Are allergen batch differences and the use of double skin prick test important?

Gert Thomsen, Vivi Schlünssen, David Lee Sherson, Lars Rauff Skadhauge, Tine Halsen Malling, David Lee Sherson, Øyvind Omland, Torben Sigsgaard

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Background: Skin prick tests (SPT) are widely used both in clinical diagnostics and in research. The standardization of allergen extracts is well documented to be crucial for the validity of SPT, whereas less emphasis has been placed on reproducibility and the SPT procedure itself. The objectives of this study are to clarify how the double skin prick test procedure influence the sensitivity and specificity of the test and to analyse the differences in weal size in skin prick tests between two batches of allergen extracts from the same vendor. Methods: The association between rhinitis and SPT was assessed among 1135 persons from a general population sample. SPT was performed twice with 10 common aeroallergens. In a subsample of 90 persons SPT was performed simultaneously with five of the allergens using different batches. Results: Thirty percent had at least one positive SPT. Among asthmatics this number was 62%. Only minor differences were seen between the sizes of two weals from the same batch. A second SPT with the same batch did not change the association between rhinitis and sensitization. When performing SPT with two different batches disagreement was observed in 2% (Birch) to 11% (Cat) of the subjects. Conclusions: Performing SPT twice with the same allergen batch does not enhance the validity of the test, and value of double testing can be questioned. Considerable differences in SPT response with different batches from the same manufacturer were observed. Thus inter batch differences in allergen extracts might be a source of variability.

OriginalsprogEngelsk
Artikelnummer33
TidsskriftB M C Pulmonary Medicine
Vol/bind15
Antal sider7
ISSN1471-2466
DOI
StatusUdgivet - 9. apr. 2015

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title = "Are allergen batch differences and the use of double skin prick test important?",
abstract = "Background: Skin prick tests (SPT) are widely used both in clinical diagnostics and in research. The standardization of allergen extracts is well documented to be crucial for the validity of SPT, whereas less emphasis has been placed on reproducibility and the SPT procedure itself. The objectives of this study are to clarify how the double skin prick test procedure influence the sensitivity and specificity of the test and to analyse the differences in weal size in skin prick tests between two batches of allergen extracts from the same vendor. Methods: The association between rhinitis and SPT was assessed among 1135 persons from a general population sample. SPT was performed twice with 10 common aeroallergens. In a subsample of 90 persons SPT was performed simultaneously with five of the allergens using different batches. Results: Thirty percent had at least one positive SPT. Among asthmatics this number was 62{\%}. Only minor differences were seen between the sizes of two weals from the same batch. A second SPT with the same batch did not change the association between rhinitis and sensitization. When performing SPT with two different batches disagreement was observed in 2{\%} (Birch) to 11{\%} (Cat) of the subjects. Conclusions: Performing SPT twice with the same allergen batch does not enhance the validity of the test, and value of double testing can be questioned. Considerable differences in SPT response with different batches from the same manufacturer were observed. Thus inter batch differences in allergen extracts might be a source of variability.",
keywords = "Aeroallergens, Population based study, Rhinitis, Skin prick test, Validity, Allergens, Pharmaceutical Preparations/standards, Rhinitis, Allergic/diagnosis, Humans, Male, Poaceae, Fungi, Dander, Cladosporium, Sensitivity and Specificity, Adult, Female, Pollen, Cats, Reproducibility of Results, Alternaria, Plant Extracts/standards, Artemisia, Skin Tests/standards, Animals, Dogs, Horses, Pyroglyphidae, Betula",
author = "Gert Thomsen and Vivi Schl{\"u}nssen and {Lee Sherson}, David and Skadhauge, {Lars Rauff} and Malling, {Tine Halsen} and {Lee Sherson}, David and {\O}yvind Omland and Torben Sigsgaard",
year = "2015",
month = "4",
day = "9",
doi = "10.1186/s12890-015-0021-3",
language = "English",
volume = "15",
journal = "B M C Pulmonary Medicine",
issn = "1471-2466",
publisher = "BioMed Central",

}

Are allergen batch differences and the use of double skin prick test important? / Thomsen, Gert; Schlünssen, Vivi; Lee Sherson, David; Skadhauge, Lars Rauff ; Malling, Tine Halsen; Lee Sherson, David; Omland, Øyvind; Sigsgaard, Torben.

I: B M C Pulmonary Medicine, Bind 15, 33, 09.04.2015.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Are allergen batch differences and the use of double skin prick test important?

AU - Thomsen, Gert

AU - Schlünssen, Vivi

AU - Lee Sherson, David

AU - Skadhauge, Lars Rauff

AU - Malling, Tine Halsen

AU - Lee Sherson, David

AU - Omland, Øyvind

AU - Sigsgaard, Torben

PY - 2015/4/9

Y1 - 2015/4/9

N2 - Background: Skin prick tests (SPT) are widely used both in clinical diagnostics and in research. The standardization of allergen extracts is well documented to be crucial for the validity of SPT, whereas less emphasis has been placed on reproducibility and the SPT procedure itself. The objectives of this study are to clarify how the double skin prick test procedure influence the sensitivity and specificity of the test and to analyse the differences in weal size in skin prick tests between two batches of allergen extracts from the same vendor. Methods: The association between rhinitis and SPT was assessed among 1135 persons from a general population sample. SPT was performed twice with 10 common aeroallergens. In a subsample of 90 persons SPT was performed simultaneously with five of the allergens using different batches. Results: Thirty percent had at least one positive SPT. Among asthmatics this number was 62%. Only minor differences were seen between the sizes of two weals from the same batch. A second SPT with the same batch did not change the association between rhinitis and sensitization. When performing SPT with two different batches disagreement was observed in 2% (Birch) to 11% (Cat) of the subjects. Conclusions: Performing SPT twice with the same allergen batch does not enhance the validity of the test, and value of double testing can be questioned. Considerable differences in SPT response with different batches from the same manufacturer were observed. Thus inter batch differences in allergen extracts might be a source of variability.

AB - Background: Skin prick tests (SPT) are widely used both in clinical diagnostics and in research. The standardization of allergen extracts is well documented to be crucial for the validity of SPT, whereas less emphasis has been placed on reproducibility and the SPT procedure itself. The objectives of this study are to clarify how the double skin prick test procedure influence the sensitivity and specificity of the test and to analyse the differences in weal size in skin prick tests between two batches of allergen extracts from the same vendor. Methods: The association between rhinitis and SPT was assessed among 1135 persons from a general population sample. SPT was performed twice with 10 common aeroallergens. In a subsample of 90 persons SPT was performed simultaneously with five of the allergens using different batches. Results: Thirty percent had at least one positive SPT. Among asthmatics this number was 62%. Only minor differences were seen between the sizes of two weals from the same batch. A second SPT with the same batch did not change the association between rhinitis and sensitization. When performing SPT with two different batches disagreement was observed in 2% (Birch) to 11% (Cat) of the subjects. Conclusions: Performing SPT twice with the same allergen batch does not enhance the validity of the test, and value of double testing can be questioned. Considerable differences in SPT response with different batches from the same manufacturer were observed. Thus inter batch differences in allergen extracts might be a source of variability.

KW - Aeroallergens

KW - Population based study

KW - Rhinitis

KW - Skin prick test

KW - Validity

KW - Allergens

KW - Pharmaceutical Preparations/standards

KW - Rhinitis, Allergic/diagnosis

KW - Humans

KW - Male

KW - Poaceae

KW - Fungi

KW - Dander

KW - Cladosporium

KW - Sensitivity and Specificity

KW - Adult

KW - Female

KW - Pollen

KW - Cats

KW - Reproducibility of Results

KW - Alternaria

KW - Plant Extracts/standards

KW - Artemisia

KW - Skin Tests/standards

KW - Animals

KW - Dogs

KW - Horses

KW - Pyroglyphidae

KW - Betula

U2 - 10.1186/s12890-015-0021-3

DO - 10.1186/s12890-015-0021-3

M3 - Journal article

C2 - 25886946

VL - 15

JO - B M C Pulmonary Medicine

JF - B M C Pulmonary Medicine

SN - 1471-2466

M1 - 33

ER -