054 - The Renaissance of allergy testing
Autor(s): D. Villalta
Issue: RIMeL - IJLaM, Vol. 4, N. 3-S1, 2008 (MAF Servizi srl ed.)
Page(s): 54-59
Since the first introduction of the in vitro diagnostic test for the determination of IgE, crude or purified extracts prepared from various allergen-containing biological material (e.g. pollens, animal danders, mites, moulds, foods, insects) have been used as agents for capturing IgE antibodies in serum. In spite of the continuous efforts produced by the manufactures to improve the quality of the allergenic material applied in these tests, they remain cumbersome to standardize regarding their allergen content. During the last two decades, the major and minor IgE binding proteins of the most prevalent allergy-causing natural sources have been characterized on a molecular level, and many of them have been produced as recombinant proteins. Diagnostic tests based on single recombinant (or natural) allergens, both in classical and in microarray format, have been developed and today it is possible to determine the complex reactivity profile of allergic patients (Component Resolved Diagnosis) (CRD). The CRD represents an innovative and revolutionary concept in allergy diagnosis because it allows the discrimination between cross and co-sensitization, the prediction of the efficacy of immunotherapy and the prediction of the severity of the clinical manifestations in food allergy. However, before the CRD tests, and in particular the microarraybased tests, become a standard diagnostic tool in clinical laboratory, the quality assurance programs for specific IgE have to be revised ad adapted for these new assays, and clinicians and pathologists have to better define their diagnostic accuracy and their impact on the clinical outcome