Allergy Work-Up Including Component-Resolved Diagnosis: How to Make Allergen-Specific Immunotherapy More Specific

Immunol Allergy Clin North Am. 2016 Feb;36(1):191-203. doi: 10.1016/j.iac.2015.08.012.

Abstract

Symptoms are recorded by obtaining a clinical history. Allergen sensitization is demonstrated by skin prick test or allergen-specific IgE serology. IgE sensitizations to allergen sources can be identified knowing the relationship between major aeroallergens and homologous allergen families. Some develop allergic sensitization to pan-allergens. Allergen extracts do not allow definitive separation of the sources. IgE antibody analysis of the major allergenic molecules facilitates differentiation of sensitizing allergen sources. IgE sensitizations to inhalant allergens are only relevant in the case of corresponding symptoms. In questionable cases, conjunctival or nasal provocation tests help induce confirmatory symptoms and identify relevant allergens for immunotherapy.

Keywords: Allergen-specific immunotherapy; Allergy diagnosis; Component-resolved diagnosis; Major allergen; Polcalcin; Pollen pan-allergen; Profilin.

Publication types

  • Review

MeSH terms

  • Allergens / immunology*
  • Animals
  • Desensitization, Immunologic*
  • Humans
  • Hypersensitivity / diagnosis*
  • Hypersensitivity / immunology
  • Hypersensitivity / therapy
  • Immunoglobulin E / metabolism
  • Molecular Targeted Therapy
  • Pollen / immunology*
  • Profilins / immunology*

Substances

  • Allergens
  • Profilins
  • Immunoglobulin E