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

Abstract

Molecular-based allergy (MA) diagnostics is an approach used to map the allergen sensitization of a patient at a molecular level, using purified natural or recombinant allergenic molecules (allergen components) instead of allergen extracts. Since its introduction, MA diagnostics has increasingly entered routine care, with currently more than 130 allergenic molecules commercially available for in vitro specific IgE (sIgE) testing.MA diagnostics allows for an increased accuracy in allergy diagnosis and prognosis and plays an important role in three key aspects of allergy diagnosis: (1) resolving genuine versus cross-reactive sensitization in poly-sensitized patients, thereby improving the understanding of triggering allergens; (2) assessing, in selected cases, the risk of severe, systemic versus mild, local reactions in food allergy, thereby reducing unnecessary anxiety for the patient and the need for food challenge testing; and (3) identifying patients and triggering allergens for specific immunotherapy (SIT).Singleplex and multiplex measurement platforms are available for MA diagnostics. The Immuno-Solid phase Allergen Chip (ISAC) is the most comprehensive platform currently available, which involves a biochip technology to measure sIgE antibodies against more than one hundred allergenic molecules in a single assay. As the field of MA diagnostics advances, future work needs to focus on large-scale, population-based studies involving practical applications, elucidation and expansion of additional allergenic molecules, and support for appropriate test interpretation. With the rapidly expanding evidence-base for MA diagnosis, there is a need for allergists to keep abreast of the latest information. The aim of this consensus document is to provide a practical guide for the indications, determination, and interpretation of MA diagnostics for clinicians trained in allergology.

Ефективність Алергенспецифічної Імунотерапії Пилковими Алергенами В Дітей Із Позиції Молекулярної Алергології

“…Наприклад, АСІТ амброзійним алергеном буде ефективною при на-явності сенсибілізації до головного алергену Amb a 1, Amb a 3 та неефективною при сенсибілізації до мінорних алергенів Amb a 6 (ліпідтранспорту-ючий білок, гомологічний алергену полину Art a 3), Amb a 8 (профілін), Amb a 9 та 10 (полькаль-цин) (http://fooke.ru/production/molekulyarnayaallergodiagnostika. html) [5,12,13].…”

Performance evaluation of ImmunoCAP® ISAC 112: a multi-site study

“…The use of allergen extracts to determine sensitizations underlying allergic symptoms is often confounded by cross-reacting allergens and poly-sensitizations [1][2][3]. Measuring specific immunoglobulin E (sIgE) antibodies against individual components (allergen molecules) can separate genuine (primary) and cross-reactive (secondary) sensitizations, thus providing valuable information on the individual IgE-repertoire and improving diagnosis of allergic diseases [2][3][4][5][6].…”

“…Measuring specific immunoglobulin E (sIgE) antibodies against individual components (allergen molecules) can separate genuine (primary) and cross-reactive (secondary) sensitizations, thus providing valuable information on the individual IgE-repertoire and improving diagnosis of allergic diseases [2][3][4][5][6].…”

“…Fluorescence intensity is measured by a microarray scanner, converted to arbitrary concentration units, and is then displayed both in arbitrary units ISAC Standardized Units for IgE (ISU-E), being internally cross-calibrated to ImmunoCAP singleplex kU A /l, and as semi-quantitative values (classes). The technical and clinical performances of the ISAC 112 have been validated in several studies that -depending on the allergen component -report comparable results to quantitative singleplex ImmunoCAP allergen component tests [3,[10][11][12][13][14][15][16][17][18][19].…”

“…The ISAC 112 platform provides a minimally invasive, rapid and efficient means of testing IgE sensitizations to a broad panel of allergen components [3], and has been used as an aid in the diagnosis and risk assessment of allergic patients [20][21][22][23][24][25], to predict allergic symptoms as well as for prescription and monitoring of immunotherapy [26][27][28][29][30], sensitization profiling [31][32][33][34], and for the study of allergic diseases [16,[35][36][37].…”