Bueno-Díaz, C. (Cristina)

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    Unraveling the Diagnosis of Kiwifruit Allergy: Usefulness of Current Diagnostic Tests
    (Esmon Publicidad, 2022) Garrido-Arandía, (M.) María; Bernad, A. (Amalia); Goikoetxea-Lapresa, M.J. (María José); Gastaminza, G. (Gabriel); Díaz-Perales, A. (Araceli); Azofra, J. (Julián); Bueno-Díaz, C. (Cristina); Garrido-Fernández, S. (Sara); D'Amelio-Garofalo, C.M. (Carmen Mariana); Garcia, B.E. (Blanca Esther); Villalba, M. (Mayte); Ferrer-Cardona, M. (Marta)
    Objectives: To determine the usefulness of the in vitro and in vivo methods used in the diagnosis of kiwifruit allergy and to specifically assess the impact of seed proteins on sensitivity. Methods: We performed skin prick tests (SPTs) using various commercial extracts, homemade pulp, and seed extracts and prick-prick tests with kiwifruit on 36 allergic patients. The presence of specific IgE (sIgE) was assessed using the ImmunoCAP (kiwifruit extract), ELISA (Act d 1, Act d 2), ISAC, and FABER assays. Immunoblotting of seed extract was carried out, and a single-blind oral food challenge was performed with whole seeds in seed-sensitized individuals. Results: The prick prick test with kiwifruit demonstrated the highest diagnostic capacity (81.8% sensitivity and 94.1% specificity) among the in vivo tests. The sIgE levels measured using ImmunoCAP (kiwifruit extract) showed a similar sensitivity to that of global ISAC and FABER (63.9%, 59.5%, and 58.3%, respectively). Act d 1 was the major allergen. Sensitization to Act d 1 was associated with positive sIgE results to whole kiwifruit extract detected by ImmunoCAP (P<.000). A positive SPT result to kiwifruit seeds was associated with severe symptoms induced by kiwifruit (P=.019) as a marker of advanced disease, but not with clinically relevant sensitization. Challenge testing with kiwifruit seeds performed on 8 seed-sensitized patients yielded negative results. Conclusions: Sensitization to Act d 1 is associated with a positive result in conventional diagnostic techniques, whereas kiwifruit seed sensitization does not increase the sensitivity of the diagnostic techniques evaluated.