Iranian Journal of Allergy, Asthma and Immunology 2017. 16(1):39-44.

A Real Life Comparison between Allergenic Extracts and Allergenic Molecules
Giorgio Ciprandi, Paola Comite, Francesca Ferrero, Michele Mussap


Serum IgE assay is a mainstay step in the allergy work up. Allergenic extracts and molecular components are available at present. This real life study compared the serum specific IgE levels against allergenic extracts with allergenic molecules in patients allergic to Parietaria, Betulaceae, and mites. This retrospective real life study included 489 subjects with respiratory allergy. Inclusion criteria were 1) documented diagnosis of allergic rhinitis (AR) and/or allergic asthma, and 2) documented allergy to Parietaria judaica (Par j) 2 (216 patients: 112 females, mean age 42 years), or to Betula verrucosa (Bet v) 1 (62 patients: 35 females, mean age 3 years), or Dermatophagoides pteronyssinus (Der p) 1 (211 patients: 107 females, mean age 34 years); and mono-allergy. Serum IgE, specific both for total/crude allergen extracts and individual purified/recombinant allergens, were assessed by ImmunoCap system. The serum IgE levels to birch extract were very strongly (R2=0.96) related to IgE to Bet v 1. There was a strong (R2=0.71) correlation between Dermatophagoides pteronyssinus IgE and Der p 1. A very strong (R2=0.87) correlation also existed between Parietaria extract IgE and Par j 2 IgE levels. However, there was discrepancy between percentages of positivity between allergenic extracts and molecules. Therefore, allergen molecular diagnostics may represent a useful way in allergy work up, but deserves caution in particular circumstances.


Allergic rhinitis; Asthma; Bet v 1; Der p 1; Extract; Molecule; Par j 2; Serum IgE

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1. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update (in collaboration with the World Health Organization, GA2LEN and AllerGen). Allergy 2008; 63(Suppl. 86):8-160.

2. WAO White book on allergy 3. Fasce L, Tosca MA, Baroffio M, Olcese R, Ciprandi G.

Atopic infants with wheezing start always with monosensitization. Allergy Asthma Proc 2007;28(4):449-53.

4. Melioli G, Marcomini L, Agazzi A, Bazurro G, Tosca, Rossi GA, et al. The IgE repertoire in children and adolescents resolved at component level: A cross- sectional study. Pediatr Allergy Immunol 2012;23(5):433-40.

5. Arbes SJ, Jr., Gergen PJ, Elliott L, Zeldin DC.Prevalences of positive skin test responses to 10 common allergens in the US population: results from the third National Health and NutritionExaminationSurvey. J Allergy Clin Immunol 2005; 116(2):377-83.

6. Baatenburg de Jong A, Dikkeschel LD, Brand PL.Sensitization patterns to food and inhalant allergens in childhood: a comparison of non-sensitized, monosensitized, and polysensitized children. Pediatr Allergy Immunol 2011; 22(2):166-71.

7. Silvestri M, Rossi GA, Cozzani S, Pulvirenti G, Fasce L.Age-dependent tendency to become sensitized to other classes of aeroallergens in atopic asthmatic children. Ann Allergy Asthma Immunol 1999; 83(4):335-40.

8. Brunetto B, Tinghino R, Braschi MC, Antonicelli L, Pini C, Iacovacci P. Characterization and comparison of commercially available extracts for in vivo diagnosis. Allergy 2010; 65(2):184-90.

9. Mari A, Alessandri C, Bernardi ML, Ferrara R, Scala E, Zennaro D. Microarrayed allergen molecules fort he diagnosis of allergic diseases. Curr All Asthma Resp 2010; 10(5):357-64.

10. Sastre J. Molecular diagnosis in allergy. Clin Exp Allergy 2010; 40(10):1442-60.

11. Sastre J, Landivar ME, Ruiz-Garcia M, Andregnette- G. Ciprandi, et al.Rosign MV, Mahillo I. How molecular diagnosis can change allergen-specific immunotherapy prescription in a complex pollen area. Allergy 2012; 67(5):709-11.

12. Leimgruber A, Mosimann B, Claeys M, Seppey M, Jaccard Y, Aubert V, et al. Clinical evaluation of a new in-vitro assay for specific IgE, the immuno CAP system. Clin Exp Allergy 1991; 21(1):127-31.

13. Seagroatt V, Anderson SG. The second international reference preparation for human serum immunoglobulin E and the first British standard for human serum immunoglobulin E. J Biol Stand 1981; 9(4):431-7.

14. de Vos G. Skin testing versus serum-specific IgE testing: which is better for diagnosing aeroallergen sensitization and predicting clinical allergy? Curr Allergy Asthma Rep 2014; 14(5):430.

15. van Hage-Hamsten M, Kronqvist M, Zetterström O, Johansson E, Niederberger V, Vrtala S, et al. Skin test evaluation of genetically engineered hypoallergenic derivatives of the major birch pollen allergen, Bet v 1: results obtained with a mix of two recombinant Bet v 1 fragments and recombinant Bet v 1 trimer in a Swedish population before the birch pollen season. J Allergy Clin Immunol 1999; 104(5):969-77.

16. Moverare R, Westritschnig K, Svensson M, Hayek B,Bende M, Pauli G, et al. Different IgE reactivity profiles in birch pollen-sensitive patients from six European populations revealed by recombinant allergens: an imprint of local sensitization. Int Arch Allergy Immunol 2002;128(4):325-35.

17. Sekerková A, Poláčková M. Detection of Bet v1, Bet v2 and Bet v4 specific IgE antibodies in the sera of children and adult patients allergic to birch pollen: evaluation of different IgE reactivity profiles depending on age and local sensitization. Int Arch Allergy Immunol 2011;154(4):278-85.

18. Guhsl EE, Hofstetter G, Lengger N, Hemmer W, Ebner C, Fröschl R, et al. IgE, IgG4 and IgA specific to Bet v 1- related food allergens do not predict oral allergy syndrome. Allergy 2015; 70(1):59-66.

19. Hauser M, Asam C, Himly M, Palazzo P, Voltolini S, Montanari C, et al. Bet v 1-like pollen allergens of multiple Fagales species can sensitize atopic individuals. Clin Exp Allergy 2011; 41(12):1804-14.

20. Van der Linden IJM, de Groot MJM, de Jong NCCM, Bozkurt Z, Cobbaert CM. The diagnostic performance of allergen-molecules in comparison to allergen-extracts. Clin Chem Lab Med 2012; 50(1):129-32.


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