Comparison of immediate intradermal test reactivity with serum IgE quantitation by use of a radioallergosorbent test and two ELISA in horses with and without atopy

Gwendolen Lorch Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1092.

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Andrew Hillier Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1092.

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 BVSc, DACVD
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Kenneth W. Kwochka Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1092.

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William J. Saville Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1092.

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Catherine W. Kohn Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1092.

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Bruce E. LeRoy Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210-1092.

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Abstract

Objective—To compare a radioallergosorbent test and 2 ELISA with intradermal testing for the determination of environmental allergen hypersensitivity in horses with and without atopic diseases.

Design—Prospective clinical study.

Animals—10 horses with recurrent urticaria, 7 with atopic dermatitis, 16 with chronic obstructive pulmonary disease, and 22 without atopy.

Procedure—History, physical examination, hemogram, serum biochemical analyses, bronchoalveolar lavage, and an intradermal test (used as the criterion standard) with a regional panel of 73 allergens were performed in all horses. Serum was analyzed by use of the 3 in vitro assays of allergen-specific IgE.

Results—An ELISA based on the α chain of the highaffinity IgE receptor, the Fc∈ receptor immunoglobin ∈ chain (Fc∈RIα) for IgE, had the overall highest kappa statistic (0.238), positive predictive value (49%), and negative predictive value (78%). Overall agreement between the Fc∈RIα-based ELISA and the intradermal test was fair. The highest kappa statistic was obtained by the Fc∈RIα-based ELISA in horses with atopic dermatitis (0.330). Kappa statistics for the radioallergosorbent test and a polyclonal antibody-based ELISA agreed slightly with that of the intradermal test at best.

Conclusions and Clinical Relevance—None of the 3 serum allergy tests reliably detected allergen hypersensitivity, compared with the intradermal test. The Fc∈RIα-based ELISA performed significantly better overall than the other 2 tests. Low sensitivity of all 3 assays indicates the need for continued study to elucidate a more sensitive test for the determination of potentially pathogenic allergens in horses. (J Am Vet Med Assoc 2001;218:1314–1322)

Abstract

Objective—To compare a radioallergosorbent test and 2 ELISA with intradermal testing for the determination of environmental allergen hypersensitivity in horses with and without atopic diseases.

Design—Prospective clinical study.

Animals—10 horses with recurrent urticaria, 7 with atopic dermatitis, 16 with chronic obstructive pulmonary disease, and 22 without atopy.

Procedure—History, physical examination, hemogram, serum biochemical analyses, bronchoalveolar lavage, and an intradermal test (used as the criterion standard) with a regional panel of 73 allergens were performed in all horses. Serum was analyzed by use of the 3 in vitro assays of allergen-specific IgE.

Results—An ELISA based on the α chain of the highaffinity IgE receptor, the Fc∈ receptor immunoglobin ∈ chain (Fc∈RIα) for IgE, had the overall highest kappa statistic (0.238), positive predictive value (49%), and negative predictive value (78%). Overall agreement between the Fc∈RIα-based ELISA and the intradermal test was fair. The highest kappa statistic was obtained by the Fc∈RIα-based ELISA in horses with atopic dermatitis (0.330). Kappa statistics for the radioallergosorbent test and a polyclonal antibody-based ELISA agreed slightly with that of the intradermal test at best.

Conclusions and Clinical Relevance—None of the 3 serum allergy tests reliably detected allergen hypersensitivity, compared with the intradermal test. The Fc∈RIα-based ELISA performed significantly better overall than the other 2 tests. Low sensitivity of all 3 assays indicates the need for continued study to elucidate a more sensitive test for the determination of potentially pathogenic allergens in horses. (J Am Vet Med Assoc 2001;218:1314–1322)

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