J Vet Sci.  2019 Nov;20(6):e60. 10.4142/jvs.2019.20.e60.

Evaluation of multiple allergen simultaneous (sIgE) testing compared to intradermal testing in the etiological diagnosis of atopic dermatitis in horses

Affiliations
  • 1Sub-Department of Clinical Diagnostics and Veterinary Dermatology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, 20-612 Lublin, Poland. pwilku@poczta.onet.pl
  • 2Institute of Mathematics, Marie Curie-SkÅ‚odowska University, 20-031 Lublin, Poland.
  • 3Equine Breeding and Management Unit, Department of Biology and Animal Breeding, University of Life Sciences in Lublin, 20-950 Lublin, Poland.
  • 4Nicolaus Copernicus University in Torun, Faculty of Biological and Veterinary Sciences, 87-100 Torun, Poland.

Abstract

Although intradermal testing (IDT) is commonly used in the etiological diagnosis of allergies, in vitro testing for specific IgE (sIgE) is an attractive alternative. Currently, new laboratory techniques in veterinary allergological practice, including multiple allergen simultaneous tests (MASTs), gradually supersede in vivo tests. Both, serological (sIgE) and IDTs in fourteen atopic Malopolski horses were performed. Correlation and agreement between test results were evaluated. Receiver operating characteristic analysis showed that sIgE to Acarus siro had the best diagnostic performance (Area under the ROC curve [AUC] = 0.969), followed by Dermatophagoides pteronyssinus (AUC = 0.844), Dermatophagoides farinae (AUC = 0.813) and Tyrophagus putrescentiae (AUC = 0.803). A significant positive correlation between IDT and MAST was found for A. siro (r(S) = 0.870; p = 0.00005), and D. farinae (r(S) = 0.657; p = 0.011). There was significant moderate agreement for 2 of 5 allergens, A. siro (κ = 0.569) and D. farinae (κ = 0.485) in semiquantitative assessment and significant fair to substantial agreement for 3 of 5 allergens, D. pteronyssinus (κ = 0.689), A. siro (κ = 0.569), D. farinae (κ = 0.432) in dichotomic assessment. Sensitivity ranged from 44% to 89%, depending on the allergen, while specificity was significantly higher for all allergens in MAST (60%-100%); the mean accuracy was 73% (manufacturer cut-off) and 77.4% (optimal cut-off) based on the Youden index. Compared with IDT, serological MAST showed good detection performance for 60% allergen sIgE in dichotomic assessment with substantial diagnostic capability, but careful clinical interpretation is needed for some allergens.

Keyword

Atopy; sIgE; intradermal testing; ROC curve; horses

MeSH Terms

Allergens
Dermatitis, Atopic*
Dermatophagoides farinae
Dermatophagoides pteronyssinus
Diagnosis*
Horses*
Hypersensitivity
Immunoglobulin E
In Vitro Techniques
Intradermal Tests*
Mites
ROC Curve
Sensitivity and Specificity
Allergens
Immunoglobulin E
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