Allergy Work-Up Including Component-Resolved Diagnosis : How to Make Allergen-Specific Immunotherapy More Specific - 27/11/15

Doi : 10.1016/j.iac.2015.08.012

Jörg Kleine-Tebbe, MD ^a,^⁎ , Paolo M. Matricardi, MD ^b, Robert G. Hamilton, PhD, D.ABMLI ^c
^a Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Ackermann & Kleine-Tebbe, Spandauer Damm 130, Haus 9, Berlin D-14050, Germany
^b AG Molecular Allergology and Immunomodulation, Department of Pediatric Pneumology and Immunology, Charité Medical University, Augustenburger Platz 1, Berlin D-13353, Germany
^c Johns Hopkins Dermatology, Allergy and Clinical Immunology Reference Laboratory, Johns Hopkins Asthma and Allergy Center, Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Room 1A20, Baltimore, MD 21224, USA

^∗Corresponding author.

Résumé

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.

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