Multi-Center Study on the Performance Characteristics of Two Skin-Test Devices – ComforTen® and Multi-Test II®
Katial and Cox
(Abstract No. 2069, World Allergy Organization International Scientific Conference, Hyderabad, India 2012.) Download the WAO, 2012 Abstract No. 2069 Skin Test Study Poster PDF

“Overall, 57% of subjects showed preference to using CF10, while only 9% preferred MT.”
“Comparing device- histamine combinations as described by each company’s product insert, i.e. CF10 with 6mg/mL vs. MT with 1mg/mL, wheals were not significantly different….”
“Optimal performance across sites showed that both devices required 6mg/mL histamine but with device specific cut-offs CF10-1mm (sensitivity=93%, specificity=99%), and MT-3mm (sensitivity=94%, specificity=91%).”

Immunologic Response to Administration of Standardized Dog Allergen Extract at Differing Doses
Lent, Harbeck, Strand, Sills, Schmidt, Efaw, Lebo, and Nelson
(Journal of Allergy and Clinical Immunology 2006; 118: 1249–56.)

“The purpose of the is study was to examine the immunologic response to 3 doses of dog extract expressed as their Can f 1 content [0.6 µg (micrograms), 3.0 µg, or 15.0 µg Can f 1 per 0.5 mL maintenance dose].”
“The greatest and most consistent response is seen with a dose containing 15 µg Can f 1.”
“…most dog allergen extracts are reported to contain roughly 5 µg Can f 1 per mL concentrated extract. On the other hand, the AP dog extract produced by HollisterStier Laboratories reportedly contains more than 100 µg Can f 1 per mL (1:100 w/v).”

Comparison of Conventional and Acetone Precipitated Dog Allergen Extracts in Identification of Dog Allergy by Skin Prick Test
Krassilnikova, Nikiforov, and Chegini
(Journal of Allergy and Clinical Immunology 2009; 123 (2): S205.)

“AP [Acetone Precipitated extract] is superior to TMB [traditional mixed breed extract] in identifying allergic sensitization to dog. AP should be used in patients with a history suggestive of allergy to dog to maximize diagnostic value of SPT.”
“AP identified 38 dog allergic patients (70%) that were missed by the TMB, whereas only 2 patients (3.7%) had positive reaction to TMB and not AP.”

Discordance between Conventional and Acetone Precipitated (AP) Dog Extract in Skin Prick Testing
Turbyville, Nelson, and Mikita
(Journal of Allergy and Clinical Immunology 2008; 121 (2): S58.)

“AP dog extract appears to be a more sensitive indicator of dog skin prick reactivity than conventional dog extract.”
“Of those testing positive to dog, 3/11 (27%) were positive to both AP and conventional dog, and 8/11 (73%) were positive only to AP dog…. No patients were positive to conventional dog and negative to AP dog.”

Skin Testing
Oppenheimer and Nelson
(Annals of Allergy, Asthma & Immunology 2006; 96 (Suppl 1):S6–S12.)

“Skin testing remains the central test to confirm an allergic response. It is minimally invasive and when performed correctly has good reproducibility. Results are easily quantifiable and correlate well with end organ challenge.”
“Allergists must consider controllable variables that affect skin test results and their interpretation. When not considered, they may be responsible for some of the inaccuracies associated with allergy skin testing.”

Dog Allergen (Can f 1) and Cat Allergen (Fel d 1) in U.S. Homes: Results from the National Survey of Lead and Allergens in Housing
Arbes, Cohn, Yin, Muilenberg, Friedman, and Zeldin
(Journal of Allergy and Clinical Immunology 2004; 114: 111-7.)

“Although a dog or cat had lived in only 49.1% of homes in the previous 6 months, Can f 1 and Fel d 1 were detected in 100% and 99.9% of homes, respectively.”
“Because of the transportability of these allergens on clothing, elevated levels in homes without pets, particularly among demographic groups in which pet ownership is more prevalent, implicate the community as an important source of these pet allergens.”

Quantitation of the Major Fungal Allergens, Alt a 1 and Asp f 1, in Commercial Allergenic Products
Vailes, Sridhara, Cromwell, Weber, Breitenbach, and Chapman
(Journal of Allergy and Clinical Immunology 2001; 107: 641-6.)

“Alt a 1 levels in Alternaria extracts from 8 companies produced in 1998 and 1999 ranged from less than 0.01 to 6.09 μg/mL [micrograms per milliliter] (mean 1.4 ± 1.6 μg/mL, n = 15).”
“Aspergillus extracts showed much greater variability in Asp f 1 levels, with extracts from 8 companies containing from less than 0.1 to 64 μg/mL Asp f 1 (mean 16.3 ± 23.9 μg/mL, n = 15).”
“Alternaria and Aspergillus extracts manufactured by HollisterStier (formerly Bayer) had consistently high levels of measurable Alt a 1 and Asp f 1 major allergen, compared to extracts produced by many of the other manufacturers.”

Insect Sting Allergy and Venom Immunotherapy: A Model and a Mystery
(Journal of Allergy and Clinical Immunology 2005; 115: 439-47.)

“The recommended dose is 100 µg [microgram], but some patients require higher doses for full protection. Venom immunotherapy is continued every 4 to 8 weeks for at least 5 years in most cases. Skin test results become negative in only 25% after 5 years of therapy but in 60% to 70% after 7 to 10 years. When treatment is stopped after 5 years or more, there is a 10% chance of systemic reaction to each future sting, but most reactions are mild.”