Resumen:
Background:
Traditional diagnostic tests such as skin prick tests (SPT) and specific IgE (sIgE) against whole
Anisakis simplex
extract have
low specificity. Consequently, allergy to
A simplex
is overdiagnosed.
Objective:
Our aim was to compare tests used in component-resolved diagnosis.
Methods:
We evaluated 34 patients with allergy to
A simplex
, 15 patients with acute urticaria who were sensitized to
A simplex
but had
no clinical history of allergy to
A simplex
, and 10 patients allergic to seafood. SPT, sIgE (ELISA and ISAC-112), and the basophil activation
test (BAT) were performed with
A simplex
whole extract and the molecular components rAni s 1, rAni s 3, and nPen m 1. Sensitivity and
specificity were calculated and compared with different cutoffs.
Results:
With the
A simplex
whole extract, SPT, sIgE, and BAT yielded specificity values of 72%, 68%, and 70%, respectively, with a cutoff
(wheal size) of 11.2 mm, an sIgE value of 7.9 kU
A
/L, and a stimulation index of 1.9. Specificity increased to 100% using the molecular
component rAni s 1 with SPT, sIgE by ELISA, and ISAC-112. Neither rAni s 3 sensitization nor cross-reactivity with Pen m 1 was observed
in patients sensitized to
A simplex
.
Conclusion:
rAni s 1 is recognized by 100% of our patients and is able to distinguish between patients allergic to A simplex and patients
with acute urticaria who are sensitized to
A simplex
but have no clinical history of allergy to this parasite