Anisakis simplex recombinant allergens increase diagnosis specificity preserving high sensitivity.

Area of Science:

• Allergy and Immunology
• Parasitology
• Diagnostic Medicine

Background:

• Current Anisakis simplex (A. simplex) allergy diagnosis relies on skin prick tests (SPTs) and ImmunoCAP, which use whole parasite extracts.
• These methods exhibit good sensitivity but poor specificity due to cross-reactivity with non-specific IgE antibodies.
• There is a need for more specific diagnostic tools for A. simplex allergy.

Purpose of the Study:

• To evaluate the diagnostic performance of recombinant Anisakis simplex allergens (Ani s 1, Ani s 3, Ani s 5, Ani s 9, Ani s 10).
• To compare the specificity and sensitivity of these recombinant allergens against commercial diagnostic methods (SPTs and ImmunoCAP).

Main Methods:

• A cross-sectional study involving 99 fish-tolerant individuals and 35 A. simplex-allergic patients.
• Patients underwent SPTs, ImmunoCAP assays, and dot blotting for specific IgE detection against recombinant A. simplex allergens.
• IgE detection was performed using sera from both patient groups.

Main Results:

• All A. simplex-allergic patients showed positive results with SPTs and ImmunoCAP.
• Specific IgE against recombinant allergens was found in 100% of allergic patients and 15% of tolerant patients.
• Dot blotting with recombinant allergens demonstrated higher specificity (84.85%) compared to ImmunoCAP (82.83%), while maintaining 100% sensitivity.

Conclusions:

• A significant proportion (15%) of tolerant individuals possess specific IgE to key A. simplex allergens.
• Recombinant Anisakis simplex allergens enhance diagnostic specificity for A. simplex allergy.
• Incorporating these recombinant allergens into diagnostic tests can improve the accuracy of A. simplex allergy diagnosis.