Prevalence of immunoglobulin E against cross-reactive carbohydrate determinants and the impact of a blocker in canine sera

Zusammenfassung

Gegenstand und Ziel Kreuzreaktive Kohlenhydrat-Seitenketten (cross reactive carbohydrate determinants, CCD) führen bei saisonalen In-vitro-Allergietests zu multipositiven Ergebnissen. Diese Bindung von Immunglobulin E gegen CCD von Pollenallergenen (Anti-CCD-IgE) verursacht falsch-positive/klinisch irrelevante Resultate. Ziel dieser Studie war, die Prävalenz von polysensibilisierten Serumproben zu untersuchen und die Auswirkungen eines CCD-Inhibitors/Blockers auf die Ergebnisse von saisonalen Allergietests bei Hunden zu evaluieren.

Methoden Die Analyse berücksichtigte Seren von 4614 Hunden, die für einen Allergietest zum Nachweis von IgE gegen saisonale Allergene (ELISA basierend auf der Fc-Epsilon-Rezeptor-Technologie) von Juli 2017 bis Juni 2018 eingeschickt worden waren. Die Proben wurden als polysensibilisierte Seren (Gruppe A) und nicht polysensibilisierte Seren (Gruppe B) klassifiziert. Seren der Gruppe A wurden nach Zugabe eines modifizierten Glykoprotein-Pflanzenextrakts (Blocker) erneut getestet. Um die Auswirkung des Blockers auf jedes Allergen zu bestimmen, erfolgte eine Analyse der Ergebnisse von 96 zufällig ausgewählten Proben vor und nach dem Blocken.

Ergebnisse Eine Polysensibilisierung gegen saisonale Allergene zeigte sich bei 818 (17,7 %) Serumproben. Der Blocker eliminierte die Bindung von Anti-CCD-IgE an Allergenextrakte vollständig (49 %) oder erniedrigte die Reaktionsklassen (40 %), was auf das Vorhandensein von klinisch relevantem IgE hinweist. Negative Reaktionen nach Zugabe des Blockers ergaben sich beim 6-Gräser-Mix (29 %), bei Roggen (22 %) und Sauerampfer (20 %) weniger häufig als bei Brennnessel (82 %), Weide (70 %), Birke-Hasel (65 %), Beifuß-Ragweed (63 %) und Spitzwegerich (57 %).

Schlussfolgerung und klinische Relevanz Der Blocker sollte bei polysensibilisierten Seren eingesetzt werden, um die Qualität saisonaler In-vitro-Allergietests zu verbessern und die Verwendung klinisch irrelevanter Allergene in der allergenspezifischen Immuntherapie (ASIT) zu vermeiden.

Abstract

Objective Cross-reactive carbohydrate determinants (CCD) cause multiple positive results in seasonal in vitro allergy tests. False positive/clinically irrelevant results have been identified due to the binding of immunoglobulin E against CCD (anti-CCD IgE) when testing for pollen allergens. The aim of this study was to investigate the prevalence of polysensitised serum samples and evaluate the impact of a CCD inhibitor/blocker in seasonal allergy test results.

Material and methods A total of 4614 canine serum samples, submitted from July 2017 to June 2018 for seasonal in vitro allergy test via ELISA Fc-Ε receptor technology, were studied. Samples were grouped into polysensitised (group A) and non-polysensitised (group B). Polysensitised samples were retested after adding a modified glycoprotein plant extract (blocker). To determine the impact of the blocker for each allergen, results prior and post blocking were investigated in 96 randomly selected samples.

Results Polysensitisation to seasonal allergens was diagnosed in 818 (17.7 %) serum samples. The blocker eliminated the binding of anti-CCD IgE to allergen extracts (49 %) or suppressed the reaction classes (40 %) which are indicative of the presence of clinically relevant IgE. Negative reactions after blocking were less common when testing for antibodies against a mixture of 6-grass mix (29 %), rye (22 %), and sheep sorrel (20 %) in comparison to nettle (82 %), willow (70 %), birch-hazel (65 %), mugwort-ragweed (63 %) and English plantain (57 %).

Conclusion and clinical relevance Blocking should be used in the case of polysensitized results to improve the quality of seasonal in vitro allergy tests and avoid the use of allergen-specific immunotherapy (ASIT) for clinically irrelevant allergens.

Schlüsselwörter

Hund - Serumtest - Kreuzreaktion - falsch-positive Ergebnisse - Anti-CCD-IgE

Key words

Dog - serum test - cross-reaction - false positive results - anti-CCD IgE

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