Making the Most of In Vitro Tests to Diagnose Food Allergy

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    Abstract

    Various in vitro tests assess different aspects of the underlying immune mechanism of IgE-mediated food allergy. Some can be used for diagnostic purposes; specific IgE to allergen extracts is widely available; specific IgE to allergen components is used in most specialist centers, and the basophil activation test is becoming increasingly used clinically. IgE to allergen peptides, T-cell assays, allergen-specific/total IgE ratios, and allergen-specific IgG4/IgE ratios are currently reserved for research. Different factors can modulate the likelihood of IgE-mediated food allergy of a given allergy test result, namely, the patients' age, ethnicity, previous allergic reaction to the identified food, concomitant atopic conditions, and geographical location, and need to be taken into account when interpreting the allergy test results in the clinic. The importance of the specific food, the clinical resources available, and patient preferences are additional aspects that need to be considered when deciding whether an oral food challenge is required to reach an accurate diagnosis of IgE-mediated food allergy.
    Original languageEnglish
    Pages (from-to)237-248
    Number of pages12
    JournalThe Journal of Allergy and Clinical Immunology: In Practice
    Volume5
    Issue number2
    Early online date7 Mar 2017
    DOIs
    Publication statusPublished - Mar 2017

    Keywords

    • In vitro tests
    • Diagnosis
    • Food allergy
    • Specific IgE
    • Basophil activation test
    • Component-resolved diagnosis
    • IgG4/IgE ratio
    • Specific/total IgE ratio
    • Peptide microarray
    • T-cell assay

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