Evaluation of the applicability of the Immuno-solidphase allergen chip (ISAC) assay in atopic patients in Singapore

Amelia Santosa, Anand Kumar Andiappan, Olaf Rotzschke, Hung Chew Wong, Amanda Chang, Mei Bigliardi-Qi, De Yun Wang, Paul Lorenz Bigliardi

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background/Objective: Molecular-based allergy diagnostics are gaining popularity in clinical practice. Our aim was to evaluate their role in the tropics, given the inherent genetic and environmental differences. Methods: We recruited subjects with history of atopy and collected data on demographics and atopic symptoms using validated questionnaires. Subjects underwent a series of skin prick tests (SPT). Serum total and specific IgE levels were measured using ImmunoCAP FEIA and ImmunoCAP ISAC® , respectively. We describe their pattern of sensitization and agreement between test methods. Results: A total of 135 subjects were recruited; mean ± SD age of 31.18 ± 12.72 years, 52.7% female. Allergic rhinitis (AR) was the most prevalent clinical manifestation of atopy (70.7%), followed by atopic dermatitis (AD) (50.5%) and asthma (26.2%). Polysensitization was seen in 51.1% of subjects by both SPT and ISAC. House dust mites (HDM) were the dominant allergen, with sensitization in 67.8% and 62% of subjects on SPT and ISAC, respectively. A group of subjects with monosensitization to B. tropicalis was identified. HDM sensitization was strongly associated with AR, while AD and asthma were not associated with sensitization to any allergen. Agreement between SPT and ISAC was mostly suboptimal. Greatest agreement was documented for the measurement of HDM sensitization with both methods (κ = 0.64). Sensitization to the bulk of the remaining allergens in the ISAC panel was infrequent. Conclusion: Multiplex methods should not be used as a screening tool, especially in a population with lower rates of polysensitization and a dominant sensitizing allergen. There may be a role in adjusting the antigen spectrum in the ISAC panel to regional differences.

Original languageEnglish (US)
Article number9
JournalClinical and Translational Allergy
Issue number1
StatePublished - Feb 27 2015

Bibliographical note

Funding Information:
The project was supported by grants from the Singapore Immunology Network, the Biomedical Research Council, Singapore; (SIgN-06-006, SIgN-08-020 and SIgN-10-029) and the core funding from the Singapore Immunology Network, Agency for Science, Technology and Research (A*STAR).

Publisher Copyright:
© 2015 Santosa et al.


  • Atopy
  • ISAC
  • Sensitization
  • Skin prick test
  • Specific IgE


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