ISAC-test

The ISAC test is a new direction in the diagnosis of allergic reactions:

determination of allergens at the molecular level - component allergodiagnostics.

This technique is based on the detection of sensitization to allergens at the molecular level using natural highly purified and recombinant allergen molecules, that is, their components, not extracts.

In the late 1980s, when DNA technology began to be introduced, it was possible to characterize and clone allergen molecules, which helped to identify antigenic determinants in various allergic diseases. This, in turn, played a crucial role in the emergence of molecular diagnostics that led to the development of more effective allergy treatments.

Determination of antibodies to recombinant allergens allows the identification of the leading component in the composition of complex allergens at the molecular level. This allows you to differentiate between true and cross-allergy. This technique is a new tool in the diagnosis of type I allergic reactions, which allows you to obtain detailed information about the sensitization of the patient, cross-reactivity with other allergens, and to justify the feasibility and predict the effectiveness of allergen-specific immunotherapy (ASIT).

Based on state-of-the-art biochip technology, the **“ISAC-test”** is a miniaturized immunoassay platform designed for the comprehensive measurement of specific IgE antibodies to more than a hundred recombinant allergens simultaneously. This direction will change the views on the examination and treatment of patients with allergies in Kazakhstan and bring them in line with the requirements of international standards.

There are 3 main advantages of doing this analysis:

Molecular allergodiagnostics, which makes it possible to differentiate true sensitization from sensitization due to cross-reactivity. These data will help identify the sources of allergies: a single one, several closely related ones, or many different ones.
Molecular allergodiagnostics will eliminate the need for provocative tests and allow you to give clearer recommendations regarding the elimination of contact with allergens.
Molecular allergodiagnostics is necessary in the selection of allergen-specific immunotherapy (ASIT), in persons with polyvalent sensitization, as the most accurate way to determine the most important allergen for which ASIT will be performed. It is shown that the use of molecular diagnostic methods makes it necessary to change the ASIT, selected according to the results of skin prick tests.

Allergen molecules are given a name, at the beginning the first three letters of the Latin genus name, then the first letter of the species, and an Arabic numeral, the allergen number (the number depends on the order of isolation and/or clinical importance).

Allergy components included in the ISAC test (ImmunoCAP ISAC E112i)

№	Name of allergen	Name of the molecule	Type of protein
1	Egg white	nGal d 1	Ovomucoid
2	Egg white	nGal d 2	Ovalbumin
3	Egg white	nGal d 3	Conalbumin/ovotransferrin
4	Egg yolk/chicken meat	nGal d 5	Livetin/serum albumin
5	Cow's milk	nBos d 4	Alpha-lactoglobulin
6	Cow's milk	nBos d 5	Beta-lactoglobulin
7	Cow's milk and meat	nBos d 6	Serum albumin
8	Cow's milk	nBos d 8	Casein
9	Cow's milk	nBos d lactoferrin	Transferrin
10	Red meat or beef	o215 Alpha-Gal	Thyroglobulin, bovine
11	Cod	rGad c 1	Parvalbumin
12	Shrimp	nPen m 1	Tropomyosin
13	Shrimp	nPen m 2	Arginine kinase
14	Shrimp	nPen m 4	Sarcoplasmic calcium-binding protein
15	Cashew	rAna o 2	Storage protein, 11S globulin
16	Cashew	Ana o 3	Storage protein, 2S albumin
17	Brazil nut	rBer e 1	Storage protein, 2S albumin
18	Hazelnuts	rCor a 1.0401	PR-10 protein
19	Hazelnuts	nCor a 8	Lipid transfer proteins (nsLTP)
20	Hazelnuts	nCor a 9	Storage protein, 11S globulin
21	Hazelnuts	nCor a 14	Storage protein, 2S albumin
22	Walnut	rJug r 1	Storage protein, 2S albumin
23	Walnut	nJug r 3	Lipid transfer proteins (nsLTP)
24	Sesame	nSes I 1	Storage protein, 2S albumin
25	Peanuts	rAra h 1	Storage protein, 7S globulin
26	Peanuts	rAra h 2	Storage protein, conglutinin
27	Peanuts	rAra h 3	Storage protein, 11S globulin
28	Peanuts	nAra h 6	Storage protein, 2S albumin
29	Peanuts	rAra h 8	PR-10 protein
30	Peanuts	rAra h 9	Lipid transfer proteins (nsLTP)
31	Soybeans	rGly m 4	PR-10 protein
32	Soybeans	nGly m 5	Storage protein, beta-conglycin
33	Soybeans	nGly m 6	Storage protein, glycinin
34	Buckwheat, buckwheat flour	nFag e 2	Storage protein, 2S albumin
35	Wheat	rTri a 14	Lipid transfer proteins (nsLTP)
36	Wheat	rTri a 19.0101	Omega-5 gliadin
37	Wheat	nTri a aA_TI	Alpha-amylase/trypsin inhibitor
38	Kiwi	nAct d 1	Cysteine protease
39	Kiwi	nAct d 2	Thaumatin-like protein
40	Kiwi	nAct d 5	Kivelin
41	Kiwi	rAct d 8	PR-10 protein
42	Apple	rMal d 1	PR-10 protein
43	Peach	rPru p 1	PR-10 protein
44	Peach	rPru p 3	Lipid transfer proteins (nsLTP)
45	Celery	rApi g 1	PR-10 protein
46	Pigsty	nCyn d 1	Herb group 1
47	Timothy grass	rPhl p 1	Herb group 1
48	Timothy grass	rPhl p 2	Herb group 2
49	Timothy grass	rPhl p 4	Berberine bridge enzyme
50	Timothy grass	rPhl p 5	Herb group 5
51	Timothy grass	rPhl p 6	Herb group 6
52	Timothy grass	rPhl p 7	Polcalcin
53	Timothy grass	rPhl p 11	Ole e 1-associated protein
54	Timothy grass	rPhl p 12	Profilin
55	Alder	rAln g 1	PR-10 protein
56	Birch	rBet v 1	PR-10 protein
57	Birch	rBet v 2	Profilin
58	Birch	rBet v 4	Polcalcin
59	Hazel pollen	rCor a 1.0101	PR-10 protein
60	Japanese cedar	nCry j 1	Pectalysase
61	Cypress	nCup a 1	Pectalysase
62	Olive pollen	rOle e 1	Common olive group 5
63	Olive pollen	nOle e 7	Lipid transfer proteins (nsLTP)
64	Olive pollen	rOle e 9	Beta-1,3-glucanase
65	Plane tree	rPla a 1	Invertase inhibitor
66	Plane tree	rPla a 3	Lipid transfer proteins (nsLTP)
67	Ragweed	nAmb a 1	Pectatlyase
68	Wormwood	nArt v 1	Defensin
69	Wormwood	nArt v 3	Lipid transfer proteins (nsLTP)
70	Mary	rChe a 1	Ole e 1 associated protein
71	Mercury	rMer a 1	Profilin
72	Wall pellitory	rPar j 2	Lipid transfer proteins (nsLTP)
73	Plantain	rPla I 1	Ole e 1-associated protein
74	Salt grape	nSal k 1	Pectin methylesterase
75	Dog	rCan f 1	Lipocalin
76	Dog	rCan f 2	Lipocalin
77	Dog	rCan f 4	Lipocalin
78	Dog	nCan f 3	Serum albumin
79	Dog	rCan f 5	Arginine esterase
80	Dog	rCan f 6	Lipocalin
81	Horse	rEqu c 1	Profilin
82	Horse	nEqu c 3	Serum albumin
83	Cat	rFel d 1	Uteroglobin
84	Cat	nFel d 2	Serum albumin
85	Cat	rFel d 4	Lipocalin
86	Mouse	nMus m 1	Lipocalin
87	Alternaria	rAlt a 1	Acid glycoprotein
88	Alternaria	rAlt a 6	Enolase
89	Aspergillus	rAsp f 1	Mitogillin family
90	Aspergillus	rAsp f 3	Peroxisomal protein
91	Aspergillus	rAsp f 6	Mn superoxide dismutase
92	Cladosporium	rCla h 8	Mannitol dehydrogenase
93	B.tropicalis (HDM)	rBlo t 5	Tick allergen group 5
94	D.farinae (HDM)	nDer f 1	Cysteine protease
95	D.farinae (HDM)	nDer f 2	NPC 2 family
96	D.pteronyssinus (HDM)	nDer p 1	Cysteine protease
97	D.pteronyssinus (HDM)	nDer p 2	NPC 2 family
98	D.pteronyssinus (HDM)	rDer p 10	Tropomyosin
99	D.pteronyssinus (HDM)	rDer p 23	Peritrophin-like protein
100	L.destructor (storage mite)	rLep d 2	NPC 4 family
101	Cockroach	rBla g 1	Group 1 cockroach allergens
102	Cockroach	rBla g 2	Aspartate protease
103	Cockroach	rBla g 5	Glutathione S-transferase
104	Cockroach	nBla g 7	Tropomyosin
105	Anisakis	rAni s 1	Serine protease inhibitor
106	Anisakis	rAni s 3	Tropomyosin
107	Latex	rHer b 1	Rubber elongation factor
108	Latex	rHer b 3	Small rubber particle protein
109	Latex	rHer b 5	Acidic protein
110	Latex	rHer b 6.01	Progevin
111	Latex	rHev b 8	Profilin
112	CCD	nMUXF3	CCD