Detecting IgE sensitizations in the serum of allergic dogs is commonly performed using allergen extracts, but these are difficult to standardize. This article details the development and validation of the Pet Allergy Xplorer (PAX; Nextmune, Stockholm, Sweden), the first multiplex macroarray for the detection of IgE sensitization in dogs using allergen extracts and molecular components; the PAX is derived from the Allergy Xplorer (ALEX²; MacroArray Diagnostics, Vienna, Austria). The selection of allergens, cartridge processing, strategy for identifying and blocking IgE directed against cross-reactive carbohydrate determinants (CCDs), and the method used for determining the positivity threshold are described. The validation of the PAX included evaluations of the specificity of its anti-IgE monoclonal antibody, specificity of IgE binding to target allergens, assay precision, and internal consistency. Additionally, the influence of possible confounding factors, such as sample type, the influence of hemolysis, lipemia, bilirubinemia, and elevated CCD-IgE, was tested. Finally, the sensitization rates of 23,858 European dogs to 145 environmental and Hymenoptera venom allergens were summarized. The PAX is accurate and reproducible and has a unique CCD-detection and blocking strategy; its molecular allergens offer a unique window on allergen cross-reactivity.

Cross-reactive carbohydrate determinants (CCDs) are complex N-glycans shared among allergens of plant, insect venom, and nematode origin. In allergic humans, IgE anti-CCD often develop and cause discrepancies between serological and skin tests. Overall, CCD-IgE are believed to be of low pathogenic relevance. IgE-targeting CCDs are also detected in companion animals, but their pathogenic potential and biological relevance are unknown. Herein, we first establish that, in 34 dogs with atopic dermatitis, the presence of serum anti-CCD IgE was detected in 14 pets (41.2%). In dogs, as in humans, IgE-targeting CCDs are heterogeneous, as they differentially recognized four distinct CCD-expressing proteins. The presence of CCD-IgE was associated with a higher and more frequent recognition of plant extracts in serological but not intradermal tests. Two different CCD-expressing proteins did not elicit immediate reactions when injected intradermally in dogs with detectable serum anti-CCD IgE. Similarly, two different CCD-expressing proteins did not induce the activation of mast cells passively transferred with canine anti-CCD IgE. Altogether, these results suggest that in dogs, as in humans, anti-CCD IgE are likely to have little pathogenic potential and blocking them in allergen-specific IgE serological tests is warranted to avoid false-positive results to plant extracts.

Extracts used for allergen sensitization testing in humans are heterogeneous in composition and may contain low levels of important allergens. In contrast, there is scant information on the variability of veterinary allergen extracts. We selected two batches of extracts of Dermatophagoides farinae house dust mites from each of three different manufacturers. We observed a 3.4-fold difference in total protein content between the two extracts with the lowest and highest amounts of allergens. After electrophoresis, the band migration patterns were found to be similar between the two batches of extracts from two manufacturers and dissimilar in the third; the migration profiles were heterogeneous between manufacturers. The six extracts did not contain the same concentrations of Der f 1 and Der f 2, with fold changes between the highest and lowest concentrations measured to be 14.3× for Der f 1 and 8.0× for Der f 2. This allergen composition heterogeneity resulted in differences in ELISA seropositivity when allergic dogs had low serum concentrations of IgE against Der f 1 and Der f 2. Our findings demonstrate that, like in human allergology, allergen extracts for veterinary use are also heterogeneous in their protein content and allergen composition. This heterogeneity can impact results when determining allergen sensitizations using crude extracts.

Detecting IgE sensitizations in the serum of allergic dogs is commonly done using allergen extracts, but these are difficult to standardize. This article details the development and validation of the Pet Allergy Xplorer (PAX; Nextmune, Stockholm, Sweden), the first multiplex macroarray for the detection of IgE sensitization in dogs using allergen extracts and molecular components; the PAX is derived from the Allergy Xplorer (ALEX2; MacroArray Diagnostics, Vienna, Austria). The selection of allergens, cartridge processing, strategy for identifying and blocking IgE directed against cross-reactive carbohydrate determinants (CCD), and the method used for determining the positivity threshold are described. The validation of the PAX included evaluations of the specificity of its anti-IgE monoclonal antibody, specificity of IgE binding to target allergens, assay precision, and internal consistency. Additionally, the influence of possible confounding factors, such as sample type, the influence of hemolysis, lipemia, bilirubinemia, and elevated CCD-IgE, was tested. Finally, the sensitization rates of 23,858 European dogs to 145 environmental and Hymenoptera venom allergens were summarized. The PAX is accurate and reproducible and has a unique CCD-detection and blocking strategy; its molecular allergens offer a unique window on allergen cross-reactivity.