Larenas-Linnemann, Desiree, Luna-Pech, Jorge A. ORCID: 0000-0001-6278-964X and Mosges, Ralph (2017). Debates in Allergy Medicine: Allergy skin testing cannot be replaced by molecular diagnosis in the near future. World Allergy Organ. J., 10. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 1939-4551

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Abstract

Percutaneous skin prick tests (SPT) have been considered the preferred method for confirming IgE-mediated sensitization. This reliable and minimally invasive technique correlates with in vivo challenges, has good reproducibility, is easily quantified, and allows analyzing multiple allergens simultaneously. Potent extracts and a proficient tester improve its accuracy. Molecular-based allergy diagnostics (MA-Dx) quantifies allergenic components obtained either from purification of natural sources or recombinant technology to identify the patient's reactivity to those specific allergenic protein components. For a correct allergy diagnosis, the patient selection is crucial. MA-Dx has been shown to have a high specificity, however, as MA-Dx testing can be ordered by any physician, the pre-selection of patients might not always be optimal, reducing test specificity. Also, MA-Dx is less sensitive than in vitro testing with the whole allergen or SPT. Secondly, no allergen-specific immunotherapy (AIT) trial has yet shown efficacy with patients selected on the basis of their MA-Dx results. Thirdly, why would we need molecular diagnosis, as no molecular treatment can yet be offered? Then there are the practical arguments of costs (SPT highly cost-efficient), test availability for MA-Dx still lacking in wide areas of the world and scarce in others. As such, it is hard physicians can build confidence in the test and their interpretation of the MA-Dx results. In conclusion: as of now these techniques should be reserved for situations of complex allergies and polysensitization; in the future MA-Dx might help to reduce the number of allergens for AIT, but trials are needed to prove this concept.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Larenas-Linnemann, DesireeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Luna-Pech, Jorge A.UNSPECIFIEDorcid.org/0000-0001-6278-964XUNSPECIFIED
Mosges, RalphUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-217584
DOI: 10.1186/s40413-017-0164-1
Journal or Publication Title: World Allergy Organ. J.
Volume: 10
Date: 2017
Publisher: ELSEVIER SCIENCE BV
Place of Publication: AMSTERDAM
ISSN: 1939-4551
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MICROARRAY; IMMUNOTHERAPY; EFFICACY; CHILDREN; VACCINE; ISACMultiple languages
Allergy; ImmunologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/21758

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