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Gewählte Publikation:

Hemmer, W; Altmann, F; Holzweber, F; Gruber, C; Wantke, F; Wohrl, S.
(2018): ImmunoCAP cellulose displays cross-reactive carbohydrate determinant (CCD) epitopes and can cause false-positive test results in patients with high anti-CCD IgE antibody levels
J ALLERGY CLIN IMMUN. 2018; 141(1): 372-+. FullText FullText_BOKU

Abstract:
BACKGROUND: Cross-reactive carbohydrate determinants (CCDs) in plants and insect venoms are a common cause of irrelevant positive test results during in vitro allergy diagnosis. We observed that some CCD-positive sera show nonspecific IgE binding even with CCD-free recombinant allergens when using the Phadia ImmunoCAP platform. OBJECTIVE: We investigated whether cellulose used as an allergen carrier in ImmunoCAP harbors residual N-glycans, causing nonspecific background binding in CCD-positive sera. METHODS: IgE binding to 6 samples of blank ImmunoCAPs coupled to either streptavidin (SA-CAP-1 or 2) or nonallergenic maltose-binding protein (MBP; MBP-CAP-1 to 4) and binding to a panel of 4 recombinant allergens were compared in CCD-positive sera before and after inhibition with a CCD inhibitor (MUXF3-human serum albumin). RESULTS: Of 52 CCD-positive sera (bromelain, 1.01-59.6 kilounits of antigen per liter [kU(A)/L]) tested on SA-CAP-1, 35 (67%) showed IgE binding of greater than 0.35 kU(A)/L (0.41-4.22 kU(A)/L). Among those with anti-CCD IgE levels of greater than 7.0 kU(A)/L, 90% (26/29) were positive. IgE binding to SA-CAP-1 correlated with IgE binding to bromelain (r = 0.68) and was completely abolished by serum preincubation with the CCD inhibitor (n = 15). Binding scores with SA-CAP-2 and MBP-CAP-1 to MBP-CAP-4 were generally lower but strongly correlated with those of SA-CAP-1 and bromelain. IgE reactivity of 10 CCD-positive sera (14.0-52.5 kU(A)/L) with the recombinant allergens rPhl p 12, rFel d 1, rAra h 2, and rPru p 3 was positive to at least 1 allergen in 8 of 10 (0.36-1.63 kU(A)/L) and borderline in 2 of 10 (0.21-0.25 kU(A)/L). Binding correlated with antibody binding to bromelain (r = 0.61) and to all blank ImmunoCAPs (r > 0.90) and could be completely blocked by the CCD inhibitor. Overall, mean background binding to cellulose CCDs corresponded to 2% to 3% of the reactivity seen with bromelain. CONCLUSIONS: Cellulose used as a solid-phase allergen carrier can contain varying amounts of CCDs sufficient to cause false-positive test results up to 2 kU(A)/L with nonglycosylated recombinant allergens in patients with high levels of anti-CCD IgE antibodies.
Autor/innen der BOKU Wien:
Altmann Friedrich
Grünwald-Gruber Clemens
BOKU Gendermonitor:


Find related publications in this database (Keywords)
CCDs
cellulose
component-resolved diagnosis
cross-reactive carbohydrate determinants
in vitro diagnosis
IgE measurement
ImmunoCAP
N-glycans


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