We cannot rely on commercial skin prick test antigens for flour, latex and storage mites

This study looks at a wide range of skin prick test allergens available in Europe for flour (wheat, rye, Soy) Cow, storage mites and latex. The tests were carried out on 116 bakers, 47 farmers and 33 latex exposed workers, all with work-related rhinitis and/or asthma symptoms. Specific IgE usuing the Phadia ImmunoCap was used as the reference standard rather than the diagnosis based on specific challenge tests. A posive sIgE was >= 0.35kU/l.
Eack skin tests was applied twice in each individual, both were positive in 82% when at least one was positive. i.e. a negative spt may me due to problems with the technique (as well as the antigen).  There were substantial differences between antigens from different manufacturers, particularly for  rye flour, storage mites and cow. The overall specificity (against sIgE) was 80-100%, but sensitivity was low, particularly for wheat and soy (<60%). The threshold which could be considered positive was often >1.5mm, particularly for flour antigens.

The best wheat and Rye flour allergens were from Stalergenes, but sensitivity was low (wheeat 58% Rye 81%). The best Soya allergen had a sensiivity of 44% (Allerbio and Stallergenes). HAL and Lofarma had the most sensitive cow antigens (sensitivity 93 and 90%)

References

	van Kampen V, de Blay F, Folletti I, Kobierski P, Moscato G, Olivieri M, Quirce S, Sastre J, Walusiak-Skorupa J, Kotschy-Lang N, Müsken H, Mahler V, Schliemann S, Ochmann U, Sültz J, Worm M, Sander I, Zahradnik E, Brüning T, Merget R, Raulf-Heimsoth M, Evaluation of commercial skin prick test solutions for selected occupational allergens, Allergy, 2013;68:651-658,

	van Kampen V, de Blay F, Folletti I, Kobierski P, Moscato G, Olivieri M, Quirce S, Sastre J, Walusiak-Skorupa J, Raulf-Heimsoth M, EAACI position paper: skin prick testing in the diagnosis of occupational type I allergies, Allergy, 2003;68:580-584,

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