Detection of Serum-Specific IgE by Fluoro-Enzyme Immunoassay for Diagnosing Type I Hypersensitivity Reactions to Penicillins

Ariza, Adriana; Mayorga, Cristobalina; Bogas, Gádor; Gaeta, Francesco; Salas, María; Valluzzi, Rocco L.; Labella, Marina; Pérez-Sánchez, Natalia; Caruso, Cristiano; Molina, Ana; Fernández, Tahia D.; Torres, María José; Romano, Antonino

doi:10.3390/ijms23136992

Open AccessArticle

Detection of Serum-Specific IgE by Fluoro-Enzyme Immunoassay for Diagnosing Type I Hypersensitivity Reactions to Penicillins

by

Adriana Ariza

^1,†,

Cristobalina Mayorga

^1,2,3,†

,

Gádor Bogas

^1,2,

Francesco Gaeta

⁴,

María Salas

^1,2,

Rocco L. Valluzzi

⁵

,

Marina Labella

^1,2,

Natalia Pérez-Sánchez

^1,2

,

Cristiano Caruso

⁶

,

Ana Molina

¹,

Tahia D. Fernández

^1,7,

María José Torres

^{1,2,3,8,*,†} and

Antonino Romano

^9,†

¹

Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Malaga, Spain

²

Allergy Unit, Hospital Regional Universitario de Málaga, 29009 Malaga, Spain

³

Andalusian Center for Nanomedicine and Biotechnology-BIONAND, 29590 Malaga, Spain

⁴

Allergy Unit, Columbus Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy

⁵

Department of Pediatrics, Division of Allergy, Pediatric Hospital Bambino Gesù, 00165 Rome, Italy

⁶

UOSD DH Gastroenterologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy

⁷

Departamento de Biología Celular, Genética y Fisiología, Universidad de Málaga, 29010 Malaga, Spain

⁸

Departamento de Medicina, Universidad de Málaga, 29010 Malaga, Spain

⁹

Oasi Research Institute-IRCCS, 94018 Troina, Italy

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Int. J. Mol. Sci. 2022, 23(13), 6992; https://doi.org/10.3390/ijms23136992

Submission received: 11 May 2022 / Revised: 15 June 2022 / Accepted: 21 June 2022 / Published: 23 June 2022

(This article belongs to the Special Issue State-of-the-Art Molecular Immunology in Spain)

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Abstract

Diagnosis of type I hypersensitivity reactions (IgE-mediated reactions) to penicillins is based on clinical history, skin tests (STs), and drug provocation tests (DPTs). Among in vitro complementary tests, the fluoro-enzyme immunoassay (FEIA) ImmunoCAP^® (Thermo-Fisher, Waltham, MA, USA) is the most widely used commercial method for detecting drug-specific IgE (sIgE). In this study, we aimed to analyze the utility of ImmunoCAP^® for detecting sIgE to penicillin G (PG) and amoxicillin (AX) in patients with confirmed penicillin allergy. The study includes 139 and 250 patients evaluated in Spain and Italy, respectively. All had experienced type I hypersensitivity reactions to penicillins confirmed by positive STs. Additionally, selective or cross-reactive reactions were confirmed by DPTs in a subgroup of patients for further analysis. Positive ImmunoCAP^® results were 39.6% for PG and/or AX in Spanish subjects and 52.4% in Italian subjects. When only PG or AX sIgE where analyzed, the percentages were 15.1% and 30.4%, respectively, in Spanish patients; and 38.9% and 46% in Italian ones. The analysis of positive STs showed a statistically significant higher percentage of positive STs to PG determinants in Italian patients. False-positive results to PG (16%) were detected in selective AX patients with confirmed PG tolerance. Low and variable sensitivity values observed in a well-defined population with confirmed allergy diagnosis, as well as false-positive results to PG, suggest that ImmunoCAP^® is a diagnostic tool with relevant limitations in the evaluation of subjects with type I hypersensitivity reactions to penicillins.

Keywords: allergy diagnosis; drug allergy; IgE; immunologic tests

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MDPI and ACS Style

Ariza, A.; Mayorga, C.; Bogas, G.; Gaeta, F.; Salas, M.; Valluzzi, R.L.; Labella, M.; Pérez-Sánchez, N.; Caruso, C.; Molina, A.; et al. Detection of Serum-Specific IgE by Fluoro-Enzyme Immunoassay for Diagnosing Type I Hypersensitivity Reactions to Penicillins. Int. J. Mol. Sci. 2022, 23, 6992. https://doi.org/10.3390/ijms23136992

AMA Style

Ariza A, Mayorga C, Bogas G, Gaeta F, Salas M, Valluzzi RL, Labella M, Pérez-Sánchez N, Caruso C, Molina A, et al. Detection of Serum-Specific IgE by Fluoro-Enzyme Immunoassay for Diagnosing Type I Hypersensitivity Reactions to Penicillins. International Journal of Molecular Sciences. 2022; 23(13):6992. https://doi.org/10.3390/ijms23136992

Chicago/Turabian Style

Ariza, Adriana, Cristobalina Mayorga, Gádor Bogas, Francesco Gaeta, María Salas, Rocco L. Valluzzi, Marina Labella, Natalia Pérez-Sánchez, Cristiano Caruso, Ana Molina, and et al. 2022. "Detection of Serum-Specific IgE by Fluoro-Enzyme Immunoassay for Diagnosing Type I Hypersensitivity Reactions to Penicillins" International Journal of Molecular Sciences 23, no. 13: 6992. https://doi.org/10.3390/ijms23136992

APA Style

Ariza, A., Mayorga, C., Bogas, G., Gaeta, F., Salas, M., Valluzzi, R. L., Labella, M., Pérez-Sánchez, N., Caruso, C., Molina, A., Fernández, T. D., Torres, M. J., & Romano, A. (2022). Detection of Serum-Specific IgE by Fluoro-Enzyme Immunoassay for Diagnosing Type I Hypersensitivity Reactions to Penicillins. International Journal of Molecular Sciences, 23(13), 6992. https://doi.org/10.3390/ijms23136992

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Detection of Serum-Specific IgE by Fluoro-Enzyme Immunoassay for Diagnosing Type I Hypersensitivity Reactions to Penicillins

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