Studies on the relationship between the level of specific IgE antibodies and the clinical expression of allergy: definition of levels distinguishing patients with symptomatic from patients with asymptomatic allergy to common aeroallergens

Journal of Allergy and Clinical Immunology, Vol. 96, No. 5, Part 1, November 1995

The Study and Its Purpose
The American Academy of Allergy, Asthma, and Immunology identified a need for a quantitative assay to "facilitate better definition of the relationship between quantity of IgE antibody and the symptoms or risk of disease." This study was designed to determine whether, in patients with some evidence of allergy, results from in vivo tests and quantitative results from in vitro tests would allow clinicians to distinguish those patients with clinically significant allergic disease from those with no clinical symptoms.

Summary of Results/Conclusions

• Sensitivity, specificity, and diagnostic values for the antibody assays were determined and compared with values obtained similarly for skin prick test (SPT) results.

• Skin testing had a lower diagnostic value (sum of sensitivity and specificity) than the Pharmacia CAP System™ (ImmunoCAP Technology) in vitro test.

• The clinical cutoff values for ImmunoCAP appear to be more useful than the clinical cutoff values for SPT because they have a greater diagnostic value (the sum of sensitivity and specificity).

• It was concluded that the clinical cutoff values for specific serum IgE antibody levels are likely to be useful in clinical practice to distinguish symptomatic from asymptomatic allergy in patients with positive skin test results.

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