Objective To compare allergen specific immunoglobulin E (sIgE) with allergen component test in diagnosing food allergy, in order to explore the application value of allergen component test in diagnosing food allergy. Methods Children with history of allergen sIgE and allergen component test were enrolled in this study, from Children's Hospital of Fudan University, Harbin Children's Hospital, Peking University Third Hospital, Hubei Maternal and Child Health Hospital and Children's Hospital of Chongqing Medical University from October 2017 to March 2019. ImmunoCAP system and enzyme-linked immunoblotting were used to detect eggs, milk, peanuts sIgE and corresponding allergen components respectively. Results 1) Among 242 children with food allergy, 162 had egg allergies, 152 had milk allergies and 72 had peanut allergies, with 50 healthy children as controls. Among children with egg allergy, the highest rate of positive sIgE testing was for ovalbumin (96.3%,156/162), followed by ovotransferrin(92.6%,150/162) and ovomucoid(83.9%, 136/162). Among children with milk allergy, the highest rate of positive sIgE testing was for α-lactalbumin (82.9%, 126/152), followed by β-lactoglobulin (81.6%, 124/152), casein (80.3%, 122/152) and bovine serum albumin (75.0%, 114/152). The sIgE positivity for peanut allergen components in children with peanut allergy ranged from 0% to 13.8%. More than 70% of egg or milk allergies were sensitized to three or more allergen components concomitantly. The higher the level of allergen sIgE in children with egg allergy, the greater the variety of allergen components that cause allergy (r=0.212, P=0.002). 2) The sensitivity of the egg, milk and peanut allergen component test for diagnosing food allergy were 0.975, 0.993 and 0.208, respectively, with specificities of 0.660, 0.920 and 0.980, positive predictive values of 0.903, 0.974 and 0.938 and negative predictive values of 0.892, 0.979 and 0.462, respectively, and the area under the receiver operative characteristic curve were 0.818 (95%CI: 0.735 - 0.900), 0.957 (95%CI: 0.912 - 1.000) and 0.594 (95%CI: 0.494 - 0.694), respectively. Conclusion Food allergen component testing can be used in conjunction with allergen sIgE testing as an adjunct to the diagnosis of IgE-mediated food allergy, to identify the allergenic protein fraction and to better guide the individual clinical management of children with food allergy.
Key words
food allergy /
allergen component testing /
allergen specific IgE /
children
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