Usefulness of currently available methods for the diagnosis of Anisakis simplex allergy.

BACKGROUND: Serodiagnosis of anisakiosis and Anisakis allergy is difficult since many Anisakis antigens show cross-reactivity complications. In the present study, we assess the usefulness of the major immunologic methods currently available for the diagnosis of Anisakis allergy. METHODS: Four tests (skin prick test, CAP-FEIA system, Western blotting, and an antigen-capture ELISA using O-deglycosylated antigen bound by the monoclonal antibody UA3) were applied to Anisakis-free subjects and subjects with confirmed Anisakis allergy. RESULTS: The skin prick test, CAP-FEIA, and the antigen-capture ELISA identified Anisakis allergy sera with 100% sensitivity, while Western blotting showed 96%/ sensitivity. The antigen-capture ELISA also showed 100% specificity, but CAP-FEIA showed a specificity of only 50%. In Western blotting, none of the bands detected were specific for either Anisakis-free or Anisakis allergy subjects. The skin prick test was not applied to the Anisakis-free subjects, so its specificity could not be determined. CONCLUSIONS: On the basis of these results, we suggest that the most appropriate procedure for diagnosis of Anisakis allergy suspected on clinical grounds is the antigen-capture ELISA using UA3, or, alternatively, a preliminary skin prick test with a positive result subsequently confirmed by UA3-ELISA.