Molecular allergy diagnostic tests: development and relevance in clinical practice
J. Kleine-Tebbe1, U. Jappe2, 3
1 Allergie- und Asthma-Zentrum Westend, Praxis Hanf, Ackermann und Kleine-Tebbe, Berlin, 2 Forschungsgruppe Klinische und Molekulare Allergologie, Forschungszentrum Borstel, Deutsches Zentrum für Lungenforschung, 3 Klinik für Dermatologie, Allergologie und Venerologie, Universität zu Lübeck
DOI 10.5414/ALX01617E
Abstract
Molecular allergy is based on identification, characterization and subsequent use of single allergens, being components of complex allergen sources like pollen, mites, furred animals, foods or insect venoms. Only few protein families contain relevant allergens of similar sequence and structure, carrying common IgE epitopes as the basis of cross reactivity. Used as purified or recombinant (glyco)proteins single allergens can potentially improve in-vitro diagnostics, particularly allergen-specific IgE assays through a) increased sensitivity, b) use of risk and marker allergens, c) component-resolved diagnostics (CRD). CRD can differentiate primary, species-specific from secondary, cross-reactive sensitizations to single allergens. Allergen components facilitate an increased analytical sensitivity, particularly if they are underrepresented or missing in conventional allergen extracts. They are mainly used in single assays (singleplex) for the detection of IgE, but also in a microarray format (multiplex) with 112 components from 50 allergen sources with slightly decreased analytical sensitivity. Concepts of molecular allergy can only be separately defined and utilized for each allergen source (pollen, mites, foods or insect venoms). As soon as essential singe allergens are available, their specific role in diagnostics should be defined. This requires well characterized patient cohorts from various countries, since exposure, allergic immune response and clinical relevance can vary substantially between individual subjects and geographical regions. The patient’ clinical information is essential for proper interpretation of molecular allergology results. The history and/ or challenge test results will finally provide evidence, in how far a sensitization to single allergens might be clinically relevant or not.
Author Details
Authors
Departments
- 1 Allergie- und Asthma-Zentrum Westend, Praxis Hanf, Ackermann und Kleine-Tebbe, Berlin,
- 2 Forschungsgruppe Klinische und Molekulare Allergologie, Forschungszentrum Borstel, Deutsches Zentrum für Lungenforschung,
- 3 Klinik für Dermatologie, Allergologie und Venerologie, Universität zu Lübeck
Address
PD Dr. med. J. Kleine-Tebbe
Allergie- und Asthma-Zentrum Westend
Praxis Hanf, Ackermann & Kleine-Tebbe
Spandauer Damm 130, Haus 9
D-14050 Berlin
Email:
[email protected]
Citation
J. Kleine-Tebbe and U. Jappe.Molecular allergy diagnostic tests: development and relevance in clinical practice. 2017; 1: 169-189. doi: 10.5414/ALX01617E.