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Clinical relevance is associated with allergen-specific wheal size in skin prick testing
BACKGROUND: Within a large prospective study, the Global Asthma and Allergy European Network (GA(2)LEN) has collected skin prick test (SPT) data throughout Europe to make recommendations for SPT in clinical settings. OBJECTIVE: To improve clinical interpretation of SPT results for inhalant allergens...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BlackWell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215109/ https://www.ncbi.nlm.nih.gov/pubmed/24283409 http://dx.doi.org/10.1111/cea.12240 |
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author | Haahtela, T Burbach, G J Bachert, C Bindslev-Jensen, C Bonini, S Bousquet, J Bousquet-Rouanet, L Bousquet, P J Bresciani, M Bruno, A Canonica, G W Darsow, U Demoly, P Durham, S R Fokkens, W J Giavi, S Gjomarkaj, M Gramiccioni, C Kowalski, M L Losonczy, G Orosz, M Papadopoulos, N G Stingl, G Todo-Bom, A von Mutius, E Köhli, A Wöhrl, S Järvenpää, S Kautiainen, H Petman, L Selroos, O Zuberbier, T Heinzerling, L M |
author_facet | Haahtela, T Burbach, G J Bachert, C Bindslev-Jensen, C Bonini, S Bousquet, J Bousquet-Rouanet, L Bousquet, P J Bresciani, M Bruno, A Canonica, G W Darsow, U Demoly, P Durham, S R Fokkens, W J Giavi, S Gjomarkaj, M Gramiccioni, C Kowalski, M L Losonczy, G Orosz, M Papadopoulos, N G Stingl, G Todo-Bom, A von Mutius, E Köhli, A Wöhrl, S Järvenpää, S Kautiainen, H Petman, L Selroos, O Zuberbier, T Heinzerling, L M |
author_sort | Haahtela, T |
collection | PubMed |
description | BACKGROUND: Within a large prospective study, the Global Asthma and Allergy European Network (GA(2)LEN) has collected skin prick test (SPT) data throughout Europe to make recommendations for SPT in clinical settings. OBJECTIVE: To improve clinical interpretation of SPT results for inhalant allergens by providing quantitative decision points. METHODS: The GA(2)LEN SPT study with 3068 valid data sets was used to investigate the relationship between SPT results and patient-reported clinical relevance for each of the 18 inhalant allergens as well as SPT wheal size and physician-diagnosed allergy (rhinitis, asthma, atopic dermatitis, food allergy). The effects of age, gender, and geographical area on SPT results were assessed. For each allergen, the wheal size in mm with an 80% positive predictive value (PPV) for being clinically relevant was calculated. RESULTS: Depending on the allergen, from 40% (blatella) to 87–89% (grass, mites) of the positive SPT reactions (wheal size ≥ 3 mm) were associated with patient-reported clinical symptoms when exposed to the respective allergen. The risk of allergic symptoms increased significantly with larger wheal sizes for 17 of the 18 allergens tested. Children with positive SPT reactions had a smaller risk of sensitizations being clinically relevant compared with adults. The 80% PPV varied from 3 to 10 mm depending on the allergen. CONCLUSION: These ‘reading keys’ for 18 inhalant allergens can help interpret SPT results with respect to their clinical significance. A SPT form with the standard allergens including mm decision points for each allergen is offered for clinical use. |
format | Online Article Text |
id | pubmed-4215109 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BlackWell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-42151092014-11-18 Clinical relevance is associated with allergen-specific wheal size in skin prick testing Haahtela, T Burbach, G J Bachert, C Bindslev-Jensen, C Bonini, S Bousquet, J Bousquet-Rouanet, L Bousquet, P J Bresciani, M Bruno, A Canonica, G W Darsow, U Demoly, P Durham, S R Fokkens, W J Giavi, S Gjomarkaj, M Gramiccioni, C Kowalski, M L Losonczy, G Orosz, M Papadopoulos, N G Stingl, G Todo-Bom, A von Mutius, E Köhli, A Wöhrl, S Järvenpää, S Kautiainen, H Petman, L Selroos, O Zuberbier, T Heinzerling, L M Clin Exp Allergy Original Articles BACKGROUND: Within a large prospective study, the Global Asthma and Allergy European Network (GA(2)LEN) has collected skin prick test (SPT) data throughout Europe to make recommendations for SPT in clinical settings. OBJECTIVE: To improve clinical interpretation of SPT results for inhalant allergens by providing quantitative decision points. METHODS: The GA(2)LEN SPT study with 3068 valid data sets was used to investigate the relationship between SPT results and patient-reported clinical relevance for each of the 18 inhalant allergens as well as SPT wheal size and physician-diagnosed allergy (rhinitis, asthma, atopic dermatitis, food allergy). The effects of age, gender, and geographical area on SPT results were assessed. For each allergen, the wheal size in mm with an 80% positive predictive value (PPV) for being clinically relevant was calculated. RESULTS: Depending on the allergen, from 40% (blatella) to 87–89% (grass, mites) of the positive SPT reactions (wheal size ≥ 3 mm) were associated with patient-reported clinical symptoms when exposed to the respective allergen. The risk of allergic symptoms increased significantly with larger wheal sizes for 17 of the 18 allergens tested. Children with positive SPT reactions had a smaller risk of sensitizations being clinically relevant compared with adults. The 80% PPV varied from 3 to 10 mm depending on the allergen. CONCLUSION: These ‘reading keys’ for 18 inhalant allergens can help interpret SPT results with respect to their clinical significance. A SPT form with the standard allergens including mm decision points for each allergen is offered for clinical use. BlackWell Publishing Ltd 2014-03 2014-02-22 /pmc/articles/PMC4215109/ /pubmed/24283409 http://dx.doi.org/10.1111/cea.12240 Text en © 2013 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Haahtela, T Burbach, G J Bachert, C Bindslev-Jensen, C Bonini, S Bousquet, J Bousquet-Rouanet, L Bousquet, P J Bresciani, M Bruno, A Canonica, G W Darsow, U Demoly, P Durham, S R Fokkens, W J Giavi, S Gjomarkaj, M Gramiccioni, C Kowalski, M L Losonczy, G Orosz, M Papadopoulos, N G Stingl, G Todo-Bom, A von Mutius, E Köhli, A Wöhrl, S Järvenpää, S Kautiainen, H Petman, L Selroos, O Zuberbier, T Heinzerling, L M Clinical relevance is associated with allergen-specific wheal size in skin prick testing |
title | Clinical relevance is associated with allergen-specific wheal size in skin prick testing |
title_full | Clinical relevance is associated with allergen-specific wheal size in skin prick testing |
title_fullStr | Clinical relevance is associated with allergen-specific wheal size in skin prick testing |
title_full_unstemmed | Clinical relevance is associated with allergen-specific wheal size in skin prick testing |
title_short | Clinical relevance is associated with allergen-specific wheal size in skin prick testing |
title_sort | clinical relevance is associated with allergen-specific wheal size in skin prick testing |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215109/ https://www.ncbi.nlm.nih.gov/pubmed/24283409 http://dx.doi.org/10.1111/cea.12240 |
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