Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Larenas-Linnemann, Desiree UNSPECIFIED UNSPECIFIED UNSPECIFIED Luna-Pech, Jorge A. UNSPECIFIED orcid.org/0000-0001-6278-964X UNSPECIFIED Mosges, Ralph UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language MICROARRAY; IMMUNOTHERAPY; EFFICACY; CHILDREN; VACCINE; ISAC Multiple languages Allergy; Immunology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21758