Component Testing for Furry Animal Allergies

Component Testing for Furry Animal Allergies

This document focuses on guideline-supported component testing for furry pet allergies following dog, cat, and horse whole allergen extract testing.

See also 22 related tests 0 related guides Test Guide List

Component Testing for Furry Animal Allergies

Topic Brief

 

Component Testing for Furry Pet Allergy

Introduction

The worldwide prevalence of dog and/or cat allergy is about 10% to 20%, and up to 5% of people with respiratory allergies are allergic to horses.1,2 In the United States, exposure to dander from these animals can be significant because almost 40% of households report owning dogs, over 20% own cats, and approximately 1% own horses.3 Allergy symptoms can include asthma, allergic rhinitis, rhinoconjunctivitis, anaphylaxis, and conditions such as bronchial inflammation.

Diagnostic testing

Suspicion of dog, cat, or horse allergy is usually prompted by the presence of symptoms, and support for the diagnosis commonly involves a skin-prick test (SPT) or specific IgE testing based on whole allergen extracts.4 But the use of extracts to assess suspected animal allergy has drawbacks.5 Commercially available extracts may have variable potency, may contain other allergens, or may contain proteins which cross-react with other allergens. This can lead to false-positive results.6

Also, although sensitization (ie, production of IgE antibodies) to antigenic proteins from dander can cause an allergic reaction, some patients with a suspected allergy may be only sensitized to an antigen without having a true allergy. Patients who are sensitized but not truly allergic have developed IgE antibodies to the antigen on initial exposure but do not mount an IgE-mediated immune response (ie, allergic reaction) on re-exposure.

Components are the specific proteins found in whole allergen extracts. The identification of IgE antibodies to component proteins can help confirm that patients are sensitized to the animal in question and that the positive extract result is not due to cross reactivity. The presence of reactivity to multiple components increases the likelihood that the patient is truly allergic.

Test availability

Quest Diagnostics offers fluorescent enzyme immunoassay-based (ImmunoCAP Specific IgE) whole-allergen (dander) tests with reflex to component panels (Table 1). The component panels test for specific IgE antibodies to dog (Can f 1-6), cat (Fel d 1, 2, 4, and 7), and horse (Equ c 1) allergens.

Table 1. ImmunoCAP Component IgE Tests for Respiratory Allergens

Test name

Test code

Tests with reflex testinga

 

Cat Dander (e1) IgE With Reflex to Component Panel

10564

Dog Dander (e5) IgE With Reflex to Component Panel

10571

Horse Dander (e3) IgE With Reflex to Component

10629

Tests without reflex testing

 

Cat Dander Component Panel

10558

Dog Dander Component Panel

10569

Horse Dander Component Panel

10583
a Reflex tests are performed at an additional charge and are associated with an additional CPT® code(s).

 

Quest also offers respiratory profile panels that include dog and cat allergen testing. These panels are appropriate for 14 different regions of the United States, including Alaska and Puerto Rico. Details for these panels, for regions designated I through XI, XVI, XVIII, and XIX can be found in the Test Directory at https://testdirectory.questdiagnostics.com/test/home.

Test selection and interpretation

Component testing is offered with or without reflex testing (Table 1) with the latter being appropriate if an IgE response to the animals’ dander has already been established. Compared with extract testing alone (Cat Dander [e1] IgE [test code 2601]; Dog Dander [e5] IgE [test code 2605]; Horse Dander [e3] IgE [test code 2603]), component testing provides more information about the patient’s reactivity and can help assess risk of severe symptoms.

Positive results (ie, >0.10 kU/L) for certain components can help assess the risk of asthma development and severity (Table 2 2,7–25). For example, levels of Can f 1–specific IgE antibodies are correlated with the severity of asthma symptoms in patients who are allergic to dogs.8,9 Component testing can also have a positive impact on the management of the patient’s course. For instance, sensitization to one of the components associated only with male dogs can help allow the patient to have a female dog.23

Table 2. Specific Cat, Dog, and Horse Component Proteins

Allergen (protein family)

Clinical significance of IgE sensitization

Cat

Fel d 1 (uteroglobin)
  • Major cat allergen; detected in up to 90% of people with cat allergy10
  • Associated with asthma in patients with IgE monosensitivity11 to Fel d 1
  • Associated with cat allergy, bronchial hyperresponsiveness (ie, increased sensitivity to airway-narrowing stimuli), and increased fractional exhaled nitric oxide (FeNO, a type 2 inflammation biomarker) in patients polysensitized12 to Fel d 1, 2, and 4

Fel d 2 (albumin)
  • Minor cat allergen12
  • Associated with moderate/severe rhinitis and asthma12
  • Associated with atopic dermatitis in children13

Fel d 4 (lipocalin)
  • Associated with cat allergy, bronchial hyperresponsiveness (ie, increased sensitivity to airway-narrowing stimuli), and increased FeNO in patients polysensitized12 to Fel d 1, 2, and 4
  • Associated with atopic dermatitis in children13

Fel d 7 (lipocalin)
  • Cross-reactive with Can f 1, which is associated with asthma

Dog

Can f 1 (lipocalin)
  • Major dog allergen; >50% of individuals14 with dog allergy are sensitized to Can f 1
  • IgE levels correlated with asthma severity8,9

Can f 2 (lipocalin)
  • Minor dog allergen and most patients15,16 sensitized to Can f 2 will have cosensitivity to Can f 1
  • Associated with bronchial inflammation and severe asthma17

Can f 3 (serum albumin)
  • Reported sensitization to Can f 3 ranges from 25% to 90% in patients with dog allergy7,14,16,18,19
  • Associated with increased risk of asthma and allergic rhinitis20

Can f 4 (lipocalin)
  • Major dog allergen; most abundant detected allergen found in dog dander21
  • Associated with asthma22

Can f 5 (kallikrein)
  • Associated with severe asthma and strongly associated with rhinoconjunctivitis in children who are monosensitized20 to Can f 5
  • People sensitized only to this component can tolerate female dogs23

Can f 6 (lipocalin)
  • Major dog allergen
  • Associated with asthma and rhinitis20

Horse

Equ c 1 (lipocalin)
  • Major horse allergen2
  • Associated with severe asthma in adults and children24,25

 

The risk and severity of allergy is also greater in patients who are cosensitized or polysensitized to dog, cat, and/or horse allergens compared to patients who are monosensitized.17,19,26,27 For example, in a study of 259 animal-sensitized children, cosensitization to Can f 5 and Can f 1 or f 2 conferred the greatest risk for asthma.7 Other studies have shown that sensitization to ≥3 dog and/or cat components is more common in patients with severe asthma.17,19,26

Negative results for IgE to dog, cat, or horse component protein(s) indicate absent or undetectable levels of IgE to the protein(s). Negative results may not rule out dog, cat, or horse allergy. For example, studies with dog extract IgE-positive sera have found that as many as 40% are negative to Can f 1, Can f 2, and Can f 5.8

References

  1. Chan SK, Leung DYM. Dog and cat allergies: current state of diagnostic approaches and challenges. Allergy, Asthma Immunol Res. 2018;10(2):97-105. doi:10.4168/aair.2018.10.2.97
  2. Arseneau AM, Hrabak TM, Waibel KH. Inhalant horse allergens and allergies: a review of the literature. Mil Med. 2012;177(7):877-882. doi:10.7205/milmed-d-12-00038
  3. Association AVM. U.S. pet ownership statistics. Accessed December 6, 2023. https://www.avma.org/resources-tools/reports-statistics/us-pet-ownership-statistics
  4. Asthma and Allergy Foundation of America. How does a doctor diagnose an animal/pet allergy? Accessed October 24, 2023. https://aafa.org/allergies/types-of-allergies/pet-dog-cat-allergies/
  5. American Academy of Allergy Asthma & Immunology. Pet allergy symptoms & diagnosis. Accessed October 16, 2023. https://www.aaaai.org/conditions-treatments/allergies/pet-allergy
  6. Veen MJ van der, Mulderb M, Witteman AM, et al. False-positive skin prick test responses to commercially available dog dander extracts caused by contamination with house dust mite (Dermatophagoides pteronyssinus) allergens. J Allergy Clin Immunol. 1996;98(6):1028-1034. doi:10.1016/s0091-6749(96)80187-4
  7. Bjerg A, Winberg A, Berthold M, et al. A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatr Allergy Immunol. 2015;26(6):557-563. doi:10.1111/pai.12422
  8. Simpson A, Lazic N, Belgrave DCM, et al. Patterns of IgE responses to multiple allergen components and clinical symptoms at age 11 years. J Allergy Clin Immunol. 2015;136(5):1224-1231. doi:10.1016/j.jaci.2015.03.027
  9. Perzanowski MS, Ronmark E, James HR, et al. Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden. J Allergy Clin Immunol. 2016;138(6):1582-1590. doi:10.1016/j.jaci.2016.05.017
  10. Grönlund H, Saarne T, Gafvelin G, et al. The major cat allergen, Fel d 1, in diagnosis and therapy. Int Arch Allergy Immunol. 2010;151(4):265-274. doi:10.1159/000250435
  11. Konradsen JR, Fujisawa T, Hage M van, et al. Allergy to furry animals: new insights, diagnostic approaches, and challenges. J Allergy Clin Immunol. 2015;135(3):616-625. doi:10.1016/j.jaci.2014.08.026
  12. Popescu FD, Ganea CS, Panaitescu C, et al. Molecular diagnosis in cat allergy. World J Methodol. 2021;11(3):46-60. doi:10.5662/wjm.v11.i3.46
  13. Vachová M, Panzner P, Vlas T, et al. Analysis of sensitization profiles in Central European allergy patients focused on animal allergen molecules. Int Arch Allergy Immunol. 2020;181(4):278-284. doi:10.1159/000505518
  14. Saarelainen S, Taivainen A, Rytkönen-Nissinen M, et al. Assessment of recombinant dog allergens Can f 1 and Can f 2 for the diagnosis of dog allergy. Clin Exp Allergy. 2004;34(10):1576-1582. doi:10.1111/j.1365-2222.2004.02071.x
  15. Groot H de, Goei KGH, Swieten P van, et al. Affinity purification of a major and a minor allergen from dog extract: serologic activity of affinity-purified Can f I and of Can f I-depleted extract. J Allergy Clin Immunol. 1991;87(6):1056-1065. doi:10.1016/0091-6749(91)92150-y
  16. Spitzauer S, Schweiger Ch, Anrather J, et al. Characterisation of dog allergens by means of immunoblotting. Int Arch Allergy Immunol. 1993;100(1):60-67. doi:10.1159/000236389
  17. Nordlund B, Konradsen JR, Kull I, et al. IgE antibodies to animal-derived lipocalin, kallikrein and secretoglobin are markers of bronchial inflammation in severe childhood asthma. Allergy. 2012;67(5):661-669. doi:10.1111/j.1398-9995.2012.02797.x
  18. Spitzauer S, Schweiger C, Sperr WR, et al. Molecular characterization of dog albumin as a cross-reactive allergen. J Allergy Clin Immunol. 1994;93(3):614-627. doi:10.1016/s0091-6749(94)70073-7
  19. Konradsen JR, Nordlund B, Onell A, et al. Severe childhood asthma and allergy to furry animals: refined assessment using molecular-based allergy diagnostics. Pediatr Allergy Immunol. 2014;25(2):187-192. doi:10.1111/pai.12198
  20. Käck U, Asarnoj A, Grönlund H, et al. Molecular allergy diagnostics refine characterization of children sensitized to dog dander. J Allergy Clin Immunol. 2018;142(4):1113-1120.e9. doi:10.1016/j.jaci.2018.05.012
  21. Wintersand A, Asplund K, Binnmyr J, et al. Allergens in dog extracts: Implication for diagnosis and treatment. Allergy. 2019;74(8):1472-1479. doi:10.1111/all.13785
  22. Schoos AMM, Kattan JD, Gimenez G, et al. Sensitization phenotypes based on protein groups and associations to allergic diseases in children. J Allergy Clin Immunol. 2016;137(4):1277-1280. doi:10.1016/j.jaci.2015.09.035
  23. Schoos AMM, Chawes BL, Bloch J, et al. Children monosensitized to Can f 5 show different reactions to male and female dog allergen extract provocation: a randomized controlled trial. J Allergy Clin Immunol: Pr. 2020;8(5):1592-1597.e2. doi:10.1016/j.jaip.2019.12.012
  24. Schoos AMM, Nwaru BI, Borres MP. Component-resolved diagnostics in pet allergy: current perspectives and future directions. J Allergy Clin Immunol. 2021;147(4):1164-1173. doi:10.1016/j.jaci.2020.12.640
  25. Nwaru BI, Suzuki S, Ekerljung L, et al. Furry animal allergen component sensitization and clinical outcomes in adult asthma and rhinitis. J Allergy Clin Immunol: Pr. 2019;7(4):1230-1238.e4. doi:10.1016/j.jaip.2018.12.018
  26. Dávila I, Domínguez-Ortega J, Navarro-Pulido A, et al. Consensus document on dog and cat allergy. Allergy. 2018;73(6):1206-1222. doi:10.1111/all.13391
  27. Patelis A, Gunnbjornsdottir M, Alving K, et al. Allergen extract vs. component sensitization and airway inflammation, responsiveness and new-onset respiratory disease. Clin Exp Allergy. 2016;46(5):730-740. doi:10.1111/cea.12607

Content reviewed 03/2024

top of page

This document focuses on guideline-supported component testing for furry pet allergies following dog, cat, and horse whole allergen extract testing.

Test Guide List

Component Testing for Furry Animal Allergies

Topic Brief

 

Component Testing for Furry Pet Allergy

Introduction

The worldwide prevalence of dog and/or cat allergy is about 10% to 20%, and up to 5% of people with respiratory allergies are allergic to horses.1,2 In the United States, exposure to dander from these animals can be significant because almost 40% of households report owning dogs, over 20% own cats, and approximately 1% own horses.3 Allergy symptoms can include asthma, allergic rhinitis, rhinoconjunctivitis, anaphylaxis, and conditions such as bronchial inflammation.

Diagnostic testing

Suspicion of dog, cat, or horse allergy is usually prompted by the presence of symptoms, and support for the diagnosis commonly involves a skin-prick test (SPT) or specific IgE testing based on whole allergen extracts.4 But the use of extracts to assess suspected animal allergy has drawbacks.5 Commercially available extracts may have variable potency, may contain other allergens, or may contain proteins which cross-react with other allergens. This can lead to false-positive results.6

Also, although sensitization (ie, production of IgE antibodies) to antigenic proteins from dander can cause an allergic reaction, some patients with a suspected allergy may be only sensitized to an antigen without having a true allergy. Patients who are sensitized but not truly allergic have developed IgE antibodies to the antigen on initial exposure but do not mount an IgE-mediated immune response (ie, allergic reaction) on re-exposure.

Components are the specific proteins found in whole allergen extracts. The identification of IgE antibodies to component proteins can help confirm that patients are sensitized to the animal in question and that the positive extract result is not due to cross reactivity. The presence of reactivity to multiple components increases the likelihood that the patient is truly allergic.

Test availability

Quest Diagnostics offers fluorescent enzyme immunoassay-based (ImmunoCAP Specific IgE) whole-allergen (dander) tests with reflex to component panels (Table 1). The component panels test for specific IgE antibodies to dog (Can f 1-6), cat (Fel d 1, 2, 4, and 7), and horse (Equ c 1) allergens.

Table 1. ImmunoCAP Component IgE Tests for Respiratory Allergens

Test name

Test code

Tests with reflex testinga

 

Cat Dander (e1) IgE With Reflex to Component Panel

10564

Dog Dander (e5) IgE With Reflex to Component Panel

10571

Horse Dander (e3) IgE With Reflex to Component

10629

Tests without reflex testing

 

Cat Dander Component Panel

10558

Dog Dander Component Panel

10569

Horse Dander Component Panel

10583
a Reflex tests are performed at an additional charge and are associated with an additional CPT® code(s).

 

Quest also offers respiratory profile panels that include dog and cat allergen testing. These panels are appropriate for 14 different regions of the United States, including Alaska and Puerto Rico. Details for these panels, for regions designated I through XI, XVI, XVIII, and XIX can be found in the Test Directory at https://testdirectory.questdiagnostics.com/test/home.

Test selection and interpretation

Component testing is offered with or without reflex testing (Table 1) with the latter being appropriate if an IgE response to the animals’ dander has already been established. Compared with extract testing alone (Cat Dander [e1] IgE [test code 2601]; Dog Dander [e5] IgE [test code 2605]; Horse Dander [e3] IgE [test code 2603]), component testing provides more information about the patient’s reactivity and can help assess risk of severe symptoms.

Positive results (ie, >0.10 kU/L) for certain components can help assess the risk of asthma development and severity (Table 2 2,7–25). For example, levels of Can f 1–specific IgE antibodies are correlated with the severity of asthma symptoms in patients who are allergic to dogs.8,9 Component testing can also have a positive impact on the management of the patient’s course. For instance, sensitization to one of the components associated only with male dogs can help allow the patient to have a female dog.23

Table 2. Specific Cat, Dog, and Horse Component Proteins

Allergen (protein family)

Clinical significance of IgE sensitization

Cat

Fel d 1 (uteroglobin)
  • Major cat allergen; detected in up to 90% of people with cat allergy10
  • Associated with asthma in patients with IgE monosensitivity11 to Fel d 1
  • Associated with cat allergy, bronchial hyperresponsiveness (ie, increased sensitivity to airway-narrowing stimuli), and increased fractional exhaled nitric oxide (FeNO, a type 2 inflammation biomarker) in patients polysensitized12 to Fel d 1, 2, and 4

Fel d 2 (albumin)
  • Minor cat allergen12
  • Associated with moderate/severe rhinitis and asthma12
  • Associated with atopic dermatitis in children13

Fel d 4 (lipocalin)
  • Associated with cat allergy, bronchial hyperresponsiveness (ie, increased sensitivity to airway-narrowing stimuli), and increased FeNO in patients polysensitized12 to Fel d 1, 2, and 4
  • Associated with atopic dermatitis in children13

Fel d 7 (lipocalin)
  • Cross-reactive with Can f 1, which is associated with asthma

Dog

Can f 1 (lipocalin)
  • Major dog allergen; >50% of individuals14 with dog allergy are sensitized to Can f 1
  • IgE levels correlated with asthma severity8,9

Can f 2 (lipocalin)
  • Minor dog allergen and most patients15,16 sensitized to Can f 2 will have cosensitivity to Can f 1
  • Associated with bronchial inflammation and severe asthma17

Can f 3 (serum albumin)
  • Reported sensitization to Can f 3 ranges from 25% to 90% in patients with dog allergy7,14,16,18,19
  • Associated with increased risk of asthma and allergic rhinitis20

Can f 4 (lipocalin)
  • Major dog allergen; most abundant detected allergen found in dog dander21
  • Associated with asthma22

Can f 5 (kallikrein)
  • Associated with severe asthma and strongly associated with rhinoconjunctivitis in children who are monosensitized20 to Can f 5
  • People sensitized only to this component can tolerate female dogs23

Can f 6 (lipocalin)
  • Major dog allergen
  • Associated with asthma and rhinitis20

Horse

Equ c 1 (lipocalin)
  • Major horse allergen2
  • Associated with severe asthma in adults and children24,25

 

The risk and severity of allergy is also greater in patients who are cosensitized or polysensitized to dog, cat, and/or horse allergens compared to patients who are monosensitized.17,19,26,27 For example, in a study of 259 animal-sensitized children, cosensitization to Can f 5 and Can f 1 or f 2 conferred the greatest risk for asthma.7 Other studies have shown that sensitization to ≥3 dog and/or cat components is more common in patients with severe asthma.17,19,26

Negative results for IgE to dog, cat, or horse component protein(s) indicate absent or undetectable levels of IgE to the protein(s). Negative results may not rule out dog, cat, or horse allergy. For example, studies with dog extract IgE-positive sera have found that as many as 40% are negative to Can f 1, Can f 2, and Can f 5.8

References

  1. Chan SK, Leung DYM. Dog and cat allergies: current state of diagnostic approaches and challenges. Allergy, Asthma Immunol Res. 2018;10(2):97-105. doi:10.4168/aair.2018.10.2.97
  2. Arseneau AM, Hrabak TM, Waibel KH. Inhalant horse allergens and allergies: a review of the literature. Mil Med. 2012;177(7):877-882. doi:10.7205/milmed-d-12-00038
  3. Association AVM. U.S. pet ownership statistics. Accessed December 6, 2023. https://www.avma.org/resources-tools/reports-statistics/us-pet-ownership-statistics
  4. Asthma and Allergy Foundation of America. How does a doctor diagnose an animal/pet allergy? Accessed October 24, 2023. https://aafa.org/allergies/types-of-allergies/pet-dog-cat-allergies/
  5. American Academy of Allergy Asthma & Immunology. Pet allergy symptoms & diagnosis. Accessed October 16, 2023. https://www.aaaai.org/conditions-treatments/allergies/pet-allergy
  6. Veen MJ van der, Mulderb M, Witteman AM, et al. False-positive skin prick test responses to commercially available dog dander extracts caused by contamination with house dust mite (Dermatophagoides pteronyssinus) allergens. J Allergy Clin Immunol. 1996;98(6):1028-1034. doi:10.1016/s0091-6749(96)80187-4
  7. Bjerg A, Winberg A, Berthold M, et al. A population-based study of animal component sensitization, asthma, and rhinitis in schoolchildren. Pediatr Allergy Immunol. 2015;26(6):557-563. doi:10.1111/pai.12422
  8. Simpson A, Lazic N, Belgrave DCM, et al. Patterns of IgE responses to multiple allergen components and clinical symptoms at age 11 years. J Allergy Clin Immunol. 2015;136(5):1224-1231. doi:10.1016/j.jaci.2015.03.027
  9. Perzanowski MS, Ronmark E, James HR, et al. Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden. J Allergy Clin Immunol. 2016;138(6):1582-1590. doi:10.1016/j.jaci.2016.05.017
  10. Grönlund H, Saarne T, Gafvelin G, et al. The major cat allergen, Fel d 1, in diagnosis and therapy. Int Arch Allergy Immunol. 2010;151(4):265-274. doi:10.1159/000250435
  11. Konradsen JR, Fujisawa T, Hage M van, et al. Allergy to furry animals: new insights, diagnostic approaches, and challenges. J Allergy Clin Immunol. 2015;135(3):616-625. doi:10.1016/j.jaci.2014.08.026
  12. Popescu FD, Ganea CS, Panaitescu C, et al. Molecular diagnosis in cat allergy. World J Methodol. 2021;11(3):46-60. doi:10.5662/wjm.v11.i3.46
  13. Vachová M, Panzner P, Vlas T, et al. Analysis of sensitization profiles in Central European allergy patients focused on animal allergen molecules. Int Arch Allergy Immunol. 2020;181(4):278-284. doi:10.1159/000505518
  14. Saarelainen S, Taivainen A, Rytkönen-Nissinen M, et al. Assessment of recombinant dog allergens Can f 1 and Can f 2 for the diagnosis of dog allergy. Clin Exp Allergy. 2004;34(10):1576-1582. doi:10.1111/j.1365-2222.2004.02071.x
  15. Groot H de, Goei KGH, Swieten P van, et al. Affinity purification of a major and a minor allergen from dog extract: serologic activity of affinity-purified Can f I and of Can f I-depleted extract. J Allergy Clin Immunol. 1991;87(6):1056-1065. doi:10.1016/0091-6749(91)92150-y
  16. Spitzauer S, Schweiger Ch, Anrather J, et al. Characterisation of dog allergens by means of immunoblotting. Int Arch Allergy Immunol. 1993;100(1):60-67. doi:10.1159/000236389
  17. Nordlund B, Konradsen JR, Kull I, et al. IgE antibodies to animal-derived lipocalin, kallikrein and secretoglobin are markers of bronchial inflammation in severe childhood asthma. Allergy. 2012;67(5):661-669. doi:10.1111/j.1398-9995.2012.02797.x
  18. Spitzauer S, Schweiger C, Sperr WR, et al. Molecular characterization of dog albumin as a cross-reactive allergen. J Allergy Clin Immunol. 1994;93(3):614-627. doi:10.1016/s0091-6749(94)70073-7
  19. Konradsen JR, Nordlund B, Onell A, et al. Severe childhood asthma and allergy to furry animals: refined assessment using molecular-based allergy diagnostics. Pediatr Allergy Immunol. 2014;25(2):187-192. doi:10.1111/pai.12198
  20. Käck U, Asarnoj A, Grönlund H, et al. Molecular allergy diagnostics refine characterization of children sensitized to dog dander. J Allergy Clin Immunol. 2018;142(4):1113-1120.e9. doi:10.1016/j.jaci.2018.05.012
  21. Wintersand A, Asplund K, Binnmyr J, et al. Allergens in dog extracts: Implication for diagnosis and treatment. Allergy. 2019;74(8):1472-1479. doi:10.1111/all.13785
  22. Schoos AMM, Kattan JD, Gimenez G, et al. Sensitization phenotypes based on protein groups and associations to allergic diseases in children. J Allergy Clin Immunol. 2016;137(4):1277-1280. doi:10.1016/j.jaci.2015.09.035
  23. Schoos AMM, Chawes BL, Bloch J, et al. Children monosensitized to Can f 5 show different reactions to male and female dog allergen extract provocation: a randomized controlled trial. J Allergy Clin Immunol: Pr. 2020;8(5):1592-1597.e2. doi:10.1016/j.jaip.2019.12.012
  24. Schoos AMM, Nwaru BI, Borres MP. Component-resolved diagnostics in pet allergy: current perspectives and future directions. J Allergy Clin Immunol. 2021;147(4):1164-1173. doi:10.1016/j.jaci.2020.12.640
  25. Nwaru BI, Suzuki S, Ekerljung L, et al. Furry animal allergen component sensitization and clinical outcomes in adult asthma and rhinitis. J Allergy Clin Immunol: Pr. 2019;7(4):1230-1238.e4. doi:10.1016/j.jaip.2018.12.018
  26. Dávila I, Domínguez-Ortega J, Navarro-Pulido A, et al. Consensus document on dog and cat allergy. Allergy. 2018;73(6):1206-1222. doi:10.1111/all.13391
  27. Patelis A, Gunnbjornsdottir M, Alving K, et al. Allergen extract vs. component sensitization and airway inflammation, responsiveness and new-onset respiratory disease. Clin Exp Allergy. 2016;46(5):730-740. doi:10.1111/cea.12607

Content reviewed 03/2024

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Reference ranges are provided as general guidance only. To interpret test results use the reference range in the laboratory report.

The tests listed by specialty and category are a select group of tests offered. For a complete list of Quest Diagnostics tests, please adjust the filter options chosen, or refer to our Directory of Services.