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Published on: June 4, 2017
Prick test accuracy for Der p components in pediatric rhinitis
Antonio Bonillo-Perales1, Esperanza Jiménez-Nogueira1, Patricia Juárez-Marruecos1
1Pediatrics Unit, University Hospital Torrecardenas, Almeria, Spain.
Insights
Skin prick tests accurately estimate specific IgE sensitization to Der p1, Der p2, and Der p23 in children with rhinitis. Positive results can guide immunotherapy decisions without further lab tests.
Area of Science:
- Allergy and Immunology
- Pediatric Respiratory Medicine
- Dermatophagoides pteronyssinus research
Background:
- Immunoglobulin E (IgE) Der p components are crucial for diagnosing and predicting outcomes in children with rhinitis and allergic asthma.
- These components also guide immunotherapy decisions for individuals sensitized to Dermatophagoides pteronyssinus.
- Previous research has not fully detailed the sensitization profile to Der p components via prick testing in pediatric rhinitis patients.
Purpose of the Study:
- To assess the accuracy of prick tests for Der p1, Der p2, and Der p23 in estimating specific IgE sensitization.
- To compare prick test results with specific IgE (ImmunoCAP) levels for these Dermatophagoides pteronyssinus components.
- To evaluate the predictive value of positive prick tests for specific IgE sensitization.
Main Methods:
- Retrospective cohort study of 125 children with rhinitis and positive prick test to Dermatophagoides pteronyssinus.
- Comparison of prick test sensitization with specific IgE (ImmunoCAP) for Der p1, Der p2, and Der p23.
- Analysis using Student's t-test, chi-squared tests, and ROC curves to determine accuracy.
Main Results:
- Prick tests showed significant differences compared to specific IgE for Der p1 (62.4% vs. 78.9%) and Der p2 (41.4% vs. 72.7%).
- No significant difference was observed for Der p23 (64.2% vs. 68.2%).
- Positive prick tests demonstrated high accuracy in estimating specific IgE sensitization for Der p1 (AUC: 0.88), Der p2 (AUC: 0.78), and Der p23 (AUC: 0.86).
Conclusions:
- Prick tests are highly accurate for estimating specific IgE sensitization to Der p1, Der p2, and Der p23.
- Positive prick tests can effectively guide specific immunotherapy decisions in children.
- Further laboratory testing may not be necessary when prick tests are positive.
Abstract:
This study aimed to evaluate the accuracy of prick tests for Der p1, Der p2, and Der p23 in estimating specific IgE sensitization to these components in children with rhinitis. A retrospective cohort study was conducted in 125 children with rhinitis who had a positive prick test to Dermatophagoides pteronyssinus. We compared the number of children sensitized by prick test to Der p1, Der p2, and Der p23 with those sensitized by specific IgE (ImmunoCAP) for each component. We used Student's t-test and chi-squared tests for the analysis. We also evaluated the accuracy of the molecular prick tests for estimating specific IgE to the components using ROC curves. The percentage of children sensitized by the prick test differed from those sensitized by specific IgE for Der p1 and Der p2. For Der p1, the percentages were 62.4% vs. 78.9% (p = 0.03). For Der p2, the rates were 41.4% vs. 72.7% (p < 0.001). For Der p23, the difference was not significant (64.2% vs. 68.2%, p = NS). Positive prick tests showed high accuracy for estimating specific IgE sensitization to Der p1 (AUC: 0.88, PPV: 93.7%, p < 0.001), Der p2 (AUC: 0.78, PPV: 100%, p < 0.001), and Der p23 (AUC: 0.86, PPV: 92.3%, p < 0.001).
Conclusions:
Prick tests are highly accurate for estimating specific IgE sensitization to Der p1, Der p2, and Der p23. When positive, they could guide specific immunotherapy in children without the need for additional laboratory tests.
What Is Known:
• IgE Der p components are highly useful for diagnostic and prognostic evaluation. They also guide the indication for immunotherapy in children with rhinitis, with or without allergic asthma, sensitized to D. pteronyssinus.
What Is New:
• This study is the first to describe the profile of allergic sensitization to Der p components using a prick test in children with rhinitis sensitized to D. pteronyssinus. Additionally, we describe for the first time the high predictive value of having positive IgE to Der p components in children with rhinitis who show positive prick test results for Der p components.
