Standard skin prick testing and sensitization to inhalant allergens across Europe – a survey from the GA²LEN network*

Abstract

Skin prick testing (SPT) is the standard method for diagnosing allergic sensitization but is to some extent performed differently in clinical centres across Europe. There would be advantages in harmonizing the standard panels of allergens used in different European countries, both for clinical purposes and for research, especially with increasing mobility within Europe and current trends in botany and agriculture. As well as improving diagnostic accuracy, this would allow better comparison of research findings in European allergy centres. We have compared the different SPT procedures operating in 29 allergy centres within the Global Allergy and Asthma European Network (GA(2)LEN). Standard SPT is performed similarly in all centres, e.g. using commercial extracts, evaluation after 15-20 min exposure with positive results defined as a wheal >3 mm diameter. The perennial allergens included in the standard SPT panel of inhalant allergens are largely similar (e.g. cat: pricked in all centres; dog: 26 of 29 centres and Dermatophagoides pteronyssinus: 28 of 29 centres) but the choice of pollen allergens vary considerably, reflecting different exposure and sensitization rates for regional inhalant allergens. This overview may serve as reference for the practising doctor and suggests a GA(2)LEN Pan-European core SPT panel.

Evaluation of serum s-IgE/total IgE ratio in predicting clinical response to allergen-specific immunotherapy

“…14 We cannot completely exclude the possibility of sensitization to allergens not routinely tested, nor can we apply the findings to monosensitized patients. However, it is likely that the amount of s-IgE in the serum reflects the degree of environmental exposure to individual allergens.…”

“…We considered the result of ASI to 4 aeroallergens epidemiologically very important in our geographic area (ie, grass, P judaica, O europea, and HDM) in a total of 279 patients. 14 Tests to predict the outcome of ASI would be of tremendous help in daily practice, but data about this aspect of immunotherapy have not been reported. Therefore we evaluated clinical, functional, and laboratory characteristics evaluated at the time of clinical diagnosis and analyzed the variables that were statistically different between the patients with effective and ineffective clinical responses to ASI after 4 years.…”

“…A positive response was defined as any wheal with a diameter 3 mm larger than that elicited by the negative control 15 minutes after application. 14 The wheal diameters were reported for each patient. NA, Not applicable.…”

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper

“…This epidemiologic study can be used to characterize the NAR phenotype, co-morbidities and social consequences. Skin tests are standardized between GA 2 LEN centers (148). The use of standardized extracts optimized by CREATE (149) will improve the detection of allergic patients.…”

Elevated neopterin levels in non-allergic asthma

“…Skin prick tests (SPT) can provide reliable information on this subject when an appropriate group of allergen extracts is selected. Currently, some medical centres are directing their efforts at obtaining a European Standard Allergen Panel to improve the accuracy of this diagnostic method [13]. There are also patients with a strong evidence of allergy that present negative SPT to common allergens.…”