Interleukin-4 enzyme-linked immunospot assay may be useful for diagnosing sensitization to house dust mite

• Published in: International forum of allergy & rhinology Vol. 6; no. 10; pp. 1007 - 1012
• Main Authors: Chang, Dong-Yeop, Lee, Jino, Choi, Sung-Won, Lee, Hyeong Joo, Kang, Hyunmo, Yeo, Seong Chul, Joo, Yeon-Hee, Cho, Hyun-Jin, Jeon, Sea-Yuong, Kim, Rock Bum, Kim, Sang-Wook
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2016; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Allergens - immunology; allergic rhinitis; Allergies; allergy; Animals; Antigens, Dermatophagoides - immunology; Child; Cytokines; Dermatophagoides farinae - immunology; Dermatophagoides pteronyssinus - immunology; enzyme-linked immunospot assay; Enzyme-Linked Immunospot Assay - methods; Enzymes; Female; house dust mites; Humans; Immunoglobulin E - blood; interleukin-4; Interleukin-4 - immunology; Male; Middle Aged; Pyroglyphidae - immunology; Rhinitis, Allergic - blood; Rhinitis, Allergic - diagnosis; Rhinitis, Allergic - immunology; Sensitivity and Specificity; Skin Tests; Young Adult; house dust mites; interleukin-4; allergy; allergic rhinitis; enzyme-linked immunospot assay
• ISSN: 2042-6976; 2042-6984; 2042-6984
• DOI: 10.1002/alr.21786

Background The skin prick test (SPT) is considered a standard test for identification of allergens, but it has some limitations in clinical practice. The multiple allergen simultaneous test (MAST), which measures allergen‐specific immunoglobulin E in patients’ serum, is a widely used alternative test, but is limited by its relatively low sensitivity and specificity. As a novel diagnostic test to identify allergens, we investigated the sensitivity and specificity of an interleukin‐4 (IL‐4) enzyme‐linked immunospot (ELISpot) assay for Dermatophagoides farinae (Der f) and Dermatophagoides pteronyssinus (Der p). Methods Based on the symptoms and SPT results, 43 house dust mite (HDM) allergic rhinitis (AR) patients and 41 control subjects were included. Peripheral blood was drawn from each subject for IL‐4 ELISpot assay and MAST. The receiver operating characteristic (ROC) curve analysis was conducted to determine the cutoff values. Sensitivity, specificity, and positive and neg predictive values were compared between the 2 tests. Results The sensitivity, specificity, and areas under the ROC curve (AUCs) of the IL‐4 ELISpot assay were 88.4%, 97.6%, and 0.939 for Der f, and 95.3%, 97.5%, and 0.971 for Der p, respectively. However, the sensitivity, specificity, and AUC of MAST were 76.7%, 73.2%, and 0.777 for Der f, and 69.8%, 75.6%, and 0.788 for Der p, respectively. Conclusion The IL‐4 ELISpot assay showed higher sensitivity, specificity, and AUC than MAST, which indicates its clinical feasibility for diagnosing allergy for HDM. A further study is needed to determine the accuracy of the IL‐4 ELISpot assay for other common allergens.