Component‐resolved diagnosis using guinea‐pig allergens elucidates allergen sensitization profiles in allergy to furry animals

Background Furry animals are an important source of indoor allergens. Diagnosis of allergy to small pets such as guinea‐pigs still relies on animal dander extracts which do not allow to define the primary sensitization source. Objective To identify major guinea‐pig allergens and to evaluate their potential as marker allergens for in vitro IgE‐diagnosis in comparison with dander extracts. Methods A group of patients allergic to guinea‐pig (n = 29) and a group of patients allergic to cat and dog (n = 30) were recruited for the study. A panel of four guinea‐pig lipocalin allergens was expressed as recombinant proteins in E. coli. Specific IgE were quantified by ImmunoCAP and ELISA. Results The combination of 4 guinea‐pig lipocalin allergens, including 2 new lipocalins, Cav p 1.0201 and Cav p 6.0101, and the previously characterized lipocalins Cav p 2 and Cav p 3, enabled the identification of 90% of all patients allergic to guinea‐pig. The vast majority had specific IgE to Cav p 1 (83%). Cav p 6 shares 54% sequence identity with Fel d 4 and Can f 6 and was found to be IgE‐cross‐reactive with these allergens. In the group of cat‐ and dog‐allergic patients, 73% had also specific IgE to guinea‐pig dander. However, only 27% of the cat /dog‐allergic patients had specific IgE to any of the non‐cross‐reactive guinea‐pig allergens Cav p 1, Cav p 2 or Cav p 3. The high prevalence of IgE to guinea‐pig dander could be explained by IgE‐cross‐reactivity among serum albumins and certain lipocalins. Conclusions and clinical relevance The availability of specific allergen markers is essential for the assessment of primary sensitization, especially in polysensitized patients. The proposed panel of guinea‐pig allergens Cav p 1, Cav p 2 and Cav p 3 is a first step to component‐resolved IgE‐diagnosis of allergy to small furry pets. Component resolved diagnosis and the availability of specific marker allergens (right) allows the determination of primary sensitization in patients which show multiple sensitizations to animal dander extracts (left).