg Germany
| | - Paolo Maria Matricardi
- Division of Pneumonology, Immunology and Intensive Medicine Department of Pediatrics Charité – Universitätsmedizin Berlin Germany
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