Diagnostic specificity of the Fcε-receptor based allergy screening test

N. Thom; R. Neiger; M. Linek

doi:10.1055/s-0038-1622798

Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, Table of Contents

Tierarztl Prax Ausg K Kleintiere Heimtiere 2009; 37(04): 239-243
DOI: 10.1055/s-0038-1622798

Original article

Schattauer GmbH

Diagnostic specificity of the Fcε-receptor based allergy screening test

Diagnostische Spezifität des Fcε-Rezeptor-Allergie-Screening-Tests

N. Thom

¹Small Animal Clinic, Internal Medicine (Director: Prof. R. Neiger), Justus-Liebig-University Giessen

,

R. Neiger

¹Small Animal Clinic, Internal Medicine (Director: Prof. R. Neiger), Justus-Liebig-University Giessen

,

M. Linek

²Veterinary Specialists, Hamburg

› Author Affiliations

Abstract

Summary

Objective: To evaluate the diagnostic specificity of a Fcε-receptor allergy screening test using serum from clinically non-atopic dogs. Material and methods: In this prospective study allergen-specific IgE levels were measured using the Fcε-receptor method (Allercept^® Heska) in the serum from 15 clinically non-atopic dogs, without any history of pruritic skin diseases or recurrent ear diseases. Five crossbreeds and 10 pure breed dogs were included with approximately equal sex distribution. Their age ranged between 2 and 14 years, with a median age of 4 years. A commercially available allergy screening test was performed evaluating three allergen groups: mites (house dust mites and forage mites), moulds and pollens, as well as flea-saliva. Results: All except one dog showed positive results for at least one of the allergen groups. Fourteen dogs were positive for mites (house dust mites and forage mites), five dogs each were additionally positive for flea-saliva antigen and for pollens, respectively; only one dog was positive for moulds. Overall diagnostic specificity of the allergy screening test was 6.7% for mites, 66.6% for flea-saliva and pollens and 93.3% for moulds. Conclusions: The Fcε-receptor based allergy screening test detects a high incidence of allergen-specific IgE among clinically non-atopic dogs. The low diagnostic specificity in this study confirms results of earlier studies with serological monoclonal and polyclonal allergy testing. Clinical relevance: This Fcε-receptor based allergy screening test should not be used to establish the diagnosis of canine atopic dermatitis. Diagnosis of atopic dermatitis in dogs is based on clinical criteria and exclusion of other causes of pruritus. Positive intradermal or serological allergy testing is only a minor diagnostic criterion. Any kind of allergy testing is performed for identification of the relevant allergens in atopic dogs as a precondition for allergen specific immunotherapy.

Zusammenfassung

Gegenstand: Evaluierung der diagnostischen Spezifität des Fcε-Rezeptor-Allergie-Screening-Tests anhand klinisch nicht atopischer Hunde. Material und Methoden: Serum 15 klinisch nicht atopischer Hunde wurde prospektiv auf allergenspezifisches IgE untersucht. Weder vorberichtlich noch klinisch lagen Hinweise auf Haut- oder Ohrerkrankungen vor. Der Fcε-Rezeptor-Test (Allercept^®, Heska corp, USA) umfasste die Allergengruppen Milben, Schimmelpilze, Pollen und Floh-speichel. Die Ergebnisse sind in sechs Reaktionsklassen (RK) eingeteilt, RK0 gilt als negativ. Ergebnisse: 14 Hunde waren in mindestens einer Gruppe positiv. Alle 14 Tiere zeigten auf Milben ein positives Ergebnis, jeweils fünf Hunde waren zusätzlich auf Pollen oder Flohspeichel positiv, ein Hund auf Schimmelpilze. Zwei positive Resultate waren RK1, die übrigen lagen darüber. Die Spezifität des Fcε-Rezeptor-Tests für Milben betrug 6,7%, für Pollen und Flohspeichel 66,6%, für Schimmelpilze 93,3%. Schlussfolgerung: Der Fcε-Rezeptor-Test ist bei ca. 93% der klinisch nicht atopischen Hunde positiv. Diese Ergebnisse spiegeln die Resultate früherer Studien mit mono- oder polyklonalen Antikörpern für allergenspezifisches IgE wider. Da der Fcε-Rezeptor-Test hochspezifisch für IgE ist, können hier Kreuzreaktionen mit IgG ausgeschlossen werden. Eine verbesserte Spezifität durch Grenzwertanhebung ist aufgrund der deutlich positiven Resultate nicht ohne hohen Sensitivitätsverlust erreichbar. Als Ursachen für erhöhte IgE-Spiegel gelten subklinische Hypersensitivität und Parasitosen. Klinisch und vorberichtlich lagen keine Zeichen einer Parasitose vor. Eine subklinische Hypersensitivität kann nicht ausgeschlossen werden. Klinische Relevanz: Der Nachweis von allergenspezifischem IgE ist auch mittels des hochspezifischen Fcε-Rezeptor-Tests nicht für die Diagnose der kaninen atopischen Dermatitis geeignet. Dies ist eine klinische Diagnose, die anhand spezifischer Kriterien und nach Ausschluss anderer Ursachen gestellt wird. Allergietests stellen ein diagnostisches Nebenkriterium dar und dienen der Identifikation der verantwortlichen Allergene als Grundlage für eine allergenspezifische Immuntherapie.

Key words

Fcε-receptor - allergen-specific IgE - ELISA - allergy testing - atopy - atopic dermatitis - dog

Schlüsselwörter

Fcε-Rezeptor - allergenspezifisches IgE - ELISA - Allergietest - Atopie - atopische Dermatitis - Hund

Full Text

References

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