Diagnosis of Allergy by an in-Vitro Test for Allergen Antibodies

Wide, Leif; Bennich, H.; Johansson, S. G. O.

doi:10.1016/s0140-6736(67)90615-0

Cited by 1,184 publications

(419 citation statements)

References 7 publications

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“…The former enable investigation of allergens in their native form, whereas the denaturing conditions of the latter (SDS gel electrophoresis) include a stronger risk of not presenting native IgE-binding epitopes, possibly causing detection failures. [79] and [80] RAST assays with crude allergen extracts allowed, for the first time, estimation of sIgE serum concentrations, [81], [82] and [83] but the accuracy of in vitro sIgE determinations is highly variable. [54], [84] and [85] This is, for example, due to lacking standardization of the test agents, as well as to instability of some of the respective allergenic proteins.…”

Section: Quantification Of Ige Antibodiesmentioning

confidence: 99%

Potential, pitfalls, and prospects of food allergy diagnostics with recombinant allergens or synthetic sequential epitopes

Steckelbroeck¹,

Ballmer‐Weber²,

Vieths³

2008

Journal of Allergy and Clinical Immunology

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This article aims to critically review developments in food allergy diagnostics with regard to the verification of specific IgE antibodies and the identification of the responsible allergens. Results of IgE-binding tests with food extracts are hampered by cross-reactive proteins, low-quality test agents, or both. Specificity can be increased by defining adequate cutoff values, whereas sensitivity can be improved by using high-quality test agents. IgE-binding tests with purified allergens enabled reliable quantification of allergen-specific IgE titers, with higher levels found in individuals with food allergy compared with individuals without food allergy. However, the overlap in individual test reactivity between allergic and nonallergic subjects complicates interpretation. Recombinant allergens and synthetic sequential epitopes enabled detection of sensitization profiles, with IgE specific to several allergens and substructures now being suggested as markers of severity, persistence, or both. However, high-power quantitative studies with larger numbers of patients are required to confirm these markers. This article aims to critically review developments in food allergy diagnostics with regard to the verification of specific IgE antibodies and the identification of the responsible allergens. Results of IgE-binding tests with food extracts are hampered by cross-reactive proteins, low-quality test agents, or both. Specificity can be increased by defining adequate cutoff values, whereas sensitivity can be improved by using high-quality test agents. IgE-binding tests with purified allergens enabled reliable quantification of allergen-specific IgE titers, with higher levels found in individuals with food allergy compared with individuals without food allergy. However, the overlap in individual test reactivity between allergic and nonallergic subjects complicates interpretation. Recombinant allergens and synthetic sequential epitopes enabled detection of sensitization profiles, with IgE specific to several allergens and substructures now being suggested as markers of severity, persistence, or both.However, high-power quantitative studies with larger numbers of patients are required to confirm these markers. IgE-mediated and non-IgE-mediated syndromes, where IgE-mediated manifestations are responsible for the majority of food-induced, immediate-type, immune-mediated hypersensitivity reactions. 3 The development of an IgE-mediated response to food requires a series of molecular and cellular interactions, which involve antigenpresenting cells, T lymphocytes, and B lymphocytes. [4] and [5] Depending on the route of sensitization, food allergy is the result of either genuine reactivity to comestibles through the gastrointestinal tract (class I food allergens) or secondary sensitization to cross-reactive food allergens as a consequence of the initial reactivity to homologous pollen-related allergens (class II food allergens). [6] and [7] The majority of class I food allergens are heat stable and resistan...

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Section: Quantification Of Ige Antibodiesmentioning

confidence: 99%

Potential, pitfalls, and prospects of food allergy diagnostics with recombinant allergens or synthetic sequential epitopes

Steckelbroeck¹,

Ballmer‐Weber²,

Vieths³

2008

Journal of Allergy and Clinical Immunology

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“…Discs of Whatman 54 paper 3 mm in diameter were prepared with a paper punch and activated using cyanogen bromide [14]. The discs were sensitized with purified pork or purified beef insulin (10 ug/ml), diluted in sodium bicarbonate (0.…”

Section: Patient and Methodsmentioning

confidence: 99%

An anaphylactic reaction to highly purified pork insulin. Confirmation by RAST and RAST inhibition

1982

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Summary. We describe a patient who had an anaphylactic reaction to highly purified pork insulin; he was not allergic however to beef insulin. The sensitivity to pork but not to beef insulin was confirmed by skin testing, radioallergosorbent test (RAST) and RAST inhibition. A scheme is suggested for the investigation of such patients. Key words:Anaphylaxis, radioallergosorbent test, highly purified insulin, beef insulin, allergen.There have been reports of anaphylactic reactions to insulin, the first being by Williams [1], who described a patient who was allergic to insulin extracted from pork pancreas but not to a beef extract. At that time insulin was very impure and it is likely that the allergen was not insulin. It has always been difficult to prove the precise nature of the allergen causing such reactions and with increasing purity of insulin preparations allergic reactions have become increasingly rare. Patients have been described who had allergic reactions to conventional insulins [2,4]. There have also been instances of reactions to highly purified insulins [5, 121, but with one doubtful exception all patients had received conventional insulins previously [12]. We describe a patient who became allergic to highly purified pork, but not to beef insulin, in whom we have demonstrated by skin testing and RAST that the insulin is the allergen and that the immunopathological mechanism was IgE mediated. Patient and MethodsThe patient is an Australian male born in 1953. During childhood, he experienced episodes of allergic rhinitis, there being no family history of atopy. Diabetes mellitus was diagnosed in 1968 and treatment with insulin started. Initially he received beef protamine zinc and soluble insulins. After 2 years of treatment, his insulin requirement had increased to more than 200 units daily. Treatment was then changed to Actrapid (pork) and Rapitard (pork 25%/beef 75%) insulins (Novo Industri, Denmark) with a reduction in his insulin requirement. He has been seen regularly in our diabetic clinic since 1977 and his diabetes has been well controlled on an average dose of 90 U insulin/day (weight: 80 kg) and there have been no complications of the disease.In May 1980, a change was made in his insulin regimen. Mixtard insulin (52 U), a highly purified pork insulin (30% neutral / 70% NPH; Nordisk Denmark), was substituted for the Rapitard insulin, of which he had been taking 72 U daily. After I week, wheals started to appear at injection sites and 2 weeks later a generalised reaction occurred. This reaction started within seconds of an insulin injection. The patient experienced difficulty in breathing with chest tightness and laryngeal obstruction and he developed a generalised urticarial eruption i. e. anaphylaxis. While on the Actrapid and Mixtard insulins diabetic control had been good. After the anaphylactic reaction, the patient resumed his previous insulin regimen and has subsequently been entirely free of allergic symptoms.Prick testing was performed using normal saline, insulin vehicle, and pork an...

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“…RAST was the first laboratory method developed for in vitro detection of specific IgE [21]; despite that it is no longer used and its historical importance is evident since it was the second most used test after SPT, and gave rise to development of new methodology to facilitate sIgE detection. The main advantage of this method over SPT lied on the safety of patient.…”

Section: Radio Allergo Sorbent Test (Rast)mentioning

confidence: 99%

Allergen-Based Diagnostic: Novel and Old Methodologies with New Approaches

Salazar¹,

Velázquez-Soto²,

Ayala-Balboa³

et al. 2017

Allergen

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This chapter is an extensive review of allergen-based diagnostic methodologies including old techniques such as skin prick test, radio-allergo sorbent test, enzymelinked immunosorbent assay, and fluorescent-enzyme immunosorbent assay. Novel technologies include functional tests by flow cytometry and molecular allergy based on multiplex immunoassays. We also review the importance of biochemical characteristics of allergens, sensitivity and specificity, cross-reaction between allergens, utility, reproducibility, interpretation, and methodologies for discovery of epitopes for diagnostic or therapeutic use.

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Diagnosis of Allergy by an in-Vitro Test for Allergen Antibodies

Cited by 1,184 publications

References 7 publications

Potential, pitfalls, and prospects of food allergy diagnostics with recombinant allergens or synthetic sequential epitopes

Potential, pitfalls, and prospects of food allergy diagnostics with recombinant allergens or synthetic sequential epitopes

An anaphylactic reaction to highly purified pork insulin. Confirmation by RAST and RAST inhibition

Allergen-Based Diagnostic: Novel and Old Methodologies with New Approaches

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