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"Latar belakang: Tungau debu rumah TDR merupakan alergen hirup yang penting pada asma alergik. Namun, penelitian diagnostik molekuler menggunakan Imunoglobulin E IgE spesifik akibat sensitisasi alergen TDR dihubungkan dengan derajat keparahan asma alergik belum pernah dilakukan di Indonesia.Tujuan: Mengetahui perbedaan kadar IgE spesifik serum kuantitatif akibat sensitisasi alergen Dermatophagoides D. pteronyssinus, D. farinae dan Blomia B. tropicalis pada asma alergik intermiten dan persisten.Metode: Desain penelitian potong lintang pada pasien asma alergik dewasa yang diundang untuk pemeriksaan IgE spesifik serum dan merupakan bagian dari penelitian payung di Divisi Alergi dan Imunologi Klinik, RS Cipto Mangunkusumo. Derajat keparahan asma ditentukan berdasarkan kriteria Global Initiative on Asthma GINA 2015 dan dikelompokkan menjadi intermiten dan persisten. Pemeriksaan IgE spesifik serum kuantitatif menggunakan metode multiple allergosorbent test Polycheck Allergy, Biocheck GmbH, Munster, Germany . Alergen TDR yang diperiksa adalah D. pteronyssinus, D. farinae, dan B. tropicalis. Perbedaan antara dua kelompok dianalisis dengan uji Mann-Whitney.Hasil: Sebanyak 87 subyek dilibatkan dalam penelitian ini; 69 79,3 subyek adalah perempuan. Rerata usia pasien adalah 40,2 tahun. Enam puluh tiga 72,4 pasien menderita asma dan rinitis alergik. Sebanyak 58 66,7 pasien asma persisten. Gambaran sensitisasi alergen TDR adalah 62,1 D. farinae; 51,7 D. pteronyssinus dan 48,3 B.tropicalis. Median kadar IgE spesifik secara bermakna lebih tinggi pada asma persisten dibandingkan asma intermiten untuk alergen D. farinae 1,30 vs. 0,0 kU/L; p=0,024 dan B. tropicalis 0,57 vs. 0,0 kU/L; p=0,015 . Kadar IgE spesifik D. pteronyssinus lebih tinggi pada asma persisten dibandingkan intermiten 0,67 vs. 0,00 kU/L; p=0,066.Kesimpulan:Gambaran sensitisasi alergen secara berurutan didapatkan D. farinae 62,1, D. pteronyssinus 51,7 dan B. tropicalis 48,3 . Kadar IgE spesifik akibat sensitisasi D. farinae dan B. tropicalis lebih tinggi secara bermakna pada pasien asma persisten dibandingkan asma intermiten. Kadar IgE spesifik akibat sensitisasi D. pteronyssinus lebih tinggi pada pasien asma persisten dibandingkan asma intermiten, tetapi secara statistik tidak bermakna.

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Introduction House dust mites HDM are an important inhalant allergen in allergic asthma. However, molecular diagnostic study using specific IgE level induced by HDM allergens associated with asthma severity has not been done in Indonesia.Objective To investigate the difference of serum quantitative specific IgE levels induced by Dermatophagoides D. pteronyssinus, D. farinae and Blomia B. tropicalis sensitization in intermittent and persistent allergic asthma.Method This was a cross sectional study on adult allergic asthma patients who were invited for serum specific IgE testing. This study was a part of a larger research within the Division of Allergy and Immunology, Cipto Mangunkusumo Hospital. Asthma severity was defined based on Global Initiative on Asthma GINA 2015 criteria and were grouped as intermittent or persistent. Quantitative specific IgE testing was done on blood serum using a multiple allergosorbent test Polycheck Allergy, Biocheck GmbH, Munster, Germany . The HDM allergens tested were D. pteronyssinus, D. farinae, and Blomia tropicalis. Difference between two groups were analyze using Mann Whitney test.Results A total of 87 subjects were enrolled in this study 69 79.3 were women. Mean patients rsquo age was 40, 2 years. Sixty three 72.4 patients had asthma and allergic rhinitis. Fifty eight 66.7 patients were classified as persistent asthma. The prevalence of sensitization was 62.1 D. farinae, 51.7 D. pteronyssinus, and 48.3 Blomia tropicalis. The median of specific IgE levels is significantly higher in persistent asthma compares to intermittent asthma induced by D. farinae median 1.30 vs. 0.0 kU L p 0.024 and B. tropicalis median 0.57 vs. 0.0 kU L p 0.015 sensitization. Level of Specific IgE D. pteronyssinus is also to be higher in persistent asthma than the level measured in intermittent asthma 0.67 vs. 0.00 kU L p 0.066.Conclusion Sensitization of HDM allergens is shown to be highest for D. farinae 62.1 , followed by D. pteronyssinus 51, 7 and Blomia tropicalis 48, 3 . Specific IgE level induced by D. farinae and Blomia tropicalis sensitization are significantly higher in patients with persistent compares to intermittent asthma, whereas specific IgE level induced by D. pteronyssinus sensitization to be higher in persistent asthma although not statistically significant."

"Asma merupakan inflamasi kronik saluran napas yang timbul karena respons tubuh terhadap faktor eksogen, misalnya alergen, iritasi, dan infeksi. Sebagian pasien asma dilaporkan mengalami perkembangan gejala asma karena pajanan tungau debu rumah TDR . Identifikasi TDR, tempat hidupnya, serta densitas tungau penting dilakukan untuk mengendalikan faktor pencetus, sekaligus mencegah berkembangnya penyakit asma. Penelitian kasus kontrol ini bertujuan untuk mengetahui profil TDR pada pasien asma persisten, termasuk jenis dan kepadatan tungau, serta hubungannya dengan kadar serum IgE spesifik anti-TDR. Penelitian dilakukan pada bulan Februari 2017 sampai Desember 2017. Sebanyak 13 pasien asma persisten dan 12 pasien kontrol telah menjalani pemeriksaan kadar serum IgE spesifik anti-TDR menggunakan Immulite 2000 xpi. Sampel debu rumah diambil dari rumah pasien dan diperiksa menggunakan metode Fain. Hasil penelitian menunjukkan variasi spesies TDR didominasi D. pteronyssinus. Kepadatan D. pteronyssinus adalah 83,9 yaitu 120 spesies tungau tersebut dari 143 tungau yang diperoleh. Kadar serum IgE spesifik anti-TDR pada pasien asma persisten lebih tinggi dibandingkan pasien normal, dengan rerata 2,35 kU/L nilai positif bila >0,35 kU/L . Kepadatan D. pteronyssinus dalam debu kamar tidur menunjukkan korelasi positif dengan kadar serum IgE anti-TDR pada pasien asma persisten.

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Asthma is a chronic inflammation of airways, as a response to exogenous factors, such as alergens, irritants, and infections. Some asthmatic patients had symptoms of asthma due to exposure to house dust mites HDM alergen. Identification of HDM, the habitat, and density of mites are important to control the trigger factors, and preventing the asthma pathogenesis. This case control study aimed to determine the HDM profiles in persistent asthmatic patients, including the species, density of mites, as well as its association with specific IgE anti HDM serum levels. The study was conducted in February 2017 to December 2017. A total of 13 patients with persistent asthma and 12 control patients had screened with specific anti HDM IgE levels using Immulite 2000 xpi. The house dust samples was taken and examined using the Fain method. The results showed that HDM species was predominantly D. pteronyssinus. The density was 120 species of D. pteronyssinus from 143 mites found 83.9 . Specific anti HDM IgE serum levels in persistent asthmatic levels were higher than normal patients, with a mean of 2.35 kU L positive values if 0.35 kU L . Density of D. pteronyssinus in dust of bed room showed a positive correlation with serum IgE specific of anti HDM level in persistent asthmatic patients."

"Latar belakang : Asma memengaruhi sekitar 300 juta orang di seluruh dunia dan menjadi masalah kesehatan global yang serius yang mempengaruhi semua kelompok umur. Asma alergi adalah fenotipe asma yang paling mudah dikenali dan sering dimulai sejak masa anak-anak. Sebagian besar asma alergi berhubungan dengan sensitisasi saluran napas akibat pajanan aeroalergen umum, terutama yang berasal dari tungau debu rumah. Proses inflamasi eosinofilik saluran napas menghasilkan produk akhir berupa nitrit oksida. Kadar nitrit oksida udara ekspirasi (FeNO) merupakan salah satu penanda hayati yang mengukur inflamasi saluran napas dan kadar FeNO yang tinggi pada pasien asma berhubungan dengan inflamasi saluran napas eosinofilik.Penilitian ini bertujuan mengetahui hubungan kadar IgE spesifik Der p dan Der f  dengan kadar FeNO pada pasien asma tidak terkontrol di RSUP Persahabatan.Metode : Penelitian ini merupakan studi potong lintang dengan jumlah sampel 86 subjek pasien asma tidak terkontrol berdasarkan asthma control test di RSUP Persahabatan. Metode pengumpulan subjek dilakukan dengan teknik consecutive sampling. Pemeriksaan IgE spesifik tungau debu rumah menggunakan protia Q96M. Pemeriksaan FeNO menggunakan Bedfont NObreath.Hasil : Dari 86 subjek asma tidak terkontrol didapatkan hasil rerata usia pasien asma tidak terkontrol di RSUP Persahabatan adalah  52,45 + 12,94 tahun, sebagian besar berjenis kelamin perempuan (84,9%).Proporsi pasien asma yang alergi terhadap tungau debu rumah  mencapai 64%. Prorporsi alergi Der p dan Der f 58%, alergi Der p 4,7% dan alergi Der f 1,2%. Median kadar IgE spesifik tungau debu rumah pada pasien asma tidak terkontrol di RSUP Persahabatan adalah 3,94 (0-100) IU/ml untuk Der p dan 4,47 (0-100) IU/ml untuk Der f. Median FeNO pasien asma tidak terkontrol adalah 26 (3-92) ppb. Dilakukan uji korelasi Spearman untuk kadar IgE spesifik dan kadar FeNO pasien asma tidak terkontrol. Terdapat hubungan bermakna antara kadar IgE spesifik Der p (nilai p = 0,009, r = 0,279, uji Spearman) dan Der f (nilai p = 0,001, r = 0,339, uji Spearman) dengan FeNO.Kesimpulan : Terdapat hubungan yang bermakna antara kadar IgE spesifik tungau debu rumah Der p dan Der f dengan FeNO pada pasien asma tidak terkontrol. Namun tingkat korelasi yang didapatkan lemah.

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Background : Asthma affects approximately 300 million people worldwide and is a serious global health problem affecting all age groups. Allergic asthma is the most easily recognized asthma phenotype and often begins in childhood. Most allergic asthma is associated with airway sensitization due to exposure to common aeroallergens, particularly those from house dust mites. The eosinophilic inflammatory process of the airways produces the final product in the form of nitric oxide. Fractional exhaled nitric oxide (FeNO) levels are one of the biomarkers that measure airway inflammation and high FeNO levels in asthma patients are associated with eosinophilic airway inflammation. This study aims to determine the relationship between Dermatophagoides pteronysinnus (Der p) and Dermatophagoides  farinae (Der f) specific IgE levels with FeNO levels in uncontrolled asthma patients at Persahabatan Hospital.

Method : This cross sectional study in 86 uncontrolled asthma patients based on asthma control test less than 24 points. The method of collecting subjects was done by consecutive sampling technique. House dust mite specific IgE assay using protia Q96M. FeNO examination using Bedfont NObreath.   

Result : From 86 subjects with uncontrolled asthma, the mean age of uncontrolled asthma patients at Persahabatan Hospital was 52.45 + 12.94 years, most of them were female (84.9%). The proportion of asthma patients who were allergic to house dust mites reached 64. %. The proportion of allergy to Der p and Der f 58%, allergy to Der p 4.7% and allergy to Der f 1.2%. The median level of specific IgE for house dust mites in patients with uncontrolled asthma at the Persahbatan Hospital was 3.94 (0-100) IU/ml for Der p and 4.47 (0-100) IU/ml for Der f. The median FeNO of uncontrolled asthmatic patients was 26 (3-92) ppb. Spearman correlation test was performed for specific IgE levels and FeNO levels in patients with uncontrolled asthma. There was a significant relationship between specific IgE levels Der p (p value = 0.009, r = 0.279) and Der f (p value = 0.001, r = 0.339) and FeNO.

Conclusion : There is a significant relationship between the levels of specific IgE for house dust mites Der p and Der f with FeNO in patients with uncontrolled asthma. However, the correlation level obtained is weak."

"ABSTRACTBackground: pollens from trees or grasses in Indonesia have a perennial distribution due to the tropical climate. However, pollen allergy has not been well studied. This study aimed to evaluate the profile of pollen IgE sensitization in respiratory allergic patients in Jakarta. Methods: this was a cross-sectional study in patients with a history of respiratory allergy in Jakarta, Indonesia between September and December 2016. Adult asthmatic patients aged 19-60 years were invited to undergo serum specific IgE testing at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test with environmental allergens. Quantitative determination of specific IgE in serum was carried out by multiple allergosorbent (MAST) assays (Polycheck Allergy, Biocheck GmbH, Munster, Germany). Serum specific IgE levels of more than 0.35 kU/L or Class 1 was considered positive. Results: a total of 106 cases were eligible for analysis; 81 (76.4%) were women. Patients mean age was 38.8+12.1 (range 19-59) years old. 59.4% of patients have both asthma and allergic rhinitis. There are 9 (8.5%) patients positive for IgE-pollen sensitization; 8 among them showed sensitization to at least 2 pollens. Sensitivity to goosefoot pollen is the highest (5.7%), followed by rye pollen (4.7%), plantain pollen (4.7%), wall pellitory pollen (4.7%), and Bermuda grass pollen (3.8%). Conclusion: although most pollens tested are not originated from native plants to Indonesia, a small number of patients showed specific IgE-sensitizations. Allergic persons planning to travel to the endemic areas of the relevant pollen should be advised. A panel of pollen allergens from local plants is highly desired."

"Latar Belakang : Skin prick test SPT merupakan baku emas mendiagnosis sensitisasi alergen, namun memiliki keterbatasan. Pemeriksaan IgE spesifik merupakan pemeriksaan in vitro, nyaman dan tidak ada risiko anafilaksis.Tujuan: Mendapatkan akurasi pemeriksaan IgE spesifik serum metode ELISA dalam mendiagnosis sensitisasi alergen hirup pada pasien asma dan/atau rinitis alergi.Metode: Merupakan uji diagnostik dengan desain cross sectional pada pasien asma dan rinitis alergi di poliklinik Alergi-Imunologi FKUI-RSCM. Seratus pasien diperiksa IgE spesifik serum tungau debu rumah D.pterossinus, D.farinae, B.tropicalis , kulit anjing, kulit kucing dan kecoak dengan metode ELISA serta SPT sebagai baku emas mendiagnosis sensitisasi alergen tersebut. Sensitivitas, spesifisitas, nilai duga, dan rasio kemungkinan dari IgE spesifik serum dinilai untuk masing-masing alergen.Hasil: Sensitivitas IgE spesifik serum dalam mendiagnosis sensitisasi alergen tungau debu rumah berkisar 48-77 , dengan sensitivitas tertinggi 77 IK 95 66-86 pada D.farinae. Spesifisitas berkisar 64-95 , dengan spesifitas tertinggi 95 IK 95 76-99 pada B.tropicalis, serta nilai RK antara 2,1-11, dengan tertinggi untuk B.tropicalis. Sensitivitas mendiagnosis sensitisasi kecoak 12 IK 95 4,5-27 , namun spesifisitas 100 IK 95 92-100 , dengan RK . Spesifisitas mendiagnosis sensitisasi kulit anjing 89 IK 95 79-95 , namun senstitivitas 3 IK 95 1,5-17 , dengan RK hanya 0,29 IK 95 0,03-2,26 . IgE spesifik serum memiliki spesifitas 88 IK 95 77-95 dalam mendiagnosis sensitisasi kulit kucing, namun sensitivitas 10 IK 95 3,5-26 dan RK 0,9 IK 95 0,3-3,1 .Kesimpuan: Pemeriksaan IgE spesifik serum metode ELISA memiliki akurasi diagnostik yang sedang dalam mendiagnosis sensitisasi terhadap tungau debu rumah dan kecoak, namun akurasi rendah untuk kulit anjing dan kucingKata Kunci: Skin prick test IgE spesifik serum, Akurasi, Alergen hirup

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Background Skin prick test SPT is the gold standard to diagnose allergen sensitization, but has some limitations. Serum specific IgE SSIgE is in vitro test, comfortable and has no anaphylaxis risk.Aim To get the accuracy of SSIgE test using ELISA method in diagnosing inhalant allergens sensitization in asthma and or allergic rhinitis patients.Method This is diagnostic study with subjects were asthma and or allergic rhinitis patients. One hundreds patients had SSIgE test for house dust mites D.pterossinus, D.farinae, B.tropicalis , dog dander, cat dander and cockroach allergens and SPT as gold standard to diagnose allergen sensitization. Sensitivity, specificity, predictive value, and likelihood ratio of SSIgE were evaluated.Result To diagnose house dust mites sensitization SSIgE has 48 77 sensitivity, with the highest is for D.farinae 77 95 CI 66 86 , while specificity is 64 95 , with the highest is for B.tropicalis 95 95 CI 76 99 and LR around 2,1 11, with the highest is for B.tropicalis. Sensitivity of SSIgE to diagnose cockroach sensitization is 12 95 CI 4.5 27 , but has high specificity 100 95 CI 92 100 , and high LR . SSIgE has high specificity 89 95 CI 79 95 in diagnosing dog dander sensitization, but low sensitivity 3 95 CI 1.5 17 and low LR 0.29 95 CI 0.03 2.26 . To diagnose cat dander sensitization SSIgE has 88 95 CI 77 95 specificity, but low sensitivity 10 95 CI 3.5 26 and low LR 0.9 95 CI 0.3 3.1 Conclusion SSIgE test using ELISA method has moderate accuracy in diagnosing house dust mites and cockroach sensitization, but low accuracy for dog and cat dander sensitization.Keywords Skin prick test, Serum specific IgE, Accuracy, Inhalant Allergens"

"ABSTRAK Latar Belakang: Pemeriksaan IgE spesifik serum baru diperkenalkan di Indonesia, tetapi belum ada data uji diagnostik mengenai akurasinya dalam mendeteksi alergen tungau debu rumah dan kecoa pada pasien asma dan atau rinitis alergi. Tujuan: Tujuan penelitian ini adalah untuk mendapatkan akurasi diagnosis pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t dan Blatella germanica Bla g pada pasien asma dan atau rinitis alergi.Metode: Penelitian ini adalah studi potong lintang pada pasien alergi pernapasan dan merupakan bagian dari studi epidemiologi mengenai sensitisasi IgE spesifik di Divisi Alergi-Immunologi, RS Cipto Mangunkusumo, Jakarta, antara September dan Desember 2016. Pengukuran sensitisasi IgE spesifik dilakukan dengan metode imunoblot Euroline , Euroimmun AG, Germany . Alergen yang diuji adalah Der p, Der f, Blo t, dan Bla g. Hasilnya dibandingkan dengan baku emas uji tusuk kulit. Uji diagnostik yang dilakukan meliputi sensitivitas, spesifisitas, positive predicitive value PPV , negative predictive value NPV , likelihood ratio positif dan negatif LR and LR- .Hasil: Serbanyak 101 pasien dilibatkan dalam studi, 77 76,2 di antaranya adalah perempuan. Rerata usia pasien adalah 38,8 tahun. Berdasarkan uji tusuk kulit, sensitisasi tertinggi yang didapatkan adalah terhadap Blo t 76,2 , disusul oleh Der p 70,3 , Der f 69,3 , dan Bla g 41,6 . Sensitisasi IgE-spesifik tertinggi ditunjukkan oleh Der f 52,9 , diikuti oleh Der p 38,2 , Blo t 33,3 dan Bla g 10,8 . Alergen Der p memiliki 50,7 sentivitas, 90 spesifisitas, 92,3 PPV, 43,5 NPV, 5,1 LR dan 0,1 LR-. Der f memperlihatkan 71,4 sensitivitas, 87,1 spesifisitas, 82,6 PPV, 57,4 NPV, 5,5 LR dan 0,3 LR-. Alergen Blo t menunjukkan 41,6 sensitivitas, 91,7 spesifisitas, 94,1 PPV, 32,8 NPV, 5,0 LR , dan 0,6 LR-. Alergen Bla g menghasilkan 23,8 sensitivitas, 98,3 spesifisitas, 90,9 PPV, 64,4 NPV, 14,5 LR dan 0,8 LR-.Kesimpulan: Pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, dan Blatella germanica pada pasien asma dan atau rinitis alergi memperlihatkan sensitivitas rendah sampai sedang, tetapi spesifisitas dan PPV yang tinggi.

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ABSTRACTBackground Serum specific IgE testing has recently been introduced in Indonesia, but diagnostic test has not been performed to know its performance to detect house dust mite and cockroach allergens in patients with allergic asthma and or rhinitis.Objective The objective of this study was to obtain diagnostic accuracy of serum specific IgE testing in diagnosing allergen sensitization to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis.Method This was a cross sectional study among patients with respiratory allergy and was part of a larger epidemiology study on specific IgE sensitization in the Division of Allergy Immunology, Cipto Mangunkusumo Hospital, Jakarta between September and December 2016. Specific IgE sensitization was measured using immunoblot method Euroline , EuroImmun AG, Germany . Allergens tested were Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t , and Blatella germanica Bla g . The results was compared to the standard skin prick test . Diagnostic test were performed and include sensitivity, specificity, positive predicitive value PPV , negative predictive value NPV , positive and negative likelihood ratio LR and LR .Results A total of 101 patients were enrolled 77 76.2 were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t 76.2 , followed by Der p 70.3 , Der f 69.3 , and Bla g 41.6 . Specific IgE sensitization was highest for Der f 52.9 , followed by Der p 38.2 , Blo t 33.3 and Bla g 10.8 . Der p allergen had 50.7 sentivity, 90 specificity, 92.3 PPV, 43.5 NPV, 5.1 LR and 0.1LR . Der f showed 71.4 sensitivity, 87.1 specificity, 82.6 PPV, 57.4 NPV, 5.5 LR and 0.3 LR . Blo t allergen had 41.6 sensitivity, 91.7 specificity, 94.1 PPV, 32.8 NPV, 5.0 LR , and 0.6 LR . Bla g allergen had 23.8 sensitivity, 98.3 specificity, 90.9 PPV, 64.4 NPV, 14.5 LR and 0.8 LR .Conclusion Serum specific IgE testing to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis showed only low to moderate sensitivity, but high specificity and PPV."

"ABSTRAKTungau debu rumah (TDR) merupakan alergen pencetus asma. Sebanyak 85% pasien asma, alergi terhadap Dermatophagoides pteronyssinus. Atopi adalah kecenderungan untuk menghasilkan antibodi IgE sebagai respons terhadap paparan alergen. Paparan berulang pada proses desensititasi menginduksi peningkatan sel T regulator yang memproduksi IL-10 sehingga dapat menginduksi produksi IgG4. Selama ini, IgE spesifik alergen dijadikan penanda adanya alergen namun hanya terdeteksi pada orang yang atopi. Untuk menghindari adanya pajanan alergen sebagai sumber alergi baik pada subjek atopi maupun normal, diperlukan pengembangan metode yang dapat memindai daerah/lokasi yang diduga menjadi habitat TDR. Hal ini penting agar dapat dilakukan upacaya pencegahan dan pengendalian asma. Berdasarkan hal tesebut, peneliti tertarik untuk mengetahui respon IgE dan IgG4 dan korelasinya dengan kepadatan TDR. Penelitian dilakukan pada bulan Juli 2018 sampai April 2019. Sebanyak 25 pasien asma atopi dan 21 subjek normal dilakukan pengukuran kadar serum IgE dan IgG4 Der p menggunakan metode indirek ELISA. Sampel debu rumah diambil dari rumah pasien, diidentifikasi dan dihitung jumlahnya menggunakan metode Hart & Fain. Hasil penelitian menunjukkan spesies TDR yang paling mendominasi yaitu D. pteronyssinus. Kadar serum IgE spesifik Der p pada pasien asma atopi lebih tinggi dibandingkan pasien normal (p=0,002) sedangkan kadar serum IgG4 spesifik Der p baik pada pasien asma atopi maupun normal tidak menunjukan beda signifikan (p=0,667). Kepadatan D. pteronyssinus baik di ruang tidur maupun ruang keluarga menunjukkan korelasi positif dengan kadar serum IgG4 Der p baik pada asma atopi maupun normal (Spearman,Rho=0,388,p=0,008). IgG4 spesifik Der p dapat dijadikan prediktor adanya TDR di rumah.

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ABSTRACTAs many as 85% of asthma patients are allergic to Dermatophagoides pteronyssinus. Repeated exposure to allergens induces an increase in regulator T cells that produce IL-10 which can affect B cells to switch to IgG4. Allergen-specific IgE was used as a marker of allergen exposure but was only detected in people who were atopic while in normal subjects this IgE marker did not appear, So an immunological marker was needed which could be used to scan for exposure. This is important so that efforts can be made to prevent and control asthma. Based on this, the researchers were interested in knowing correlation Der p density with the response of IgE and IgG4 spesific Der p. Twenty Five atopic asthma and 21 normal subjects were measured for serum IgE and IgG4 spesific Der p levels using the indirect ELISA method. Dust samples were taken from the patient's home, identified and counted using the Hart & Fain method. The results showed that the most dominant TDR species was D. pteronyssinus. IgE specific Der p level in atopic asthma were higher than normal (p=0.002) while IgG4 specific Der p level in both atopic asthma and normal did not show significant differences (p=0.667). Density of D. pteronyssinus showed a positive correlation with IgG4 spesific Der p level (Spearman r=0.388, p=0.008) compared to IgE spesific Der p.IgG4 can be used as a predictor of the presence of house dust mites in atopic asthma and normal subjects."

"Background: nowadays, specific IgE measurement has been conducted in Indonesia, however there is still lack of data regarding diagnostic test to detect inhalant allergen in patients with respiratory allergies.This study aimed to determine the accuracy of specific IgE test in diagnosing specific sensitization of inhalant allergen in patients with respiratory allergies.Methods: this was a cross sectional study in patients with respiratory allergies and part of epidemiology study regarding to specific IgE sensitization in Allergy-Immunollogy Division, Cipto Mangunkusumo Hospital, Jakarta within November-December 2016. Measurement of specific IgE sensitization using Immunoblot method (Euroline, Euroimmun AG, Germany). The tested allergen is house dust mites Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t) and cockroach Blatella germanica (Bla g). The result is compared with gold standard, skin prick test. The diagnostic result includes sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-).Results: a total of 101 patients were enrolled; 77 (76.2%) were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t (76.2%), followed by Der p (70.3%), Der f (69.3%), and Bla g (41.6%). Specific IgE-sensitization was highest for Der f (52.9%), followed by Der p (38.2%), Blo t (33.3%) and Bla g (10.8%). Der p allergen had 50.7% sentivity, 90% specificity, 92.3% PPV, 43.5% NPV, 5.1 LR+ and 0.1LR-. Der f showed 71.4% sensitivity, 87.1% specificity, 82.6% PPV, 57.4% NPV, 5.5 LR+ and 0.3 LR-. Blo t allergen had 41.6% sensitivity, 91.7% specificity, 94.1% PPV, 32.8% NPV, 5.0 LR+, and 0.6 LR-. Bla g allergen had 23.8% sensitivity, 98.3% specificity, 90.9% PPV, 64.4% NPV, 14.5 LR+ and 0.8 LR-.Conclusion: serum specific IgE testing to common inhalant allergen in patients with respiratory allergy showed only low-to-moderate sensitivity, but high specificity and PPV. This new assay can be used to diagnose allergen sensitization in the population with high prevalence of TDR and cockroach."