Comparison of a multi-allergen dipstick IgE assay to skin-prick test and RAST

A multi-allergen dipstick enzyme immunoassay 'Quidel Allergy Screen' (QAS) has recently been developed commercially for measuring IgE antibodies against nine allergens (house dust 1, house dust 2, Dermatophagoides pteronyssinus, D. farinae, Japanese cedar, ragweed, cat dander, sweet vernal grass, and egg white) at one time. To assess whether this assay is useful in screening allergen-specific IgE antibody, we compared the titres of IgE antibodies against the nine allergens measured by QAS to those in the skin-prick test and by RAST in 93 atopic asthmatics and 22 normal subjects. We found a good overall agreement between the results of the skin-prick test and the results of QAS (sensitivity = 47.1-81.4%, specificity = 84.5-100%, and agreement = 78.9-88.9%). The sensitivities against house dust 1, D. pteronyssinus, and D. farinae ranged from 77.2 to 81.4%. However, the sensitivities against house dust 2, Japanese cedar, ragweed, and cat dander were low (47.1-68.8%). We also found a good overall agreement between the results of RAST and the results of QAS, except for egg white (sensitivity = 46.2-94.4%, specificity = 87.4-100%, and agreement = 77.4-96.5%). The sensitivities against house dust 1 and 2, D. pteronyssinus, D. farinae, and Japanese cedar ranged from 86.0 to 94.4%. The sensitivities against ragweed, cat dander, and sweet vernal grass were low (46.2-52.6%). There were strong correlations between the titres of RAST and the titres of QAS except cat dander and egg white (r = 0.701-0.924 for the seven allergens). Thus, we conclude that QAS is useful in screening IgE antibodies against multiple allergens at one time. However, because the sensitivities against some allergens tested were low, further improvement of some allergen preparations seems to be necessary in the assay.