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PubMed1986

Serum IgE, skin and radioallergosorbent tests for house dust and mites in asthmatic children.

Thirty asthmatic children were given an intradermal skin test, total IgE measurements and the radioallergosorbent test (RAST) against house dust and house dust mites (Dermatophagoides pteronyssinus and Dermatophagoides farinae). Results of the intradermal skin test and RAST were highly positive with overall agreement in 95.6%. The correlation coefficient between the total IgE and the RAST to house dust was 0.35 (p less than 0.05). There was no significant difference between the total IgE and the RAST to D. pteronyssinus and D. farinae (p greater than 0.05). The highly significant correlation coefficient between house dust and house dust mites (D. farinae, p less than 0.0001; D. pteronyssinus, p less than 0.00001) was determined by RAST. House dust has been found to be the most important allergen in children in Taiwan. The role of mites as a possible allergen in house dust also showed a highly significant correlation in our study.

Adolescent↗
PubMed1993

[The usefulness and limitations of the radioallergosorbent test in diagnosing food allergy in atopic dermatitis].

To clarify the diagnostic value of the radioallergosorbent test (RAST), the relationship between RAST and the oral food challenge test was evaluated. 263 children with atopic dermatitis were challenged by egg, cow's milk or soy bean after their skin manifestations had been improved by elimination diet and environmental control. Of 200 cases with negative RAST results for egg white, 108 cases (54.0%) showed no reaction in egg challenge tests. However, 65 cases (31.5%) had non-immediate reactions, while 29 cases (14.5%) had immediate reactions (within 2 hours of challenge). Of 16 cases with RAST score of 1 for egg white, 11 cases (68.8%) had non-immediate reactions and 2 cases (12.5%) had immediate reactions in egg challenge tests. Of 19 cases with RAST scores of 2 for egg white, 2 cases (10.5%) had no reaction, 6 cases (31.6%) had non-immediate reactions and 11 cases (57.9%) had immediate reactions in egg challenge tests. Of 21 cases with RAST scores of 3 for egg white, 1 case (4.8%) had no reaction, 3 cases (14.3%) had non-immediate reactions and 17 cases (81.0%) had immediate reactions in egg challenge tests. All 7 cases with RAST scores of 4 for egg white had immediate reactions in egg challenge tests. Almost the same relationship between RAST and challenge tests were found in test using cow's milk or soy bean. In conclusion, false negative results were seen in 46.0% of RAST for egg white, 51.7% of RAST for cow's milk and 26.9% of RAST for soy bean.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1981

Immunodiagnosis of schistosomiasis outside endemic areas: use of histamine release from basophils by schistosomal antigens and radioallergosorbent test.

Specific allergic histamine release from leucocytes, radioallergosorbent tests (RAST) and indirect fluorescent antibody tests (IFAT) were applied for immunodiagnosis of schistosomiasis in patients outside endemic area. Of 10 parasitologically verified cases--all of them exhibiting a low and irregular egg output--8 were detected by histamine release, whereas 4 patient with filariasis, 3 with trichuriasis and 31 parasitologically normal controls were negative in this respect. By a combination of the histamine release test, RAST and IFAT all 10 cases were diagnosed. RAST and IFAT applied to 29 patients with active or treated schistosomiasis were positive in 14 (48%) and 20 (69%) cases, respectively.

Adolescent↗
PubMed1982

Efficacy of a screening radioallergosorbent test.

Controversy over the routine use of the radioallergosorbent test (RAST) for initial inhalant allergy diagnosis largely concerns expense to the patient. Presented is a method for utilizing the RAST, with all its inherent advantages, at a competitive cost to both negatively and positively responding patients. The initial use of a "screening" RAST that utilizes approximately one third the number of tests in the usual full RAST battery is recommended. When all responses on the screening RAST battery are negative, further RAST testing proves generally unnecessary. For positive responders, the screening RAST often eliminates the need of additional pollen and/or mold allergen testing, a further cost-containment feature. The presented study illustrates the efficacy of this technique. A background section is provided to familiarize the reader with the common modalities available for testing and treating IgE-mediated inhalant allergies.

Cost-Benefit Analysis↗
PubMed1978

The radioallergosorbent test in the diagnosis of canine atopic disease.

The radioallergosorbent test (RAST) was adapted for use in the dog employing purified anti-canine IgE. The agreement between positive RAST and positive skin test ranged from 82% for ragweed to only 12.5% for dandelion. Agreement between negative tests in the case of all allergens was 100%. Further developmental studies of canine RAST are warranted in view of the value of the dog as an experimental model of atopic disease.

Animals↗
PubMed1985

Use of modified radioallergosorbent testing in determining initial immunotherapy doses.

Proponents of the modified radioallergosorbent test (RAST) for allergy diagnosis claim an advantage over skin testing in that immunotherapy may often be safely begun at higher initial concentrations and maintenance achieved with fewer injections than with conventional schedules. The resulting fewer visits would offset the greater initial cost and the delay in obtaining results. The most important allergen for 58 consecutive patients with seasonal allergic rhinitis beginning immunotherapy was determined from the history, skin testing, and aeroallergen surveys. A modified RAST was performed for these allergens. Thirty-nine patients (67%) had a modified RAST class 5 (most severe); 18 patients (31%) were class 4, and one patient was class 3. Since the initial concentration and total number of injections projected to reach maintenance vary little between our conventional schedule (1:100,000 w/v, 23 injections), and those for class 5 (1:62,500 w/v, 27 injections) and class 4 (1:12,500 w/v, 21 injections), the modified RAST offers no advantage over skin testing and conventional immunotherapy dosing in our patient population.

Adolescent↗
PubMed1975

Influence of IgG antibody and glycopeptide allergens on the correlation between the radioallergosorbent test (RAST) and skin testing or bronchial challenge with alternaria.

The radioallergosorbent test (RAST) for alternaria was compared to skin tests and bronchial challenges in children suffering from chronic intractable asthma. In contrast to when such children were tested with a timothy grass pollen extract, the bronchial challenge and skin test results against alternaria did not correlate significantly. When alternaria allergens were coupled to cyanogen bromide-activated microcrystalline cellulose, the RAST correlated with the results of skin testing but not bronchial challenge. It was demonstrated by column immunabsorption that some allergic sera contained sufficient IgG antibody against alternaria to competitively inhibit the RAST. When Sepharose 2B was substituted for cellulose as the insoluble support, the inhibition by IgG antibody was largely overcome and then the RAST correlated with both skin test and bronchial challenge results. Glycopeptides contribute significantly to the allergenicity of alternaria, and when these materials were coupled to a Sepharose 2B conjugate by mild oxidation, the RAST correlated with bronchial challenge, but not skin test, results. It was concluded that in this group of steroid-dependent asthmatic children, the correlation of the RAST with the in vivo challenges was strongly influenced by the presence of IgG antibody in the allergic sera and the chemical nature of the mould allergens investigated.

Absorption↗
PubMedDate not supplied

[Sensitivity and specificity of the RAST (radioallergosorbent test) in biological diagnosis of the hydatidosis (author's transl)].

The radioallergosorbent test (RAST) for specific IgE antibodies to Echinococcus granulosus was compared with other immunological methods in regard to sensitivity, specificity and its use as a diagnostic aid for hydatid disease. Sera used were from patients with active hydatidosis proved surgically, from persons operated for hydatidosis during the previous 2-10 years and from patients with other parasitic diseases or healthy subjects. Results with enzyme-immuno assay (ELISA), indirect haemagglutination (IHA), counter-immunoelectrophoresis (CIEP) and skin test were compared with those with RAST. The percentage of positive RAST reactions (81.2%) among the patients with active hydatidosis was slightly lower than the percentage of positive ELISA (90.6%), IHA (90.6%) and skin test (87.5%) and was superior to CIEP (75%). Among the patients with previous hydatidosis, the RAST was negative in 90% of case, whereas other serological tests were positive in a considerable proportion of cases (ELISA test, 80%; IHA test, 40%; CIEP test, 40%; skin test, 60%). A high percentage (50%) of false positive RAST reactions have been observed in sera from patients infested with other parasites. Results indicated that the RAST for IgE antibodies not be used as the only method for diagnosis of hydatidosis, but it may be employed, if serological data obtained before surgery are available for comparison, for evaluate the results of surgery and to clarify the prognosis.

Adult↗
PubMed1975

Detection of IgG antibody to deoxyribonucleic acid by the radioallergosorbent test.

IgG antibodies to heat-denatured calf thymus deoxyribonucleic acid (DNA) single-stranded DNA:ss-DNA) in the sera of patients with systemic lupus erythematosus (SLE) could be detected by means of solid-phase radioimmunoassay. Single-stranded DNA coupled covalently to microcrystalline cellulose and 125I-labeled anti-human gamma chain were used for this test. The principle of this test is known as the radioallergosorbent test (RAST). This paper describes the usefulness of the RAST for the detection of human IgG antibody. Specificity of this test was examined by an inhibition test using ss-DNA and double-stranded DNA (ds-DNA). A trial for the detection of IgM and IgA antibodies to ss-DNA was also attempted.

Animals↗
PubMed1980

[Experiences with the radioallergosorbent test in house dust allergy and bronchial asthma (author's transl)].

The radioallergosorbent test (RAST) has been used for in vitro diagnosis of asthma. The paper reports about 70 investigations in 40 patients with house dust and mite allergy. In 75 p. c. the test was positive, especially in mite allergy. On the other hand increased total IgE levels only in about 50 p.c. correlated with positive case history and skin test results. After hyposensitization indeed a better correlation was found. --In conclusion RAST seems to be no alternative but a useful completion to the traditional diagnostic methods as skin test and provocations test especially in mite allergy and analogous situations, where provocation test is not usual.

Adolescent↗
PubMed1998

The diagnosis of allergic rhinitis: how to combine the medical history with the results of radioallergosorbent tests and skin prick tests.

OBJECTIVE: To identify the most useful combinations of symptoms and the results of radioallergosorbent tests (RASTs) and skin prick tests (SPTs) for the diagnosis of allergic rhinitis. DESIGN: A prospective comparison was made of symptoms and the results of RASTs and SPTs with 7 different nasal allergies; the references used were the "consensus diagnoses" provided by 3 experts. SETTING: Nineteen general practices in The Netherlands. PATIENTS: 365 consecutive patients aged 12 or over who visited their general practitioner because of chronic or recurrent nasal symptoms between 1 March 1990 and 1 March 1991. MAIN OUTCOME MEASURES: The most useful combinations of items from the history, RASTs, and SPTs, for the diagnosis of 7 different nasal allergies; the predictive probabilities of these combinations. RESULTS: Diagnostic criteria could be drawn up resulting in a near-perfect discrimination between patients diagnosed as having allergic rhinitis and patients diagnosed as not having allergic rhinitis. Most of these criteria combined only a single item from the history with either RAST or SPT. For nearly all nasal allergies, both the negative predictive probabilities and the positive predictive probabilities were 97% or more. CONCLUSIONS: The common nasal allergies can be diagnosed with a very high certainty with the aid of simple diagnostic criteria. Data from a strictly limited case history combined with either RAST or SPT are sufficient.

Adolescent↗
PubMed1975

Measurement of IgE antibodies by the radioallergosorbent test. II. Analyses of quantitative relationships in the test.

IgE antibodies have been measured by the radioallergosorbent test (RAST) and the relative amounts present in serum determined by comparison with reference standards. In this study we analyzed the quantitative aspects of the binding of IgE antibody to solid-phase ragweed antigens. With the volumes of allergic serum usually tested, IgE antibodies are in excess in the first step of the RAST. The inability of solid-phase antigens to remove IgE antibody appeared to be due to an insufficient quantity of antigen on the particles rather than steric interference with binding of IgE antibody. Dose-response curves with serums from several ragweed-sensitive subjects were not parallel when plotted on a semilog scale. In contrast, log-log plots of dose-response curves with serums from ragweed-sensitive subjects were nearly parallel. Log-log plots of dose-response curves with serums from subjects with ragweed and grass sensitivity and tested with the appropriate solid-phase antigens also were nearly parallel. Because of the latter finding, RAST could be standardized using a reference serum in every assay and plotting the results on a log-log scale. Finally, because IgE antibody is in excess in the RAST as it is usually performed, the final result reflects both the quantity and the affinity of the IgE antibody.

Allergens↗
PubMed1980

Use of the radioallergosorbent test for the study of coelenterate toxin-specific immunoglobulin E.

The radioallergosorbent test (RAST) was adapted for use to screen the immune response to sea nettle (Chrysaora quinquecirrha) and Protuguese man-o'-war (Physalia physalis) toxins. The results of a preliminary screening of serum from patients varying in their reaction to envenomations indicate the potential of these toxin proteins to induce an allergic state in humans and illustrate the use of the RAST as a screening device to detect persons sensitive to coelenterate stings.

Adult↗
PubMed1978

[Significance of the radioallergosorbent test (RAST) in the specific diagnosis of atopic bronchial asthma (author's transl)].

The radioallergosorbent test (RAST) is a recently developed radioimmunological in-vitro method for determining IgE-specific serum antibodies in reaginic allergy. There was 63.4% overall correspondence between RAST and bronchial provocation test in 423 tests with a total of eight perennial allergens on adults with asthma. Where there was disagreement, combination of postiive inhalation test and a negative RAST was much more frequent (33.6%) than in the obverse (3%). Agreement between RAST and provocation tests was 79% for the house dust mite Dermatophagoides pteronyssinus, 71.5% for cat and dog epithelium, 70% for the Penicillium mould, 63% for Alternaria, 55% for Hormodendron and Aspergillus and only 53% for house dust. In asthmatics a positive RAST usually indicates clinically relevant sensitization (positive case history or positive provacation test), while negative results (especially in cases of mould or house dust allergy) do not rule out possible significant sensitization. On the other hand, skin tests with moulds and house dust are frequently "false" positive. First test in the specific diagnosis of bronchial asthma remains a thorough case history combined with careful skin testing. When the two disagree, RAST is helpful together with as a "secondary" allergy test.

Allergens↗
PubMed1986

The effect of nonspecific binding by IgE on the radioallergosorbent test.

Human serum albumin (HSA), coupled to filter paper discs, was used in the radioallergosorbent test (RAST) to evaluate nonspecific binding which results from high levels of total serum IgE. Binding of 125I-labelled anti-IgE to HSA coated discs was significantly correlated with total IgE levels. A significantly better correlation was seen, however, using HSA chemically treated under alkaline conditions prior to coupling with the disc. Use of HSA as a control for individual serum samples in the RAST is discussed.

Humans↗
PubMed1994

Radioallergosorbent testing for penicillin allergy in family practice.

OBJECTIVES: To determine (a) the prevalence of patients supposedly allergic to penicillin who have a positive radioallergosorbent test (RAST) result for penicillin G or V and (b) the predictive power of family physicians' clinical judgement that a patient who is supposedly allergic to penicillin will have a positive RAST result. DESIGN: Prospective multicentre cross-sectional observational study. SETTING: Eleven primary care practices in Newfoundland; 10 were in a rural setting. PATIENTS: Of 110 consecutive adult patients with a supposed allergy to penicillin 97 agreed to participate in the study; 92 underwent RAST. INTERVENTIONS: Patients helped physicians complete a questionnaire and had a venous blood sample taken for the RAST. Physicians examined the clinical history and judged whether the patient was likely to have a positive RAST result. MEAN OUTCOME MEASURES: Rates of positive and negative RAST results for penicillin V and G. RESULTS: Of the 92 patients 8 had a positive RAST result and 84 a negative one. The positive predictive power of a "good" clinical history (e.g., urticaria, swollen eyes, tongue or lips, or an anaphylactic reaction witnessed by a physician) was low (10%); the negative predictive power of a "poor" clinical history (e.g., nausea, vomiting, diarrhea, fever, nonspecific rash or fainting) was 92%. CONCLUSIONS: Less than 10% of primary care patients with a supposed allergy to penicillin will have a positive RAST result. In addition, physicians' predictions of allergy in such patients are imprecise.

Adolescent↗
PubMed1984

Use of dialyzed venoms in the radioallergosorbent test.

Optimal concentrations of honeybee, hornet and yellow jacket venoms were used in the radioallergosorbent test (RAST) before and after dialysis. RAST titers in the majority of sera from insect-allergic patients increased significantly with the dialyzed yellow jacket and hornet venom-coupled discs. Of 26 sera which had negative RASTs with crude venom, 20 became positive with dialyzed venom. No change in RAST results was found with crude and dialyzed honeybee venom. The low molecular weight component in the vespid venoms removed by dialysis had no specific activity in RAST inhibition experiments, suggesting nonspecific blocking of binding sites. These results indicate the importance of the appropriate antigen preparation coupled to discs in the RAST.

Allergens↗