001490 - Comparison of skin prick tests with allergen extracts and molecular allergy diagnostics for allergen-specific immunotherapy decision-making in pollen allergy

Skin prick tests (SPT) using allergen extracts are widely applied in the diagnosis of IgE-mediated pollen allergy and are often used to guide allergen-specific immunotherapy (AIT). However, allergen extracts contain mixtures of major and minor allergens as well as cross-reactive components, which may limit their ability to identify the true immunological target of therapy. This study aimed to assess the relationship between SPT results with pollen extracts and serum specific IgE to major allergenic components (Art v 1 and Amb a 1) and to evaluate their relevance for AIT selection.

Thirty patients with seasonal allergic rhinitis were included. All subjects underwent:

• skin prick testing with mugwort and ragweed allergen extracts;

• measurement of serum specific IgE to Art v 1 and Amb a 1.

Mean wheal diameter was used for analysis. Associations between SPT wheal size and specific IgE levels were assessed using Spearman’s rank correlation. Scatter plots were used for data visualization.

For mugwort, a weak and non-significant correlation was observed between SPT wheal size and sIgE to Art v 1 (ρ = 0.27; p = 0.15).In contrast, a strong and statistically significant correlation was found between SPT results and sIgE to Amb a 1 for ragweed (ρ = 0.70; p < 0.001).

Graphical analysis demonstrated high variability for mugwort and a clear monotonic relationship for ragweed.

Skin prick tests with allergen extracts confirm IgE-mediated sensitization but do not reliably reflect the degree of molecular sensitization and have limited value for predicting the efficacy of allergen-specific immunotherapy, particularly in mugwort allergy. Molecular allergy diagnostics targeting major allergenic components is essential for accurate patient selection and personalized AIT.