Can ISAC give information on allergens not present on the chip?
Example: A patient with suspicion of allergy is tested with extract-based tests and ISAC. ISAC is used to clarify the sensitization pattern.
Result: The results confirm some allergen suspicions, but there is also a suspicion of allergy to e.g. melon, which is not presented on ISAC.
Explanation: Even though specific components for melon are not present on ISAC, cross-reacting allergens originating from other sources than melon may be responsible for the melon sensitization. Some cross-reacting protein families like profilins, PR-10 proteins, CCD and LTPs are usually well conserved across species and may be markers also for allergens present in melon.
The relevant component for the patient in focus is probably not present on the ISAC chip if explanation a) is not valid and no other ISAC components are identified. In this case it is recommended to complement with the ImmunoCAP extract-based test for e.g. melon. ISAC will never cover all allergens and therefore it is important to have knowledge regarding which allergens ISAC cover and also to what extent, i.e. if a major part of melon sensitized patients are identified with ISAC (like for peanut) or only a minor part (like for cashew) for a specific patient population.
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