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Baker’s Asthma: Is the Ratio of Rye Flour-Specific IgE to Total IgE More Suitable to Predict the Outcome of Challenge Test Than Specific IgE Alone

  • V. van Kampen
  • I. Sander
  • R. Merget
  • T. Brüning
  • M. Raulf
Chapter
Part of the Advances in Experimental Medicine and Biology book series

Abstract

Usually the diagnosis of baker’s asthma is based on specific inhalation challenge with flours. To a certain extent the concentration of specific IgE to flour predicts the outcome of challenge test in bakers. The aim of this study was to evaluate whether the ratio of specific IgE (sIgE) to total IgE (tIgE) improves challenge test prediction in comparison to sIgE alone. Ninety-five bakers with work-related respiratory symptoms were challenged with rye flour. Total IgE, sIgE, and the sIgE/tIgE ratio were determined. Receiver operator characteristic (ROC) plots including the area under the curve (AUC) were calculated using the challenge test as gold-standard. Total IgE and sIgE concentrations, and their ratio were significantly higher in bakers with a positive challenge test than in those with a negative one (p < 0.0001, p < 0.0001, and p = 0.023, respectively). In ROC analysis, AUC was 0.83 for sIgE alone, 0.79 for tIgE, and 0.64 for the ratio. At optimal cut-offs, tIgE, sIgE, and the ratio reached a positive predicted value (PPV) of 95%, 84% and 77%, respectively. In conclusion, calculating the ratio of rye flour-sIgE to tIgE failed to improve the challenge test prediction in our study group.

Keywords

Allergy Baker’s asthma Immunoglobulin E Inhalation challenge Occupational allergy Rye flour 

Notes

Acknowledgements

We gratefully acknowledge Ursula Meurer who performed the IgE measurements.

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

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Copyright information

© Springer International Publishing AG  2018

Authors and Affiliations

  • V. van Kampen
    • 1
  • I. Sander
    • 1
  • R. Merget
    • 1
  • T. Brüning
    • 1
  • M. Raulf
    • 1
  1. 1.Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University (IPA)BochumGermany

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