INMUNOCAT Study: the impact of molecular diagnosis on immunotherapy
prescription in pollen polysensitized patients from Catalonia
Abstract
Background: Recognition of specific allergens triggering immune
response is key for the appropriate prescription of allergen-specific
immunotherapy (SIT). This study aimed at evaluating the impact of using
the commercially available microarray ImmunoCAP TM
ISAC 112 (Thermo Fisher Scientific) on the etiological diagnosis and SIT
prescription compared to the conventional diagnostic methods in patients
with allergic rhinitis/rhinoconjunctivitis and/or asthma.
Methods: 300 patients with respiratory allergic disease,
sensitized to three or more pollen aeroallergens from different species,
as assessed by skin prick-test (SPT) and specific IgE assays (sIgE),
were included in this multicentric, prospective observational study. SPT
and a blood test were performed to all patients. Total serum IgE, sIgE
(ImmunoCAP TM) for allergens found positive in the SPT
and sIgE allergen components (ImmunoCAP TM ISAC 112)
were measured. Results: According to SPT results, the most
prevalent pollen sensitizers in our population were Olea europaea
followed by grass, Platanus acerifolia and Parietaria
judaica. The molecular diagnosis (MD) revealed Ole e 1 as the most
prevalent pollen sensitizer, followed by Cup a 1, Phl p 1, Cyn d 1, Par
j 2, Pla a 1, 2, and 3 and Phl p 5. Immunotherapy prescription changed,
due to MD testing, in 51% of the cases, with an increase of
prescription of SIT from 39% to 65%. Conclusion: The
identification of the allergen eliciting the respiratory disease is
essential for a correct immunotherapy prescription. The advances in
allergen characterization using methods such as the commercial
microarray ImmunoCAP TM ISAC 112 can help clinicians
to improve SIT prescription.