Real-life evaluation of molecular multiplex IgE test methods in the diagnosis of pollen associated food allergy

Allergy. 2022 Oct;77(10):3028-3040. doi: 10.1111/all.15329. Epub 2022 May 9.


Background: Diagnosis of food allergies is challenging, as combining information from specific IgE (sIgE)-sensitization pattern and skin prick tests (SPTs) with clinical history is necessary for a personalized management of allergic patients. The aim of this study was to compare two molecular tests, the ImmunoCAP ISAC (ISAC) and the Allergy Explorer, version 2 (ALEX2 ) in the context of pollen food syndrome (PFS) diagnosis in a real-life scenario, to assess the benefit of multiplex testing in PFS patients.

Methods: Diagnosis of food allergy was performed in 53 patients. Allergen-sIgE concentrations were measured with ISAC and ALEX2 . Results for sIgE were statistically compared with each other, with SPT results and with clinical presentation of the patients.

Results: Using ISAC as reference test for sIgE measurements, the average sensitivity of ALEX2 for PR-10 allergens was 83.2% and the average specificity 88.0%. If only low sIgE concentrations were included, the sensitivity was 60.8% and the specificity 91.1%. Apple and hazelnut sensitizations were confirmed in most patients by concordance of sIgE and SPT results. Significant correlations were shown between clinical symptoms and Mal d 1- and Gly m 4-sIgE levels measured by both tests and for Cor a 1-sIgE levels measured by ALEX2 . In eight patients, profilin related symptoms were supported by Hev b 8-sensitization.

Conclusion: Multiplex testing is beneficial to understand patient-specific individual sensitization profiles and to providing personalized management recommendations. In the future, custom-designed test kits might enable reducing costs of multiplex testing for specific patient groups without compromising the diagnostic value.

Keywords: food allergy; molecular diagnosis; multiplex testing; pollen food syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens
  • Food Hypersensitivity* / diagnosis
  • Humans
  • Immunoglobulin E
  • Pollen
  • Profilins*
  • Skin Tests / methods


  • Allergens
  • Profilins
  • Immunoglobulin E