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Original Article


In Vivo and In Vitro Testing With rAni s 1 Can Facilitate Diagnosis of Anisakis simplex Allergy


RM Martínez-Aranguren,1 PM Gamboa,2 E García-Lirio,2 J Asturias,3 MJ Goikoetxea,1 ML Sanz1

1Department of Allergology and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain
2Allergy Service. Hospital de Basurto, Bilbao, Spain
3I+D Departament, Laboratory Bial Arístegui, Bilbao, Spain

J Investig Allergol Clin Immunol 2014; Vol. 24(6): 431-438



Background: Traditional diagnostic tests such as skin prick tests (SPT) and specific IgE (sIgE) against whole Anisakis simplex extract have low specificity. Consequently, allergy to A simplex is overdiagnosed.

Objective: Our aim was to compare tests used in component-resolved diagnosis.

We evaluated 34 patients with allergy to A simplex, 15 patients with acute urticaria who were sensitized to A simplex but had no clinical history of allergy to A simplex, and 10 patients allergic to seafood. SPT, sIgE (ELISA and ISAC-112), and the basophil activation test (BAT) were performed with A simplex whole extract and the molecular components rAni s 1, rAni s 3, and nPen m 1. Sensitivity and specificity were calculated and compared with different cutoffs.

Results: With the A simplex whole extract, SPT, sIgE, and BAT yielded specificity values of 72%, 68%, and 70%, respectively, with a cutoff (wheal size) of 11.2 mm, an sIgE value of 7.9 kUA/L, and a stimulation index of 1.9. Specificity increased to 100% using the molecular component rAni s 1 with SPT, sIgE by ELISA, and ISAC-112. Neither rAni s 3 sensitization nor cross-reactivity with Pen m 1 was observed in patients sensitized to A simplex.

Conclusion: rAni s 1 is recognized by 100% of our patients and is able to distinguish between patients allergic to A simplex and patients with acute urticaria who are sensitized to A simplex but have no clinical history of allergy to this parasite.

Key words: Anisakis simplex allergy. Acute urticaria. Ani s 1. Component-resolved diagnosis. In vitro test. BAT. ISAC. ELISA.