期刊论文详细信息
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 卷:121
Potential, pitfalls, and prospects of food allergy diagnostics with recombinant allergens or synthetic sequential epitopes
Review
Steckelbroeck, Stephan1  Ballmer-Weber, Barbara K.2  Vieths, Stefan1 
[1] Paul Ehrlich Inst, Dept Allergol, D-63225 Langen, Germany
[2] Univ Zurich Hosp, Dept Dermatol, Allergy Unit, Zurich, Switzerland
关键词: food hypersensitivity;    component-resolved diagnosis;    recombinant food allergen;    sequential epitope;    immunoblot inhibition;    skin prick test;    IgE quantification;    sensitivity;    specificity;    cross-reactivity;   
DOI  :  10.1016/j.jaci.2008.04.008
来源: Elsevier
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【 摘 要 】

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-binding tests merely indicate sensitization, whereas the final proof of clinical relevance still relies on family/case history, physical examinations, and provocation tests. Novel technologies promise superior diagnostics. Microarray technology permits simultaneous measurement of multiple IgE reactivities regarding specificity, abundance, reactivity, or interaction. Improved functional tests might enable reliable estimation of the clinical relevance of IgE sensitizations at justifiable expenses.

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