Correlation between Component-resolved Diagnostics (CRD) and Clinical Symptoms in Allergic Children: A One-year Study at the Children's Medical Center (April 2023–March 2024)
-
Maedeh Khoshkam
,
Mahshid Movahedi
,
Mohammad Gharagozlou
,
Monir Farokhzadeh Soltani
,
Masoud Movahedi
Abstract
Component- Resolved Diagnosis (CRD) is an effective tool in allergy diagnosis, that detects specific IgE to allergenic molecules. The ALEX (Allergy Explorer) test, commercially available since 2019, measures specific IgE to allergenic extracts and components associated with inhalant, food, animal, latex, and insect allergens. CRD results should be interpreted based on the patient's clinical history.
Since Children's Medical Center Hospital is one of the largest referral centers for allergic patients, we evaluated the results of the ALEX2 test in patients referred to this center and compared them with the patients’ clinical symptoms.
Clinical symptoms were concordant with positive CRD (ALEX2) test in 76.7% of cases. The overall agreement between positive allergen components and clinical symptoms was 58%.
These findings indicate that the ALEX2 test can improve diagnostic accuracy in allergic patients; however, positive test results should be interpreted in the context of the patient’s clinical history.
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19. Eiringhaus K, Renz H, Matricardi P, Skevaki C. Component-resolved diagnosis in allergic rhinitis and asthma. J Appl Lab Med. 2019;3(5):883-98.
20. Čelakovská J, Čermákova E, Vaňková R, Andrýs C, Krejsek J. ALEX2 multiplex examination – results of specific IgE to fish and shrimps in patients with atopic dermatitis. Food Agric Immunol. 2021;33(1):1-19.
21. Li J, Zhang J, Qiong C, She T, Bian Y, Lin S, et al. Component resolved diagnostic study of cow's milk allergy in infants and young children in northern China. Int Immunopharmacol. 2018;61:126-31.
22. Inoue Y, Sato S, Takahashi K, Yanagida N, Yamamoto H, Shimizu N, et al. Component-resolved diagnostics for hazelnut allergy in Japanese children. Allergol Int. 2020;69(2):239-45.
2. Sicherer SH, Sampson HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133(2):291-307.
3. Nwaru BI, Hickstein L, Panesar SS, Muraro A, Werfel T, Cardona V, et al. The epidemiology of food allergy in Europe: a systematic review and meta-analysis. Allergy. 2014;69(1):62-75.
4. Sicherer SH. Epidemiology of food allergy. J Allergy Clin Immunol. 2011;127(3):594-602.
5. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood. Lancet. 2006;368(9537):733-43.
6. Foong RX, Dantzer JA, Wood RA, Santos AF. Improving diagnostic accuracy in food allergy. J Allergy Clin Immunol Pract. 2021;9(1):71-80.
7. Kalayci O. In-vitro diagnosis of allergic diseases. Clin Biochem. 2014;47(9):728-9.
8. Luengo O, Cardona V. Component resolved diagnosis: when should it be used? Clin Transl Allergy. 2014;4:28.
9. Sastre J. Molecular diagnosis in allergy. Clin Exp Allergy. 2010;40(10):1442-60.
10. Flores Kim J, McCleary N, Nwaru BI, Stoddart A, Sheikh A. Diagnostic accuracy, risk assessment, and cost-effectiveness of component-resolved diagnostics for food allergy: A systematic review. Allergy. 2018;73(8):1609-21.
11. Sonneveld LJH, Emons JAM, Arends NJT, Landzaat LJ, Veenbergen S, Schreurs MWJ. ALEX versus ISAC multiplex array in analyzing food allergy in atopic children. Clin Mol Allergy. 2022;20(1):10.
12. Barber D, Diaz-Perales A, Escribese MM, Kleine-Tebbe J, Matricardi PM, Ollert M, et al. Molecular allergology and its impact in specific allergy diagnosis and therapy. Allergy. 2021;76(12):3642-58.
13. Buzzulini F, Da Re M, Scala E, Martelli P, Conte M, Brusca I, et al. Evaluation of a new multiplex assay for allergy diagnosis. Clin Chim Acta. 2019;493:73-8.
14. Heffler E, Puggioni F, Peveri S, Montagni M, Canonica GW, Melioli G. Extended IgE profile based on an allergen macroarray: a novel tool for precision medicine in allergy diagnosis. World Allergy Organ J. 2018;11(1):7.
15. Alvaro-Lozano M, Akdis CA, Akdis M, Alviani C, Angier E, Arasi S, et al. EAACI Allergen Immunotherapy User's Guide. Pediatr Allergy Immunol. 2020;31(Suppl 25):1-101.
16. Palosuo K, Alenius H, Varjonen E, Kalkkinen N, Reunala T. Rye gamma-70 and gamma-35 secalins and barley gamma-3 hordein cross-react with omega-5 gliadin. Clin Exp Allergy. 2001;31(3):466-73.
17. Ricci G, Andreozzi L, Cipriani F, Giannetti A, Gallucci M, Caffarelli C. Wheat allergy in children: a comprehensive update. Medicina (Kaunas). 2019;55(7):400.
18. González-Mancebo E, Domínguez-Ortega J, Blanco-Bermejo S, González-Seco E, Trujillo MJ, de la Torre F, et al. Comparison of two diagnostic techniques in the follow-up of paediatric patients with pollinosis. Allergol Immunopathol (Madr). 2017;45(2):121-6.
19. Eiringhaus K, Renz H, Matricardi P, Skevaki C. Component-resolved diagnosis in allergic rhinitis and asthma. J Appl Lab Med. 2019;3(5):883-98.
20. Čelakovská J, Čermákova E, Vaňková R, Andrýs C, Krejsek J. ALEX2 multiplex examination – results of specific IgE to fish and shrimps in patients with atopic dermatitis. Food Agric Immunol. 2021;33(1):1-19.
21. Li J, Zhang J, Qiong C, She T, Bian Y, Lin S, et al. Component resolved diagnostic study of cow's milk allergy in infants and young children in northern China. Int Immunopharmacol. 2018;61:126-31.
22. Inoue Y, Sato S, Takahashi K, Yanagida N, Yamamoto H, Shimizu N, et al. Component-resolved diagnostics for hazelnut allergy in Japanese children. Allergol Int. 2020;69(2):239-45.
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How to Cite
1.
Khoshkam M, Movahedi M, Gharagozlou M, Farokhzadeh Soltani M, Movahedi M. Correlation between Component-resolved Diagnostics (CRD) and Clinical Symptoms in Allergic Children: A One-year Study at the Children’s Medical Center (April 2023–March 2024). Iran J Allergy Asthma Immunol. 2025;:1-8.
