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概要

Eosinophilic Esophagitis and Ige-Mediated Allergy in Children: Specific Ige by Component-Based-Allergen Microarray

Francesca Rea, Leila Emma D’Urbano, Rosa Luciano, Marta Muraca, Luigi Dall’Oglio, Giovanni Cavagni and Paola De Angelis

Background: Atopy is prevalent in eosinophilic esophagitis (EoE) but the relative role of airborn and food allergens in the etiopathogenesis is still incompletely understood; allergic immediate and delayed reactions are involved.

Objective: We characterized the sIgE profile by a component-based allergen microarray with highly purified allergens in EoE in comparison with traditional sIgE assay and we evaluated a possible correlation between clinical features and sIgE results.

Methods: In 30 consecutive patients diagnosed with EoE, three diagnostic tests were performed: skin prick test (SPT), ImmunoCAP �sIgE and an allergen component microarray chip called ImmunoCAP ISAC. The ISAC chips cover 103 recombinant or purified allergen molecules including food, airborn and cross-reactive allergens.

Results: Out of the 30 patients, 15, 16 and 17 of the patients were sensitized as assess with SPT, ISAC and ImmunoCAP respectively. Thirteen of the patients were multi-sensitized. The three diagnostic methods were in good agreement for all patients; the ISAC method provided new information in 8 patients, not revealed by the traditional tests, either by detection of panallergens or unsuspected triggering allergens.

Conclusions: sIgE detection by the ISAC microarray revealed that airborne allergens and panallergens are more frequently involved than food allergens in our population. The ISAC data were in agreement with both traditional tests and doctor’s diagnosis/open challenge and revealed new information that can improve understanding of the EoE pathogenesis and management.

Key message: immune-solid phase allergen chip (ISAC) gives new information about cross reactive molecules and identification of panallergens, which are not possible to obtain from traditional test.