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Table 3 Advantages and disadvantages of ISAC, immunoCAP, and skin prick tests

From: A WAO - ARIA - GA²LEN consensus document on molecular-based allergy diagnostics

  Advantages Disadvantages
ISAC • 30 μl of serum or plasma (capillary or venous blood) • Manual method
• 112 allergens can be assayed in parallel • Semi-quantitative assay
• Natural and recombinants proteins • Less sensitive
• Less allergen needed (approximately 100, 000-fold, pg vs. μg) per assay • More variability in the inter-assay analysis for certain allergens
• No interference from very high total IgE • Greater coefficient of variation
  • Some allergen sources are not included
  • Less appropriate for monitoring sensitization
  • Potential interference between IgE and other isotypes, principally IgG
ImmunoCAP • Automatic method • 40 μl of serum per allergen
• Quantitative assay • One allergen per assay
• High sensitivity • Detect low-affinity antibody that may have little to no clinical relevance
• Lower coefficient of variation  
• Natural or recombinants proteins or crude extracts  
• Appropriate for monitoring sensitization  
Skin prick test • High sensitivity (extract-dependent) • Manual
• Immediate reading • One allergen per prick
  • Only crude extracts
  • Not appropriate for monitoring sensitization