Agreement and association analyses of skin prick testing and serum specific IgE assay for aeroallergen detection in patients with allergic rhinitis from Jiangsu and Anhui areas
- YANG Qing, LU Meiping, CHENG Lei
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Objective To assess the agreement and association between skin prick testing(SPT)and serum specific IgE(sIgE)in detecting common aeroallergens in patients with allergic rhinitis(AR). Methods The study included 101 patients(53 males and 48 females; age range: 4 to 68 years, average age: 38.5±14.8 years)from the Jiangsu and Anhui Provinces who received treatment for AR in the First Affiliated Hospital of Nanjing Medical University from November 2018 to December 2019. All the patients simultaneously underwent SPT and sIgE for the detection of 10 aeroallergens; these included 6 perennial indoor allergens(Dermatophagoides farina, Dermatophagoides pteronyssinus, cat dander, dog dander, Blattella germanica, and Alternaria alternate)and 4 seasonal pollen allergens(birch, ragweed, humulus, and Artemisia ［A. annua or A. argyi］). Meanwhile, the results of the allergen detection were analyzed by SPSS 24.0 software. Results The agreement percentages of the detections of D. farina, D. pteronyssinus, A. alternata, cat dander, dog dander, humulus, B. germanica, ragweed, Artemisia, and birch by SPT and sIgE were 75.28%, 72.09%, 39.13%, 36.84%, 11.11%, 14.29%, 12.50%, 22.22%, 13.33%, and 15.38%, respectively. Cohen's kappa statistics showed that the κ-coefficients were between 0.146 and 0.484. Among them, the κ-coefficients of A. alternata, cat dander, and D. farina were 0.484, 0.471, and 0.413, respectively, which indicated moderate agreements. The κ-coefficients of D. pteronyssinus, ragweed, and birch were 0.398, 0.330, and 0.215, respectively, which indicated lower agreements. All the κ-coefficients of the other four allergens were less than 0.20, indicating poor agreement. Spearman's rank correlation analysis showed positive correlations between the SPT and sIgE results for the detection of the 10 aeroallergens(rs ranged from 0.174 to 0.548). The rs values of D. farina, A. alternata, cat dander, and D. pteronyssinus were 0.548, 0.532, 0.483, and 0.440, respectively, indicating moderate correlations. The rs values of humulus, birch, and dog dander were 0.240, 0.239, and 0.210, respectively, indicating poor correlations. The rs values of the other three allergens were all < 0.20, indicating very poor correlation. Conclusion This study demonstrated large discrepancies in the agreement and association between the SPT and sIgE detections of common aeroallergens in patients with AR in the Jiangsu and Anhui areas. The combination of in vivo and in vitro methods for allergen testing is recommended to improve the accuracy of the clinical diagnosis of AR.