Usefulness of currently available methods for the diagnosis of Anisakis simplex allergy

Background: Serodiagnosis of anisakiosis and Anisakis allergy is difficult since many Anisakis antigens show cross-reactivity complications. In the pr esent study, we assess the usefulness of the major immunologic methods curr ently available for the diagnosis of Anisakis allergy. Methods: Four tests (skin prick test, CAP-FEIA system, Western blotting, an d an antigen-capture ELISA using O-deglycosylated antigen bound by the mono clonal antibody UA3) were applied to Anisakis-free subjects and subjects wi th confirmed Anisakis allergy. Results: The skin prick test, CAP-FEIA, and the antigen-capture ELISA ident ified Anisakis allergy sera with 100% sensitivity, while Western blotting s howed 96% sensitivity. The antigen-capture ELISA also showed 100% specifici ty, but CAP-FEIA showed a specificity of only 50%. In Western blotting, non e of the bands detected were specific for either Anisakis-free or Anisakis allergy subjects. The skin prick test was not applied to the Anisakis-free subjects, so its specificity could not be determined. Conclusions: On the basis of these results, we suggest that the most approp riate procedure for diagnosis of Anisakis allergy suspected on clinical gro unds is the antigen-capture ELISA using UA3, or, alternatively, a prelimina ry skin prick test with a positive result subsequently confirmed by UA3-ELI SA.