Allergy screening with extract-based skin prick tests demonstrates higher sensitivity over in vitro molecular allergy...

Area of Science:

• Allergy diagnostics
• Immunology
• Clinical medicine

Background:

• Extract-based skin prick testing (SPT) and in vitro molecular allergy tests have distinct advantages.
• Routine allergy diagnosis often employs both SPT and molecular tests.
• Resource limitations necessitate evaluating the diagnostic yield of using only one test.

Purpose of the Study:

• To compare the diagnostic sensitivity of SPT versus in vitro molecular allergy testing for major allergens.
• To determine the potential for underdiagnosis if only one allergy testing method is used.

Main Methods:

• Retrospective analysis of 2646 patients from an Austrian allergy clinic in 2018.
• Inclusion of patients with allergen-specific history and paired SPT and molecular allergy test results.
• Comparison of test results for birch pollen, house dust mite, grass pollen, and cat allergens.

Main Results:

• Skin prick testing (SPT) exhibited higher sensitivity than sIgE-based molecular allergy testing across all tested allergen sources.
• For birch pollen allergy, 78.6% of patients were positive by both tests, 15.2% by SPT only, and 6.2% by molecular test only.
• Similar patterns were observed for house dust mite, grass pollen, and cat allergies, with statistically significant differences (p < 0.0001).

Conclusions:

• Major molecular allergen screening shows lower sensitivity compared to extract-based skin tests.
• Optimal allergy detection sensitivity requires a combination of both skin prick testing and molecular allergy testing.