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Original Article


Contribution of Molecular Diagnosis of Allergy to the Management of Pediatric Patients With Allergy to Pollen


E Casquete-Román,1 T Rosado-Gil,2 I Postigo,3 R Pérez-Vicente,1 M Fernández,1 HE Torres,1 J Martínez-Quesada3,4

1Service of Clinical Analysis and Biochemistry, León, Spain
2Unit of Pediatric Allergy, Complejo Hospitalario de León, León, Spain
3Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country, Vitoria-Gasteiz, Álava, Spain
4Applications Laboratory, Phadia Spain SL, Barcelona, Spain

J Investig Allergol Clin Immunol 2009; Vol. 19(6): 439-445



Background: Component-resolved diagnosis based on recombinant allergens facilitates treatment of multiple sensitization and/or crossreactivity in allergic patients.

Objective: To assess the usefulness of molecular diagnosis in childhood allergies.

Methods: A total of 162 children aged 4-16 years diagnosed with allergic rhinitis or asthma/rhinitis caused by pollen were referred for recombinant allergen–based diagnosis in 2006. Specific immunoglobulin (Ig) E against pollen allergens and purified recombinant Phleum pratense pollen allergens were measured using an in vitro quantitative assay, and considering the recombinant allergens Phl p 1+Phl p 5
as P pratense–specific allergens and Phl p 7+Phl p 12 as cross-reacting allergens. Conditional probability was calculated to determine the relationship between values for specific IgE against major allergens and those for cross-reacting allergens.

Results: Specific IgE antibodies against P pratense were detected in 99.4% of serum samples, and cross-reacting allergens in 46%. Multiple sensitization to pollen was documented in 38% of patients, with Plantago lanceolata as the main cause. Conditional probability calculations showed that patients with specific IgE values of 75-80 kUA/L to Phl p 1+Phl p 5 were 75% (95% confidence interval) more likely to present
values ≥2 kUA/L to Phl p 7+Phl p 12.

Conclusions: Our results show that recombinant DNA technology can help diagnose allergy in cases of multiple sensitization and crossreactivity, and is therefore a promising option for improving prognosis and management of allergic pediatric populations.

Key words: Allergens/immunology. Immunologic tests/methods. Recombinant proteins/immunology. Immunoglobulin E/analysis. Crossreactions.