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METHODS article
Front. Allergy
Sec. Allergy Diagnosis
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1515294
Multiplex IgE peanut panels: critical appraisal of assay designs and the overall good, the bad and the ugly features of the applied allergen components
Provisionally accepted- 1Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, Netherlands
- 2Department of Allergology and Clinical Immunology, Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands
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Background: Multiplex allergy assays are nowadays well established in allergy diagnostics. However, the different assays in terms of designs and performance are also claimed to be heterogeneously as no agreed standards and requirements are available.We aimed to compare the analytical assay designs of ISAC, ALEX and EUROLINE peanut (Ara h) panels as well as the features of the applied isoallergens and variants in order to create more awareness of the heterogeneity of multiplex allergy assays.We conducted a multi-source survey in publicly available data sources as well as amongst manufacturers and performed correlation studies using patients' serum samples.The survey proved that the panels are indeed very heterogeneous in many ways, especially regarding the allergen component origin and isoallergen composition. Despite that, we found adequate correlations between IgE against the clinically relevant Ara h storage proteins measured by the panels. However, for the clinically relevant LTP Ara h 9 the correlations were less adequate, which could be caused by the different Arah 9 isoallergens used in the studied panels. For CCDs the results were complicated, which also corresponds to the complex nature of CCDs and the different inhibition procedures. Detection of subpopulations of patients for all panallergens illustrated the heterogeneous nature of peanut IgE in general and of the peanut panels studied. Regarding the overall features provided for the 3 panels, we classified the peanut allergen components and CCDs on the good, the bad and even the ugly features when used within these panels.The knowledge of the origin and respective isoallergen specification of the peanut allergen components including the exact CCD composition is essential. Together with that of the variants, this should be documented more adequately in scientific studies as well as in the respective instructions-for-use of multiplex allergy assays.
Keywords: Multiplex assay, specific IgE, peanut, Allergen component, Isoallergen, allergen variant
Received: 22 Oct 2024; Accepted: 17 Mar 2025.
Copyright: © 2025 De Boer, Bijnens, Slot, Nieuwhof and Bons. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Douwe De Boer, Central Diagnostic Laboratory, Maastricht University Medical Center, Maastricht, Netherlands
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