engleski

Diagnosis of hypersensitivity to inhalant and food allergens by sulfidoleukotriene assay (CAST) in patients with atopic dermatitis

Aims: Atopic dermatitis (AD) is chronic, relapsing, inflammatory skin disease characterized by eczematous skin lesions. The combination of complex interactions between multiple “ trigger” factors, such as genetic susceptibility, environmental factors and other provocation factors induces allergic sensitization and subsequently local inflammation, resulting in atopic manifestations. This chronic skin condition is associated with asthma and/or allergic rhinitis. The diagnosis of such hypersensitivity might involve some difficultes. Current allergology practice uses established tests (total and specific IgE levels, skin tests and allergen-induced proliferative responses) for detection of sensitization to various inhalant and food allergens. Previous reports suggest that the sulfidoleukotriene assay may be, in addition to other tests, a useful complement in diagnosis of immediate-type allergy. For this reason we evaluated the diagnostic potential of cellular antigen stimulation test (CAST) in the diagnosis of hypersensitivity reactions to inhalant and food allergens in patients with atopic dermatitis and rhinitis. Method: CAST test was based on sulfidoleukotriene (sLT, LTC4, LTD4 and LTE4) production after in vitro specific allergen cell stimulation. Sixty patients at the age from 3 months to 54 years with a history of hypersensitivity reactions to Der p, Der f, grass pollen, ragweed pollen, birch pollen, milk, eggs, soya and wheat were included in the study. Results: The result of the study showed that 65% (36/55) of patients had positive CAST to Der p, 70% (23/33) of patients to Der f, 72% (13/18) of patients to grass pollen, 65% (11/17) of patients to ragweed pollen, 75% (6/8) of patients to birch pollen, 26% (8/31) of patients to milk, 73% (30/41) of patients to eggs, 38% (6/16) of patients to soya and 43% (6/14) of patients to wheat. Conclusion: These results demonstrate that quantification of sulfidoleukotriene production by CAST test allows better detection of hypersensitivity reactions in patients with AD and rhinitis.

Inhalant and food allergens; CAST; atopic dermatitis

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