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Detection of hypersensitivity reactions to inhalant and food allergens by CAST assay in patients with atopic dermatitis and rhinitis

Atopic dermatitis (AD) is the most common chronic skin disorder of childhood and it usually represents the first clinical manifestation of atopy. This condition has a complex etiology that encompasses immunologic responses, susceptibility genes, environmental triggers, and compromised skin function. Diagnosis of AD is based on careful history, recognition of typical clinical manifestations and additional tests. In most cases skin tests, total IgE and allergen specific IgE determination are sufficient for detection of sensitization to various inhalant and food allergens. However, a complex diagnosis in some patients is difficult due to age, skin alterations, application of drugs, or the results of widely used tests are equivocal. We evaluated the usefulness of cellular antigen stimulation test (CAST) in detection of allergic reaction mediated by inhalant and food allergens in patients with atopic dermatitis and rhinitis. CAST assay is based on measurement of cysteinyle leukotrienes (sLT, LTC4/D4/E4) generated by peripheral blood leukocytes of sensitized patients. We tested 83 patients at the age from 3 months to 65 years with a history of hypersensitivity reactions to inhalant allergens (Der p, Der f , grass pollen, ragweed pollen and birch pollen) and food allergens ( milk , eggs, soya and wheat). Our results demonstrated that CAST test was positive in 87 % (46/53) of patients with allergy to Der p, 71% (30/42) of patients to Der f, 67% (10/15) of patients to grass pollen, 65% (11/17) of patients to ragweed pollen, 80% (8/10) of patients to birch pollen, 28% (12/43) of patients to milk, 77% (37/48) of patients to eggs, 40% (8/20) of patients to soya and 39% (9/23) of patients to wheat. These findings suggest that CAST test proved to be safe and useful in the routine investigation of hypersensitivity reaction to inhalant and food allergens.

CAST-ELISA; food and inhalant alergens

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