Arquivos de Asma, Alergia e Imunologia
https://www.aaai-asbai.org.br/article/doi/10.5935/2526-5393.20180053
Arquivos de Asma, Alergia e Imunologia
Artigo de Revisão

Testes laboratoriais de triagem para doenças alérgicas: ainda têm espaço na prática clínica?

Laboratory screening tests for allergic diseases: do they still have a role in clinical practice?

Felipe Faria Pierotti; Carolina Sanchez Aranda; Renata Rodrigues Cocco; Márcia Carvalho Mallozi; Dirceu Solé

Downloads: 0
Views: 20

Resumo

Nas últimas décadas tem se observado aumento da prevalência das doenças alérgicas em todo o mundo. Embora a história clínica seja considerada de grande importância na suspeita de uma doença alérgica, resultados falso-positivos podem ser observados quando se utiliza apenas dados da anamnese. Com isso, indicadores mensuráveis utilizados para examinar quaisquer aspectos da doença tornam-se essenciais. A dosagem de imunoglobulina E total (TIgE), assim como painéis que contemplam alérgenos de maior prevalência na população estudada, podem funcionar como testes de triagem e facilitar o futuro diagnóstico de uma doença alérgica, ou na exclusão deste. Nesta revisão, são abordados os diferentes testes de triagem para doenças alérgicas (PhadiatopEuropa®, PhadiatopInfant ®, PhadiatopUSA®) na avaliação de crianças e adolescentes com história médica de alergia. Os testes de triagem não diagnosticam doenças alérgicas. Uma vez positivo, o encaminhamento ao especialista deve ser realizado.

Palavras-chave

Criança, hipersensibilidade, imunoglobulina E, alérgenos.

Abstract

In recent decades, the prevalence of allergic diseases has increased worldwide. Although medical history is considered of great importance in the suspicion of an allergic disease, false-positive results may be observed when anamnesis data are used alone. Thus, measurable indicators used to examine any aspects of a disease have become essential. Total immunoglobulin E (TIgE) measurement as well as panels containing allergens prevalent in the population under study may serve as screening tests and facilitate later diagnosis of an allergic disease. This review addresses the use of different screening tests for allergic diseases (PhadiatopEurope®, PhadiatopInfant®, and PhadiatopUSA®) in the evaluation of children and adolescents with medical history of allergy. Screening tests do not diagnose allergic diseases. If positive, the patient should be referred to a specialist.

Keywords

Child, hypersensitivity, immunoglobulin E, allergens.

Referências

1. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733-43.

2. Mallol J, Solé D, Baeza-Bacab M, Aguirre-Camposano V, SotoQuiros M, Baena-Cagnani C, et al. Regional variation in asthma symptom prevalence in Latin American children. J Asthma. 2010;47(6):644‑50.

3. Solé D, Rosário Filho N, Sarinho EC, Silva AR, Britto M, Riedi C, et al. Prevalence of asthma and related symptoms in adolescents: findings from 3 surveys. J Investig Allergol Clin Immunol. 2015;25(1):73-4.

4. Johansson SG, Lundahl J. Asthma, atopy, and IgE: what is the link? Curr Allergy Asthma Rep. 2001;1(2):89-90.

5. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004;113(5):832-6.

6. Hamilton RG, Adkinson NF. In vitro assays for the diagnosis of IgEmediated disorders. J Allergy Clin Immunol. 2004;114:213-25.

7. Pawankar R, Canonica GW, Holgate ST, Lockey RF (ed). World Allergy Organization (WAO) White Book on Allergy. WAO, Milwaukee, Wisconsin, EUA. 2011; 220p.

8. Eigenmann PA, Atanaskovic-Markovic M, O'B Hourihane J, Lack G, Lau S, Matricardi PM, et al. Testing children for allergies: why, how, who and when: an updated statement of the European Academy of Allergy and Clinical Immunology (EAACI) Section on Pediatrics and the EAACI-Clemens von Pirquet Foundation. Pediatr Allergy Immunol. 2013;24(2):195-209.

9. Williams PB, Dolen WK, Koepke JW, Selner JC. Comparison of skin testing and three in vitro assays for specific IgE in the clinical evaluation of immediate hypersensitivity. Ann Allergy. 1992;68(1):35‑45.

10. Kam KL, Hsieh KH. Comparison of three in vitro assays for serum IgE with skin testing in asthmatic children. Ann Allergy. 1994;73(4):329‑36.

11. Williams PB, Siegel C, Portnoy J. Efficacy of a single diagnostic test for sensitization to common inhalant allergens. Ann Allergy Asthma Immunol. 2001;86:196-202.

12. Adkinson N Jr., Bochner B, Burks A, Busse W, Holgate S, Lemanske R, O'Hehir R (ed). Middleton’s allergy: principles and practice. 8th ed. Philadelphia: Elsevier Saunders, 2014; p.1896.

13. Daniluk U, Alifier M, Kaczmarski M, Stasiak-Barmuta A, Lebensztejn D. Longitudinal observation of children with enhanced total serum IgE. Ann Allergy Asthma Immunol. 2015;114:404e410.

14. Arruda LK, Rizzo MC, Chapman MD, Fernandez-Caldas E, Baggio D, Platts-Mills TAE, et al. Exposure and sensitization of dust mite allergens among asthmatic children in São Paulo, Brazil. Clin Exp Allergy. 1991;21:433-9.

15. Rizzo MC, Solé D, Rizzo A, Holanda MA, Rios JBM, Wandalsen NF, et al. Etiologia da doença atópica em crianças brasileiras, estudo multicêntrico. J Pediatr (Rio J). 1995;71:31-5.

16. Camelo-Nunes IC, Solé D, Naspitz CK. Fatores de risco e evolução clínica da asma em crianças. J Pediatr (Rio J). 1997;73:161-70.

17. Arruda LK, Ferriani VP, Vailes LD, Pomes A, Chapman MD. Cockroach allergens: environmental distribution and relationship to disease. Curr Allergy Asthma Rep. 2001;1:466-73.

18. Pastorino AC, Kuschnir FC, Arruda LK, Casagrande RR, de Souza RG, Dias GA, et al. Sensitisation to aeroallergens in Brazilian adolescents living at the periphery of large subtropical urban centres. Allergol Immunopathol (Madr). 2008;36(1):9-16.

19. Sarinho EC, Mariano J, Sarinho SW, Medeiros D, Rizzo JA, Almerinda RS, et al. Sensitisation to aeroallergens among asthmatic and nonasthmatic adolescents living in a poor region in the Northeast of Brazil. Allergol Immunopathol (Madr). 2009;37(5):239-43.

20. Sopelete MC, Moreira PF, Silva DA, Cunha-Júnior JP, Vieira FA, Sung SS, et al. Sensitization to Lolium multiflorum grass pollen in pollinosis patients: evaluation of allergenic fractions recognized by specific IgE antibodies. Int Arch Allergy Immunol. 2006;140(2):121‑30.

21. Chong Neto HJ, Rosário NA, Solé D; Latin American ISAAC Group. Asthma and Rhinitis in South America: how different they are from other parts of the world. Allergy Asthma Immunol Res. 2012;4(2):62-7.

22. Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012;67(1):18-24.

23. Itikawa A, Mallozi MC, Wandalsen GF, Solé D. Reatividade cutânea a alérgenos inalantes em crianças e adolescentes alérgicos de serviço especializado - Valor do índice cutâneo. Rev Port Imunoalerg. 2014;22:257-66.

24. Keller AF, Sarni ROS, Mallozi MC, Solé D. Body mass index and skin reactivity to histamine and Dermatophagoides pteronyssinus in children and adolescents followed in a pediatric allergy service. Eur Ann Allergy Clin Immunol. 2017;49:110-13.

25. Tschopp JM, Sistek D, Schindler C, Leuenberger P, Perruchoud AP, Wüthrich B, et al. Current allergic asthma and rhinitis: diagnostic efficiency of three commonly used atopic markers (IgE, skin prick tests, and Phadiatop). Results from 8329 randomized adults from the SAPALDIA Study. Swiss Study on Air Pollution and Lung Diseases in Adults. Allergy. 1998;53(6):608-13.

26. Hamilton RG, Oppenheimer J. Serological IgE Analyses in the Diagnostic Algorithm for Allergic Disease. J Allergy Clin Immunol Pract. 2015;3(6):833-40.

27. Park HJ, Kim EJ, Yoon D, Lee JK, Chang WS, Lim YM, et al. Prevalence of Self-reported Allergic Diseases and IgE Levels: A 2010 KNHANES Analysis. Allergy Asthma Immunol Res. 2017;9(4):329-39. Correspondência: Dirceu Solé E-mail: alergiaimunologiareumatologia@unifesp.br Não foram declarados conflitos de interesse associados à publicação deste artigo.

28. Hyun DW, Min HJ, Kim MS, Whon TW, Shin NR, Kim PS, et al. Dysbiosis of inferior turbinate microbiota is associated with high Total IgE levels in patients with allergic rhinitis. Infect Immun. 2018;86(4). pii: e00934-17.

29. Hamilton RG. Allergic sensitization is a key risk factor for but not synonymous with allergic disease. J Allergy Clin Immunol. 2014;134(2):360-1.

30. Sun BQ, Chen DH, Zheng PY, Huang HM, Luo WT, Zeng GQ, et al. Allergy-related evidences in relation to serum IgE: data from the China state key laboratory of respiratory disease, 2008-2013. Biomed Environ Sci. 2014;27(7):495-505.

31. Chang ML, Cui C, Liu YH, Pei LC, Shao B. Analysis of total immunoglobulin E and specific immunoglobulin E of 3,721 patients with allergic disease. Biomed Rep. 2015;3(4):573-7.

32. Hamilton RG. Clinical laboratory assessment of immediate-type Hypersensitivity. J Allergy Clin Immunol. 2010;125:S284-96.

33. Hamilton RG, Williams PB. Specific IgE Testing Task Force of the American Academy of Allergy, Asthma & Immunology; American College of Allergy, Asthma and Immunology. Human IgE antibody serology: a primer for the practicing North American allergist/ immunologist. J Allergy Clin Immunol. 2010;126(1):33-8.

34. Mancini I, Solé D, Naspitz CK. Níveis séricos de IgE total em crianças brasileiras normais no primeiro ano de vida. J Pediatr (Rio J). 1996,72:98-102.

35. Tanaka A, Jinno M, Hirai K, Miyata Y, Mizuma H, Yamaguchi M, et al. Longitudinal increase in total IgE levels in patients with adult asthma: an association with poor asthma control. Respir Res. 2014;15:144.

36. Moneret-Vautrin DA, Kanny G, Halpern G. Detection of antifood IgE by in vitro tests and diagnosis of food allergy. Allerg Immunol (Paris). 1993;25(5):198-204.

37. Valenta R, Vrtala S, Focke-Tejkl M, Bugajska-Schretter, Ball T, Twardosz A, et al. Genetically engineered and synthetic allergen derivatives: candidates for vaccination against type I allergy. Biol Chem. 1999;380(7-8):815-24.

38. González-Buitrago JM, Ferreira L, Isidoro-García M, Sanz C, Lorente F, Dávila I. Proteomic approaches for identifying new allergens and diagnosing allergic diseases. Clin Chim Acta. 2007;385(1‑2):21-7.

39. Yunginger JW, Ahlsted S, Egglestone PA, Homburger A, Nelson HS, Ownby DR, et al. Quantitative IgE antibody assays in allergic diseases. J Allergy Clin Immunol. 2000;105:1077-84.

40. Naspitz CK, Sole D, Aguiar MC, Chavarria ML, Rosario Filho N, Zuliani A, et al. Phadiatop in the diagnosis of respiratory allergy in children: Allergy Project - PROAL. J Pediatr (Rio J). 2004b;80(3):217‑22.

41. Ballardini N, Nilsson C, Nilsson M, Lilja G. ImmunoCAPTM Phadiatop® Infant – a new blood test for detecting IgE sensitization in children at 2 years of age. Allergy. 2006;61:337-43.

42. Nilsson C, Lilja L, Nordlund M, Berthold M, Borres MP. Phadiatop Infant detects IgE mediated diseases among preschool children: a prospective study. Pediatr Allergy Immunol. 2012;23:159-65.

43. Lau S, Nilsson M, Sulser C, Schulz G, Borres MP, Wahn U. Use of Phadiatop Infant in diagnosis of specific sensitization in young children with wheeze or eczema. Pediatr Allergy Immunol. 2008;19:337-41.

44. Halvorsen R, Jenner A, Hagelin EM, Borres MP. Phadiatop infant in the diagnosis of atopy in children with allergy-like symptoms. Int J Pediatr. 2009;2009:460737.


Submetido em:
06/12/2018

Aceito em:
15/12/2018

6a4d4051a953952ae56ea3c5 aaai Articles
Links & Downloads

Arq Asma Alerg Imunol

Share this page
Page Sections