Prävalenz von Immunglobulin E gegen kreuzreagierende Kohlenhydrat-Seitenketten (CCD) und die Wirkung eines Blockers im saisonalen In-vitro-Allergietest

 

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Zusammenfassung

Gegenstand und Ziel Kreuzreagierende Kohlenhydrat-Seitenketten (cross-reactive carbohydrate determinants, CCD) führen bei In-vitro-Allergietests zum Nachweis von IgE gegen saisonale Allergene zu polypositiven Ergebnissen. Falsch-positive/klinisch irrelevante Resultate aufgrund der Bindung von Immunglobulin IgE an CCD (Anti-CCD-IgE) wurden bei Pollenallergenen identifiziert. Bisher fehlten Studien über das Phänomen bei Katzen. Das Ziel dieser Studie war, die Prävalenz der Polysensibilisierung in Serumproben und die Auswirkung eines CCD-Inhibitors/Blockers bei multipositiven, saisonalen Allergietestergebnissen bei Katzen zu evaluieren.

Material und Methoden Insgesamt wurden 472 Katzenseren berücksichtigt, die für einen Allergietest zum Nachweis von IgE gegen saisonale Allergene (ELISA basierend auf der Fc-Epsilon-Rezeptor-Technologie) von Juli 2017 bis Juni 2018 eingeschickt wurden. Die Proben wurden in die polypositive Gruppe A und die nicht polypositive Gruppe B eingeteilt. Seren der Gruppe A wurden nach Zugabe eines modifizierten Glykoprotein-Pflanzenextrakts (Blocker) erneut getestet. Um die Auswirkung des Blockers auf jedes Allergen zu bestimmen, wurden die Ergebnisse bei 48 zufällig ausgewählten Proben vor und nach dem Blocken analysiert.

Ergebnisse Die Polysensibilisierung wurde bei 137 (29 %) Serumproben ohne Abhängigkeit von den Jahreszeiten festgestellt. Durch das Blocken wurde die Bindung von Anti-CCD-IgE an Allergenen eliminiert und das Testergebnis entweder negativ (49 %) oder um 1–4 Reaktionsklassen erniedrigt (41 %), was die zusätzliche Präsenz von klinisch relevanten allergenspezifischen IgE anzeigt. Der Anteil an negativen Testreaktionen nach dem Blocken war beim 6-Gräser-Mix (31 %), Roggen (23 %) und Sauerampfer (25 %) viel geringer im Vergleich zu Weide und Birke-Hasel (67 %), Brennnessel und Beifuß-Ragweed (65 %) sowie Spitzwegerich (54 %).

Schlussfolgerung und klinische Relevanz Für eine verbesserte Qualität des In-vitro-Allergietests auf IgE gegen saisonale Allergene sollte das Blocken bei multipositiven Ergebnissen angewendet werden, um zu vermeiden, dass bei der allergenspezifischen Immuntherapie (ASIT) klinisch nicht relevante Allergene zum Einsatz kommen.

Abstract

Objectives Cross-reactive carbohydrate determinants (CCD) cause false positive/clinically irrelevant results in seasonal in vitro allergy tests due to the binding of immunoglobulin IgE against CCD (anti-CCD IgE).There is no study regarding the presence of this phenomen in cats. The aim of this study was to investigate the prevalence of polysensitization in serum samples and evaluate the impact of a CCD inhibitor/blocker in multi-positive seasonal allergy test results in cats.

Materials and methods A total of 472 feline sera, submitted from July 2017 to June 2018 for seasonal in vitro allergy test via ELISA Fc-Ε receptor technology, were studied. Samples were grouped into polysensitized (group A) and non-polysensitized (group B). Polysensitized samples (A) were retested after adding a modified glycoprotein plants extract (blocker). To determine the impact of the blocking to each allergen, the results in 48 randomly selected samples in cats prior- and post-blocking were investigated.

Results Polysensitization to seasonal allergens was diagnosed in 137 (29 %) samples. No discrepancy in presence of polysensitization was seen in different seasons. Blocking eliminated the binding of anti-CCD IgE and produced either negative test results (49 %) or a decrease of 1–4 reaction classes (41 %) which is indicative of the simultaneous presence of clinically relevant allergen specific IgE. Total negative reactions after blocking were less common in 6-grass mix (31 %), rye (23 %) and sheep sorrel (25 %) in comparison to willow und birch-hazel (67 %), mugwort-ragweed und nettle (65 %), as well as English plantain (54 %).

Conclusion and clinical relevance In order to improve the quality of seasonal in vitro allergy test, blocking should be employed in cases of polysensitized results resulting in an avoidance of the administration of non-offending allergens during allergen-specific immunotherapy (ASIT).

Publication History

Received: 28 March 2020

Accepted: 12 August 2020

Article published online:
04 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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