Component-Resolved Diagnosis (CRD): Is It Worth It? Frequency and Differentiation in Rhinitis Patients with Mite Reactivity


Component-resolved  diagnosis (CRD) using microarray technology has recently been introduced  with the  aim to  improve diagnosis of allergy. The  aim of this study was to compare performance of this allergen microarray to those of an established extract-based skin prick testing (SPT).
45  patients  with  allergic rhinitis  were studied  (16 children  and  29  adults). SPT  to Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis extracts and allergen microarray ImmunoCAP ISAC were carried out for all patients.
Forty out of 45 patients demonstrated positive SPT to all mite extracts tested. These 40 patients  were  considered  to  be  mite-  allergic based  on  the  positive  SPT  results. The remaining 5 patients with negative SPT to  any mite extracts were classified as non-mite allergic. Comparatively, based on the microarray results, only 34 mite-allergic patients had detectable serum IgE  to  at least one of the mite allergen components  tested whereas 6 patients with positive SPT to mite extracts showed no detectable IgE reactivity to any of the components  tested. One non-mite allergic patient had a positive test- Blo t 5.  Der p 10- positive patients also reacted to other cross-reactive tropomyosin from anisakis (Ani s 3) (25%), cockroach (Bla g 7) (50%) and shrimp (Pen m 1) (75%).
CRD is a reliable tool for the diagnosis of allergy to mites. Der p 10 might be a useful indicator to identify a subset of mite-allergic patient that have additional sensitization due to cross-reactivity and thus allows selection of patients for immunotherapy.

1. Bronnert M, Mancini J, Birnbaum J, Agabriel C, Liabeuf V, Porri F, et al. Component-resolved diagnosis with commercially available D. pteronyssinus Der p 1, Der p 2 and Der p 10: relevant markers for house dust mite allergy. Clin Exp Allergy 2012; 42(9):1406-15.

2. Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 2004;24(5):758-64.

3. Sunyer J, Jarvis D, Pekkanen J, Chinn S, Janson C, Leynaert B, et al. Geographic variations in the effect of atopy on asthma in the European Community Respiratory Health Study. J Allergy Clin Immunol 2004;114(5):1033-9.

4. Gregory LG, Lloyd CM. Orchestrating house dust mite- associated allergy in the lung. Trends Immunol 2011;32(9):402-11.

5. Zhang C, Li J, Lai X, Zheng Y, Gjesing B, Spangfort MD, et al. House dust mite and storage mite IgE reactivity in allergic patients from Guangzhou, China. Asian Pac J Allergy Immunol 2012; 30(4):294-300.

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

7. Taketomi EA, Silva DA, Sopelete MC, Gervásio AM,Alves R, Sung SJ. Differential IgE reactivity to Der p 1 and Der p 2 allergens of Dermatophagoides pteronyssinus in mite-sensitized patients. J Investig Allergol Clin Immunol 2006; 16(2):104-9.

8. Valenta R, Twaroch T, Swoboda I. Component-resolved diagnosis to optimize allergen-specific immunotherapy in the Mediterranean area. J Investig Allergol Clin Immunol 2007; 17(1):36-40.

9. Bousquet J, Lockey R, Malling HJ. Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper. J Allergy Clin Immunol 1998; 102(4 Pt 1):558-62.

10. Meyer CH, Bond JF, Chen MS, Kasaian MT. Comparison of the levels of the major allergens Der p I and Der p II in standardized extracts of the house dust mite, Dermatophagoides pteronyssinus. Clin Exp Allergy1994; 24(11):1041–8.

11. Weghofer M, Thomas WR, Kronqvist M, Mari A, Purohit A, Pauli G, et al. Variability of IgE reactivity profiles among European mite allergic patients. Eur J Clin Invest 2008; 38(12):959-65.

12. Thomas WR, Smith W. Towards defining the full spectrum of important house dust mite allergens. Clin Exp Allergy 1999; 29(12):1583-7.

13. Shen HD, Lin WL, Tsai LC, Tam MF, Chua KY, Chen HL, et al. Characterization of the allergen Der f 7 from house dust mite extracts by species-specific and crossreactive monoclonal antibodies. Clin Exp Allergy 1997; 27(7):824-32.

14. Valenta R. The future of antigen-specific immunotherapy of allergy. Nat Rev Immunol 2002; 2(6):446-53.

15. Pittner G, Vrtala S, Thomas WR, Weghofer M, Kundi M,Horak F, et al. Component-resolved diagnosis of house- dust mite allergy with purified natural and recombinant mite allergens. Clin Exp Allergy 2004; 34(4):597-603.

16. Thomas WR, Heinrich TK, Smith WA, Hales BJ.Pyroglyphid house dust mite allergens. Protein Pept Lett 2007; 14(10):943-53.

17. Westritschnig K, Sibanda E, Thomas W, Auer H, Aspöck H, Pittner G, et al. Analysis of the sensitization profile towards allergens in central Africa. Clin Exp Allergy 2003; 33(1):22-7.

18. Harwanegg C, Hutter S, Hiller R. Allergen microarrays for the diagnosis of specific IgE against components of cow's milk and hen's egg in a multiplex biochip-based immunoassay. Methods Mol Biol 2007; 385:145-57.

19. Ott H, Baron JM, Heise R, Ocklenburg C, Stanzel S, Merk HF, et al. Clinical usefulness of microarray-based IgE detection in children with suspected food allergy. Allergy 2008; 63(11):1521-8.

20. Ebo DG, Hagendorens MM, De Knop KJ, Verweij MM, Bridts CH, De Clerck LS, et al. Component-resolved diagnosis from latex allergy by microarray. Clin Exp Allergy 2010; 40(2): 348-58.

21. Bousquet J, Reid J, van Weel C, Baena Cagnani C,Canonica GW, Demoly P, et al. Allergic rhinitis management pocket reference 2008. Allergy 2008;63(8):990-96.

22. Bardini G, Santos ACS, Santos KS, Arruda LK. IgE reactivity profiles in patients with asthma and/or rhinitis allergic to cockroach and mites. J Allergy Clin Immunol 2011; 127: AB171.

23. Kidon MI, Chin CW, Kang LW, Ching OT, Seng TY, Ning WK, et al. Mite component–specific IgE repertoire and phenotypes of allergic disease in childhood: The tropical perspective. Pediatr Allergy and Immunol 2011;22(2):202–10.

24. Hales BJ, Martin AC, Pearce LJ, Laing IA, Hayden CM, Goldblatt J, et al. IgE and IgG anti-house dust mite specificities in allergic disease. J Allergy Clin Immunol 2006; 118(2):361-7.

25. Trombone AP, Tobias KR, Ferriani VP, Schuurman J, Aalberse RC, Smith AM, et al. Use of a chimeric ELISA to investigate immunoglobulin E antibody responses to Der p 1 and Der p 2 in mite-allergic patients with asthma, wheezing and/or rhinitis. Clin Exp Allergy 2002; 32(9):1323-8.

26. Fernandes J, Reshef A, Patton L, Ayuso R, Reese G, Lehrer SB. Immunoglobulin E antibody reactivity to the major shrimp allergen, tropomyosin, in unexposed Orthodox Jews. Clin Exp Allergy 2003; 33(7):956-61.

27. Asturias JA, Eraso E, Moneo I, Martinez A. Is tropomyosin an allergen in Anisakis? Allergy 2000;55(9):898-9.

IssueVol 13, No 4 (2014) QRcode
Allergic rhinitis Component resolved diagnostics (CRD) Cross-reactive tropomyosin Immunotherapy Mite allergy Skin prick testing

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Mohamad Yadzir ZH, Misnan R, Abdullah N, Bakhtiar F, Leecyous B, Murad S. Component-Resolved Diagnosis (CRD): Is It Worth It? Frequency and Differentiation in Rhinitis Patients with Mite Reactivity. Iran J Allergy Asthma Immunol. 13(4):240-246.