Background: The diagnosis of non-IgE mediated food allergies may be a complex puzzle when there is no start point to establish an elimination diet to allow a clear clinical field to initiate diagnostic Oral Food Challenges tests. Objective: To evaluate the opportunity of the tube titration of precipitins to select food allergens to proceed with elimination diets to assist the diagnosis and management of adult patients with Food Allergy manifested as Intrinsic Atopic Dermatitis (IAD). Methods: The tube titration of specific precipitins against anamnesis-chosen food allergens were performed in 64 IAD patients and their titers were associated with an Improvement Verbal Scale Rate (IVSR) of the patient’s perception of the benefits of the Precipitins-based Elimination Diet (PED) performed with these specific food allergens, as well correlated with their positive or negative perception of the impairment of symptoms after the reintroduction of the Symptom-Related Food Allergen (SRFA). Results: In most cases, the PED contributed to a significant clinical improvement that allowed the patients to evaluate the individual effect of the reintroduction of each food allergen on their diets. There was a significant positive correlation coefficient between the titers of the food-specific titration of precipitins and the percentage of positive SRFA (Pearson r = 0.91; p-value = 0.0004). Conclusion: The semiquantitative titration of specific precipitins against food allergens is a promising triage test to select food allergens to proceed with elimination diets to support the diagnosis and management of non-IgE mediated Food Allergy in patients with Intrinsic Atopic Dermatitis.

Background: Due to the lack of standardized laboratory procedures able to demonstrate specific non—IgE-mediated immune responses against latex allergens, these conditions are diagnosed mostly by clinical criteria based on empiric exclusion prescriptions monitored by in vivo challenge tests. Objective: To evaluate the opportunity of an ex vivo challenge immunoassay, the Leukocyte Adherence Inhibition (LAI) Test (LAIT), to discriminate non—IgE-mediated latex-specific immunoreactivity. Methods: Ex vivo challenge tests performed with Hevea Brasiliense’s latex extract, monitored by LAIT, were assayed in an asymptomatic control group and a group of patients with diverse respiratory and cutaneous non—IgE-mediated allergic conditions, clinically diagnosed by a certified allergologist. Results: The mean LAI of the control group was 8.3%. The mean LAI of the complete patients’ group was 41.1%. The non-parametric Wilcoxon-Mann-Whitney U (WMWU) test comparing the control group with the whole patient’s group showed significance with a p-value < 0.00001. The WMWU test comparing the control group with each other patient’s group showed significance with a p-value < α = 0.05 for all comparisons. The WMWU test comparing the patients’ groups between each other did not show any significant p-value. Conclusion: Several patients from the diverse non—IgE-mediated allergic phenotypes presented variable immunoreactivity against the latex extract, as demonstrated by the LAIT, which proved to be an easy, quick, and inexpensive ex vivo immunoassay with the potential to predict individual immunoreactivity against Hevea brasiliensis latex allergens in real-world patients with non—IgE-mediated allergies.

Background: Due to the lack of standardized laboratory procedures able to demonstrate specific immune responses against the culprit allergens, the non—IgE-mediated allergy syndromes are a group of conditions diagnosed mostly by clinical examination and exclusion criteria. Objective: To evaluate the opportunity of the Leukocyte Adherence Inhibition Test (LAIT) to discriminate specific immunoreactivity against Dermatophagoides pteronyssinus (Dp) in a group of patients with non–IgE-mediated chronic allergic conditions. Methods: Ex vivo challenge tests performed with Dp were monitored by LAIT in patients presenting diverse non–IgE-mediated allergic conditions: intrinsic Atopic Dermatitis (iAD), intrinsic Allergic Rhinitis (iAR), intrinsic Ocular Allergy (iOA), intrinsic Chronic Pharyngitis (iCP), and intrinsic Asthma (iAS). Results: The mean LAI of the control group was 7%; the mean LAI of the iAR group was 34%; the mean LAI of the iCP group was 44%; the mean LAI of the iAS group was 45%; the mean LAI of the iOA group was 47%; the mean LAI of the iAD group was 55%. The non-parametric Wilcoxon-Mann-Whitney U test comparing the control group with each other group showed significance with p-value < α = 0.05 for all groups. Conclusion: The Leukocyte Adherence Inhibition Test is an easy, quick, and inexpensive ex vivo immunoassay with the potential to predict individual immunoreactivity against HDM allergens in real-world patients with non–IgE-mediated allergies.

Background: The Precision Medicine’s approach employs the endotype concept as a central feature to personalize medical treatment. Individual immunoreactivity, alongside characteristics such as genetics, environment, and diet, is one of the factors that differentiates the therapeutic-driven endotypes. Objective: To evaluate the opportunity of the Leukocyte Adherence Inhibition test to differentiate the immunoreactivity between two similar therapeutic agents employed on Allergen Immunotherapy. Methods: Side by side Leukocyte Adherence Inhibitions tests were performed with ovalbumin and carbamylated ovalbumin on a population of 33 self-reported egg-allergic individuals. Results: The results showed two endotypes inside the immune response of the studied groups: The first endotype was defined by the 16 individuals that presented a significant decrease in ovalbumin’s immunoreactivity after carbamylation (mean of differences = 35%; p = 0.002). The second endotype was defined by 17 individuals that presented a significant increase in ovalbumin’s immunoreactivity after carbamylation (mean of differences = 32%; p = 0.001). Conclusion: The Leukocyte Adherence Inhibition test was able to differentiate two distinct immunoreactivity patterns when comparing two similar therapeutic agents suggesting, as proof of concept, a potential role to be employed as a Precision Medicine tool.

Background: The Non-Celiac Gluten Sensitivity (NCGS) is a category inside the Gluten-Related Disorders (GRD) that groups the patients with unidentified mechanisms responsible for their symptoms. Objective: To evaluate the opportunity of an ex vivo challenge immunoassay, the Leukocyte Adherence Inhibition Test (LAIT), to discriminate non—IgE-mediated gluten-specific immunoreactivity in patients with NCGS. Methods: Ex vivo challenge tests performed with gluten latex extract, monitored by LAIT, were assayed in an asymptomatic control group of 30 individuals and a group of 52 patients with GRD not related to any identifiable immune mechanism (NCGS). Results: The mean Leukocyte Adherence Inhibition (LAI) of the control group was 10.9%. The mean LAI of the NCGS patients’ group was 54.9%. The non-parametric Wilcoxon-Mann-Whitney U test comparing the control group with the NCGS patient’s group showed significance with a p-value < 0.00001. Conclusion: The LAIT is an ex vivo challenge test able to discriminate gluten-sensitive and gluten-tolerant individuals, suggesting the participation of an immune Non—IgE-mediated hypersensitivity reaction in patients with the clinical diagnosis of NCGS.