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The diagnostic performance of allergen-molecules in comparison to allergen-extracts

Abstract Background: This study evaluated the diagnostic performance of naturally purified allergen-molecules compared to that of allergen-extracts for house dust mite, cat dander epithelium and dog dander. Methods: In vitro tests for allergen-specific IgE were performed on the IMMULITE® 2000 in serum samples from 66 allergic patients. Results: House dust mite: specificity for the allergen-extract (D1) and the allergen-molecules (nDer p 1, nDer f 1, nDer p 2 and nDer f 2) is comparable. The allergen-extract has a significantly higher sensitivity (100%) and total agreement (TA) (93%) relative to sensitivity (57%–70%) and TA (76%–81%) of the individual allergen-molecules. Cat dander epithelium: sensitivity (90%), specificity (96%) and TA (94%) of the allergen-molecule (nFel d 1) are comparable to those of the allergen-extract (E1). Dog dander: The allergen-molecule (nCan d 1) and allergen-extract (E5) have comparable specificity and TA. The allergen-extract has a lower sensitivity (52%) than the allergen-molecule (71%), although not significant (p=0.125). Conclusions: There is no diagnostic benefit of using allergen-molecules instead of allergen-extracts for initial allergy screening on cat dander epithelium and dog dander. However, use of these allergen-molecules might contribute to better standardization of the specific IgE tests. The studied allergen-molecules for house dust mite are of minor diagnostic value, because of loss of sensitivity.