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Related Concept Videos

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Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
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Related Experiment Video

Updated: May 6, 2026

A Component-resolved Diagnostic Approach for a Study on Grass Pollen Allergens in Chinese Southerners with Allergic Rhinitis and/or Asthma
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Screening asthmatics for atopic status using the ALergy EXplorer (ALEX2) macroarray.

Robert G Hamilton1, Mark Holbreich2, Charles Bronzert1

  • 1Johns Hopkins University School of Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, MD, USA.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|February 28, 2024
PubMed
Summary

The Allergy Explorer (ALEX2) offers a more detailed view of atopic status in asthma patients than the traditional Phadiatop screening. ALEX2 identified additional allergen sensitivities missed by Phadiatop, aiding in personalized asthma management.

Keywords:
ALEX2Phadiatopatopymacroarraymultiallergen screensingleplex

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Area of Science:

  • Allergy and Immunology
  • Pulmonology
  • Biomarker Discovery

Background:

  • Screening asthma patients for atopy is crucial for effective management.
  • The Phadiatop multi-aeroallergen screen has been the standard biomarker since 2010.
  • The Allergy Explorer (ALEX2) macroarray presents a promising quantitative alternative.

Purpose of the Study:

  • To evaluate the advantages and disadvantages of using ALEX2 for atopic screening in asthma patients.
  • To compare the diagnostic performance of ALEX2 against Phadiatop and ImmunoCAP assays.

Main Methods:

  • Evaluated atopic status (IgE sensitization) in asthmatic children using ImmunoCAP and ALEX2.
  • Subjects included Amish and Hutterite farm children with Phadiatop equivocal or positive results.
  • ALEX2 testing was performed on subjects with equivocal Phadiatop results or elevated total IgE.

Main Results:

  • ALEX2 detected IgE antibodies to allergens (mite, tree pollen) missed by Phadiatop in 44% of subjects with equivocal results, confirmed by ImmunoCAP.
  • In Phadiatop-positive subjects, ALEX2 confirmed sensitization in all but one case.
  • Specific IgE detected by ALEX2 correlated with environmental exposures (mold, rabbit) and identified cross-reactive protein sensitivities.

Conclusions:

  • ALEX2 provides enhanced specificity and detailed sensitization patterns beyond Phadiatop.
  • Clinical history remains essential for confirming the relevance of identified sensitizations.
  • ALEX2 can improve the interpretation of sensitization and management strategies for atopic asthmatics.