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Summary: Background. Gibberellin Regulated Proteins (GRPs) are small glycoproteins that induce allergy to various types of fruit. This study aimed to evaluate co-sensitization to cypress pollen and other molecules responsible for fruit allergy, such as nsLTP (Pru p 3), PR-10 (Bet v1), and Profilin (Bet v2). Methods. Sixty subjects sensitized to peach GRP (Pru p 7) were consecutively recruited from four Italian centers: 28 males and 32 females (mean age 37.9 years; range 11-79). Specific IgE for Pru p 7, Pru p 3, Bet v 1, Bet v 2, cypress pollen extract (Cup s), and Cup a 1 were determined in all subjects. Results. Sensitization rates to Cup s, Cup a 1, Pru p 3, Bet v 1, and Bet v 2 in the entire studied population were 90.0%, 83.3%, 45.8%, 40.0%, and 30.0%, respectively. In subjects residing in Northern Italy, the respective sensitization rates were 96.4%, 80.0%, 50.0%, 73.3%, and 40.0%, while in those residing in Southern Italy, they were 83.3%, 86.7%, 40.0%, 6.7%, and 20.0%. The only significant difference was observed for PR-10 (p less than 0.0001) Co-sensitization to PR-10 was found to be associated with a reduced risk of anaphylaxis (OR: 0.125). Allergic reactions were most commonly triggered by peach (26/40), followed by orange (12/40), with other foods being less frequently implicated. Conclusions. This study confirms a high association between sensitization to Pru p 7 and cypress pollen and highlights a high percentage of co-sensitization to nsLTP, PR-10, and profilin. PR-10 emerged as a protective factor against anaphylaxis.
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PURPOSE: In the last two decades, thyroglobulin autoantibodies (TgAb) measurement has progressively switched from marker of thyroid autoimmunity to test associated with thyroglobulin (Tg) to verify the presence or absence of TgAb interference in the follow-up of patients with differentiated thyroid cancer. Of note, TgAb measurement is cumbersome: despite standardization against the International Reference Preparation MRC 65/93, several studies demonstrated high inter-method variability and wide variation in limits of detection and in reference intervals. Taking into account the above considerations, the main aim of the present study was the determination of TgAb upper reference limit (URL), according to the National Academy of Clinical Biochemistry guidelines, through the comparison of eleven commercial automated immunoassay platforms. METHODS: The sera of 120 healthy males, selected from a population survey in the province of Verona, Italy, were tested for TgAb concentration using eleven IMA applied on as many automated analyzers: AIA-2000 (AIA) and AIA-CL2400 (CL2), Tosoh Bioscience; Architect (ARC), Abbott Diagnostics; Advia Centaur XP (CEN) and Immulite 2000 XPi (IMM), Siemens Healthineers; Cobas 6000 (COB), Roche Diagnostics; Kryptor (KRY), Thermo Fisher Scientific BRAHMS, Liaison XL (LIA), Diasorin; Lumipulse G (LUM), Fujirebio; Maglumi 2000 Plus (MAG), Snibe and Phadia 250 (PHA), Phadia AB, Thermo Fisher Scientific. All assays were performed according to manufacturers' instructions in six different laboratories in Friuli-Venezia Giulia and Veneto regions of Italy [Lab 1 (AIA), Lab 2 (CL2), Lab 3 (ARC, COB and LUM), Lab 4 (CEN, IMM, KRY and MAG), Lab 5 (LIA) and Lab 6 (PHA)]. Since TgAb values were not normally distributed, the experimental URL (e-URL) was established at 97.5 percentile according to the non-parametric method. RESULTS: TgAb e-URLs showed a significant inter-method variability. Considering the same method, e-URL was much lower than that suggested by manufacturers (m-URL), except for ARC and MAG. Correlation and linear regression were unsatisfactory. Consequently, the agreement between methods was poor, with significant bias in Bland-Altman plot. CONCLUSIONS: Despite the efforts for harmonization, TgAb methods cannot be used interchangeably. Therefore, additional effort is required to improve analytical performance taking into consideration approved protocols and guidelines. Moreover, TgAb URL should be used with caution in the management of differentiated thyroid carcinoma patients since the presence and/or the degree of TgAb interference in Tg measurement has not yet been well defined.
