Standardised Prick Testing in Inhalant Allergens Developed for Use in Europe: Presented at EAACI

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Title: Standardised Prick Testing in Inhalant Allergens Developed for Use in Europe: Presented at EAACI
URL: http://www.pslgroup.com/dg/2235A2.htm
Doctor's Guide
June 10, 2008

By Chris Berrie

BARCELONA, Spain -- June 10, 2008 -- A standardised prick test core panel developed for use in allergy centres throughout Europe appears to offer benefits for identification of patients with sensitisation to inhalant allergens.

Researchers who tested this prick test core panel found unexpected sensitisations to inhalant allergens, according to a presentation here on June 8 at the 27th European Academy of Allergology and Clinical Immunology Congress (EAACI).

The panel also allows the search for correlations between single allergens and allergic diseases across Europe, with establishment of a European inhalant allergen sensitisation registry now a practical reality, said study presenter Guido J. Burbach, MD, PhD, Charité UniversitätsMedizinBerlin, Berlin, Germany, who presented this Europe-wide standardisation study on behalf of the Global Allergy and Asthma European Network (GA²LEN).

Currently, no European standard is available for prick testing in inhalant allergens, so the GA²LEN alliance of allergy centres aimed to develop a standardised prick test core panel for use throughout Europe.

The study population consisted of 3,095 patients who presented to 1 of the 17 centres across 14 European countries, excluding patients taking antihistamines, corticosteroids, or beta-blockers.

Inhalant allergens tested as the GA²LEN standard prick-test core panel included Aspergillus, cat, dog, Dermatophagoides pteronyssinus, Dermatophagoides farinae, blatella, hazel, alder, birch, plane, cypress, olive, grass mix, artemisia, ambrosia, alternaria, cladosporium, and parietaria, with further region-specific antigens added. Histamine 1:100 was used as positive control, diluent as a negative control.

Standardised results were recorded after 15 minutes. A clinically relevant response was judged to be positive if the wheal diameter calculated (largest diameter plus perpendicular diameter) was 3 mm or greater. Indications of correlations between positive responses and patient history were also noted.

Dr. Burbach presented sensitisation rates according to country groups (Scandinavia, central/western Europe, Mediterranean, Poland, and Hungary) and allergens groups (pet hair, arachnids, insects, northern trees, southern trees, grasses, weeds, and fungi).

For indoor allergens, he specifically noted high sensitisation rates (30%-40%) for pet hair and dust mites across Europe. A number of unexpected high sensitisations were reported with outdoor allergens, such as for northern trees in the Mediterranean, with over 10% sensitisation rate for southern trees in Scandinavia, said Dr. Burbach.

The clinical importance and relevance of these results become further apparent in individual allergens, with sensitisation rates of 12% to 13% for olive in the Netherlands and Austria. This might be due to crossreactions with ash in Austria, Dr. Burbach indicated.

The researchers also observed higher sensitisation rates compared with previous, more local and less standardised studies, which suggests that better surveillance of inhalant allergen sensitisation rates across Europe over time might be indicated.

Dr. Burbach added that further analysis to correlate type of sensitisation to type of disease is important, such as "… correlating the single allergen sensitisations to asthma or to persistent or intermittent rhinitis or ectopic dermatitis, and calculating odds ratios." A final aim would be to promote and establish a European inhalant allergen sensitisation registry.

Funding for this study was provided by an unrestricted educational grant from Schering-Plough, and extracts donated by Allergopharma, ALK-Scherax, Stallergenes, and Leti.

[Presentation title: The GA²LEN Pan-European Standard Prick Test Study: First Results. Abstract 49]

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