Microarray-based detection of specific IgE against recombinant ω-5-gliadin in suspected wheat-dependent exercise-induced anaphylaxis.

ABSTRACT

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a rare IgE-mediated food allergy. Component-resolved measurement of specific IgE (sIgE) against ω-5-gliadin by fluorescence enzyme immunoassay (FEIA) has been postulated as a good predictive decision criterion in the diagnosis of WDEIA. More recently, microarray technology has been introduced into component-resolved diagnostics. The aim of this study was to evaluate the performance of an allergen microarray in the detection of sIgE against ω-5-gliadin in 10 patients with suspected WDEIA and high levels of sIgE against ω-5-gliadin (mean 9.31±7.53 kU/L, range 4.24-25.8) as measured by FEIA. Using an old version of the microarray assay (ImmunoCAP ISAC™, Phadia), sIgE against ω-5-gliadin was detected in only 3 of the first 6 patients. The same samples and those of another 4 patients were then analysed with an improved version of the microarray system, yielding elevated levels of sIgE against ω-5-gliadin in all patients. In conclusion, the old version of the microarray was not reliable for the detection of sIgE against ω-5-gliadin in the examined individuals with suspected WDEIA. In contrast, the improved version of the microarray seems to be as adequate as FEIA in the detection of sIgE against ω-5-gliadin. However, further large-scale studies are warranted to confirm these results.