In-house and commercial and bovine dander extracts in the diagnostics of allergic occupational diseases

Background: The inconsistency of commercial bovine dander extracts hampers the diagnostics of IgE-mediated occupational allergies. Aim: Aim was to investigate whether the in-house extract improves the diagnostics of occupational immediate allergies and reveals new information regarding bovine allergens. Methods: Altogether 102 patients with a suspected bovine-related occupational rhinitis, asthma and/or contact urticaria underwent skin-prick tests (SPTs) with in-house and available commercial bovine dander extracts. The nasal provocation test (NPT) was performed on 31 of the patients to confirm possible occupational rhinitis. The score changes of ≥ 4 point in the bilateral nasal secretion and blockage seen in anterior rhinoscopy were considered positive. Specific IgE- protein reactions from the serums of patients with positive NPTs were studied and allergens were identified from the strongest immunoblot bands using tandem mass spectrometry. Results: The in-house SPT extract yielded more positive reactions (≥ 3mm wheal) than the two commercial agents (44% vs 34% and 11%, p=0.006 and 0.001 respectively). Of the 21 patients who underwent NPTs to both in-house and commercial extract, 13 (62%) reacted only to the in-house extract, whereas five (24%) reacted to both extracts (p Conclusions: The rich allergen content of allergen extracts improves the diagnostic accuracy of immediate allergies to bovine dander. In-house bovine dander extracts are needed in the diagnostics of occupational allergies.