Abstract
The diagnosis of allergic diseases is based on a combination of clinical history, physical examination, in vivo challenges, and in vitro test methods for the detection of allergen-specific IgE antibodies in the serum of patients. In spite of the fact that the determination of allergen-specific IgE in serum is widely used in daily clinical practice, one should be aware that such determinations, although useful for routine screening of possible allergies, are not sufficient to diagnose the disease. Clinical history and provocation tests should always be considered to confirm an allergy indicated by elevated allergen-specific IgE levels in serum. This specially applies to the diagnosis of mould allergy in general, and of Aspergillus fumigatus-related allergic complications in particular.
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References
Bostock, J. (1960) Case of a periodical affection of the eyes and chest. Ann Allergy, 18, 894–5.
Blackley, C. H. (1873) Experimental Researches on the Causes and Nature of Catarrhus Aestivus (Hay-Fever or Hay-Asthma), London, UK, Bailliere Tindall & Cox.
Von Pirquet, C. (1906) Allergie. Muenchener Medizinische Wochenschrift, 53, 1457–8.
Prausnitz, C. & Küstner, H. (1921) Studien über die Überempfindlichkeit. Zentralblatt für Bakteriologie, 86, 160–9.
Johansson, S. G. & Bennich, H. (1967) Immunological studies of an atypical (myeloma) immunoglobulin. Immunology, 13, 381–94.
Ishizaka, K., Ishizaka, T. & Terry, W. D. (1967) Antigenic structure of gamma-E-globulin and reaginic antibody. J Immunol, 99, 849–58.
Geisberger, R., Crameri, R. & Achatz, G. (2003) Models of signal transduction through the B-cell antigen receptor. Immunology, 110, 401–10.
Sutton, B. J. & Gould, H. J. (1993) The human IgE network. Nature, 366, 421–8.
Dolen, W. K. (2003) IgE antibody in the serum–detection and diagnostic significance. Allergy, 58, 717–23.
Wan, T., Beavil, R. L., Fabiane, S. M., Beavil, A. J., Sohi, M. K., Keown, M., Young, R. J., Henry, A. J., Owens, R. J., Gould, H. J. & Sutton, B. J. (2002) The crystal structure of IgE Fc reveals an asymmetrically bent conformation. Nat Immunol, 3, 681–6.
Wide, L., Bennich, H. & Johansson, S. G. (1967) Diagnosis of allergy by an in-vitro test for allergen antibodies. Lancet, 2, 1105–7.
Plebani, M. (2003) Clinical value and measurement of specific IgE. Clin Biochem, 36, 453–69.
Chandler, H. M., Coulter, A. R., Healey, K., Kornitschuk, M., Macgregor, A. & Hurrell, J. G. (1983) Monoclonal hybridoma antibodies against human IgE and their use in a rapid and sensitive enzyme immunoassay for the semiquantitative assessment of total IgE levels in human blood. Int Arch Allergy Appl Immunol, 72, 267–72.
Ewan, P. W. & Coote, D. (1990) Evaluation of a capsulated hydrophilic carrier polymer (the ImmunoCAP) for measurement of specific IgE antibodies. Allergy, 45, 22–9.
Lundin, P. (2006) Evaluation of technical performance of four immunoassay instruments for allergy testing: ImmunoCAP1000, ImmunoCAP 250, ADIVA Centaur, and Immulite 2000. Clin Chem, 52, 145.
Lanotto, O. & Lundin, P. (2007) Precision, accuracy and consistency make ImmunoCAP an outstanding technology for in vitro allergy testing. Clin Lab Int, 31, 28–9.
Stadler, M. B. & Stadler, B. M. (2003) Allergenicity prediction by protein sequence. FASEB J, 17, 1141–3.
Van Ree, R., Van Leeuwen, W. A. & Aalberse, R. C. (1998) How far can we simplify in vitro diagnostics for grass pollen allergy? A study with 17 whole pollen extract and purified natural and recombinant major allergens. J Allergy Clin Immunol, 102, 184–90.
Larsen, J. N., Houghton, C. G., Lowenstein, H. & Lombardero, M. (2004) Manufacturing and standardizing allergen extracts in Europe. Clin Allergy Immunol, 18, 433–55.
http://WWW.WHO.INT/BIOLOGICALS. January 18th, 2009.
Van Ree, R. (2004) The CREATE project: EU support for the improvement of allergen standardization in Europe. Allergy, 59, 571–4.
Kauffman, H. F., Van Der Heide, S., Van Der Laan, S., Hovenga, H., Beaumont, F. & De Vries, K. (1985) Standardization of allergenic extracts of Aspergillus fumigatus. Liberation of IgE-binding components during cultivation. Int Arch Allergy Appl Immunol, 76, 168–73.
Agarwal, M. K., Jones, R. T. & Yunginger, J. W. (1982) Immunochemical and physicochemical characterization of commercial Alternaria extracts: a model for standardization of mold allergen extracts. J Allergy Clin Immunol, 70, 432–6.
Vailes, L., Sridhara, S., Cromwell, O., Weber, B., Breitenbach, M. & Chapman, M. (2001) Quantitation of the major fungal allergens, Alt a 1 and Asp f 1, in commercial allergenic products. J Allergy Clin Immunol, 107, 641–6.
Nikolaizik, W. H., Crameri, R., Blaser, K. & Schoni, M. H. (1996) Skin test reactivity to recombinant Aspergillus fumigatus allergen I/a in patients with cystic fibrosis. Int Arch Allergy Immunol, 111, 403–8.
Ricci, G., Capelli, M., Miniero, R., Menna, G., Zannarini, L., Dillon, P. & Masi, M. (2003) A comparison of different allergometric tests, skin prick test, Pharmacia UniCAP and ADVIA Centaur, for diagnosis of allergic diseases in children. Allergy, 58, 38–45.
Ollert, M., Weissenbacher, S., Rakoski, J. & Ring, J. (2005) Allergen-specific IgE measured by a continuous random-access immunoanalyzer: interassay comparison and agreement with skin testing. Clin Chem, 51, 1241–9.
Cobbaert, C. M. & Jonker, G. J. (2005) Allergy testing on the IMMULITE 2000 Random-Access immunoanalyzer – a clinical evaluation study. Clin Chem Lab Med, 43, 772–81.
Mari, A., Schneider, P., Wally, V., Breitenbach, M. & Simon-Nobbe, B. (2003) Sensitization to fungi: epidemiology, comparative skin tests, and IgE reactivity of fungal extracts. Clin Exp Allergy, 33, 1429–38.
Kerkhof, M., Schouten, J. P. & De Monchy, J. G. (2000) The association of sensitization to inhalant allergens with allergy symptoms: the influence of bronchial hyperresponsiveness and blood eosinophil count. Clin Exp Allergy, 30, 1387–94.
Bousquet, J., Anto, J. M., Bachert, C., Bousquet, P. J., Colombo, P., Crameri, R., Daeron, M., Fokkens, W., Leynaert, B., Lahoz, C., Maurer, M., Passalacqua, G., Valenta, R., Van Hage, M. & Van Ree, R. (2006) Factors responsible for differences between asymptomatic subjects and patients presenting an IgE sensitization to allergens. A GA2LEN project. Allergy, 61, 671–80.
Schmid-Grendelmeier, P. & Crameri, R. (2001) Recombinant allergens for skin testing. Int Arch Allergy Immunol, 125, 96–111.
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Work supported by the Swiss National Science Foundation Grants No. 31-310000-114634/1 and by the OPO-Foundation, Zürich.
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Crameri, R. (2009). Specific IgE Testing (RAST). In: Comarú Pasqualotto, A. (eds) Aspergillosis: From Diagnosis to Prevention. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-2408-4_11
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DOI: https://doi.org/10.1007/978-90-481-2408-4_11
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