Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Allergy and Asthma Reports
Erschienen in: Current Allergy and Asthma Reports 6/2015

01.06.2015 | Anaphylaxis and Drug Allergy (DA Khan and M Castells, Section Editors)

Utility of Component-Resolved Diagnostics in Food Allergy

verfasst von: Karen S. Tuano, Carla M. Davis

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Allergen component-resolved diagnostic testing (CRD) is a new methodology in clinical food allergy diagnosis, improving the ability to identify specific clinical phenotypes. Instead of relying on the crude allergen extracts used in standard allergy diagnostics, CRD utilizes purified or recombinant allergens for identification of specific molecules causing sensitization or allergy. This method is able to determine risk of the severity of allergic reactions in specific cases, like soy, peanut, and hazelnut allergy. The severity of allergic reaction can be predicted in peanut allergy with Ara h 2, and clinically relevant disease in pollen-allergic patients can be identified. However, age and geographic differences affect CRD results and it should always be utilized in the context of a clinical history. In the future, clinical phenotypes may be differentiated with larger prospective studies utilizing food challenges.
Literatur
1.
Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133:291–307.PubMedCrossRef
2.•
Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126:S1–58. These guidelines describe the current consensus in the United States for the diagnosis and management of food allergic disease and practical advice is contained in the guidelines.PubMedCentralPubMedCrossRef
3.
4.
Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunonol. 2001;107:891–6.CrossRef
5.
Roberts G, Lack G. Diagnosing peanut allergy with skin prick and specific IgE testing. J Allergy Clin Immunol. 2005;115:1291–6.PubMedCrossRef
6.••
Shreffler WG. Microarrayed recombinant allergens for diagnostic testing. J Allergy Clin Immunol. 2011;127:843–9. This review describes the strengths and weaknesses of molecularly defined allergy testing and the microarray platform.PubMedCrossRef
7.
Hamilton RG. Clinical laboratory assessment of immediate-type hypersensitivity. J Allergy Clin Immunol. 2010;125:S284–96.PubMedCrossRef
8.••
Canonica GW, Ansotegui IJ, Pawankar R, Schmid-Grendelmeier P, van Hage M, Baena-Cagnani, et al. A WAO–ARIA–GA2LEN consensus document on molecular-based allergy diagnostics. World Allergy Organ J. 2013;6:1–17. A WAO document that describes how molecular diagnostics can be interpreted and used for relevant information in the allergists office.CrossRef
9.
Amoah AS, Obeng BB, Larbi IA, Versteeg SA, Aryeetey Y, Akkerdaas JH, et al. Peanut-specific IgE antibodies in asymptomatic Ghanaian children possibly caused by carbohydrate determinant cross-reactivity. J Allergy Clin Immunol. 2013;132:639–47.PubMedCentralPubMedCrossRef
10.
Suratannon N, Ngamphaiboon J, Wongpiyabovorn J, Puripokai P, Chatchatee P. Component-resolved diagnostics for the evaluation of peanut allergy in a low-prevalence area. Pediatr Allergy Immunol. 2013;24:665–70.PubMedCrossRef
11.
Hochwallner H, Schulmeister U, Swoboda I, Balic N, Geller B, Nystrand M, et al. Microarray and allergenic activity assessment of milk allergens. Clin Exp Allergy. 2010;40:1809–18.PubMedCrossRef
12.
Bernard H, Créminon C, Yvon M, Wal JM. Specificity of the human IgE response to the different purified caseins in allergy to cow’s milk proteins. Int Arch Allergy Immunol. 1999;115:235–44.CrossRef
13.
D’Urbano LE, Pellegrino K, Artesani MC, Donnanno S, Luciano R, Riccardi C, et al. Performance of a component-based allergen-microarray in the diagnosis of cow’s milk and hen’s egg allergy. Clin Exp Allergy. 2010;40:1561–70.PubMedCrossRef
14.
Sicherer SH, Sampson HA. Cow’s milk protein-specific IgE concentrations in two age groups of milk-allergic children and in children achieving clinical tolerance. Clin Exp Allergy. 1999;29:507–12.PubMedCrossRef
15.
Chatchatee P, Järvinen KM, Bardina L, Vila L, Beyer K, Sampson HA. Identification of IgE and IgG binding epitopes on beta- and kappa-casein in cow’s milk allergic patients. Clin Exp Allergy. 2001;31:1256–62.PubMedCrossRef
16.
Järvinen KM, Beyer K, Vila L, Chatchatee P, Busse PJ, Sampson HA. B-cell epitopes as a screening instrument for persistent cow’s milk allergy. J Allergy Clin Immunol. 2002;110:293–7.PubMedCrossRef
17.
García-Ara MC, Boyano-Martínez MT, Díaz-Pena JM, Martín-Muñoz MF, Martín-Esteban M. Cow’s milk-specific immunoglobulin E levels as predictors of clinical reactivity in the follow-up of the cow’s milk allergy infants. Clin Exp Allergy. 2004;34:866–70.PubMedCrossRef
18.
Ott H, Baron JM, Heise R, Ocklenburg C, Stanzel S, Merk HF, et al. Clinical usefulness of microarray-based IgE detection in children with suspected food allergy. Allergy. 2008;63:1521–8.PubMedCrossRef
19.
Fung I, Kim JS, Spergel JM. Relating microarray component testing and reported food allergy and food-triggered atopic dermatitis: a real-world analysis. Ann Allergy Asthma Immunol. 2013;110:173–177.e1.PubMedCrossRef
20.••
Dang TD, Mills CE, Allen KJ. Determination of the clinical egg allergy phenotypes using component-resolved diagnostics. Pediatr Allergy Immunol 2014. A complete review of component resolved diagnostic testing in egg allergy.
21.
Rona RJ, Keil T, Summers C, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120:638–46.PubMedCrossRef
22.
Osborne NJ, Koplin JJ, Martin PE, et al. Prevalence of challenge-proven IgE mediated food allergy using population based sampling and predetermined challenge criteria in infants. J Allergy Clin Immunol. 2011;127:668–76.e2.PubMedCrossRef
23.
Venter C, Pereira B, Voigt K, et al. Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life. Allergy. 2008;63:354–9.
24.
Boyano-Martınez T, Garcıa-Ara C, Dıaz- Pena JM, Martın-Esteban M. Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy. J Allergy Clin Immunol. 2002;110:304–9.PubMedCrossRef
25.
Wood RA. The natural history of food allergy. Pediatrics. 2003;111:1631–7.PubMed
26.
Everberg H, Brostedt P, Oman H, Bohman S, Moverare R. Affinity purification of egg white allergens for improved component resolved diagnostics. Int Arch Allergy Immunol. 2011;154:33–41.PubMedCrossRef
27.
Cooke SK, Sampson HA. Allergenic properties of ovomucoid in man. J Immunol. 1997;159:2026–32.PubMed
28.
Holen E, Elsayed S. Characterization of four major allergens of hen egg-white by IEF/SDS-PAGE combined with electrophoretic transfer and IgE-immunoautoradiography. Int Arch Allergy Immunol. 1990;91:136–41.CrossRef
29.
Lemon-Mule H, Sampson HA, Sicherer SH, Shreffler WG, Noone S, Nowak-Wegrzyn A. Immunologic changes in children with egg allergy ingesting extensively heated egg. J Allergy Clin Immunol. 2008;122:977–83.e1.PubMedCrossRef
30.
Bartnikas LM, Sheehan WJ, Larabee KS, Petty C, Schneider LC, Phipatanakul W. Ovomucoid is not superior to egg white testing in predicting tolerance to baked egg. J Allergy Clin Immunol. 2013;1:354–60.e2.CrossRef
31.
Ando H, Moverare R, Kondo Y, et al. Utility of ovomucoid-specific IgE concentrations in predicting symptomatic egg allergy. J Allergy Clin Immunol. 2008;122:583–8.PubMedCrossRef
32.
Haneda Y, Kando N, Yasui M, et al. Ovomucoids IgE is a better marker than egg white-specific IgE to diagnose boiled egg allergy. J Allergy Clin Immunol. 2012;129:1681–2.PubMedCrossRef
33.••
Sicherer SH, Wood RA. Advances in diagnosing peanut allergy. J Allergy Clin Immunol: Pract. 2013;1:1–13. A practical guide in diagnosing peanut allergy in the office.CrossRef
34.
Arbes SJ Ur, Gergen PJ, Elliott L, Zeldin DC. Prevalence of positive skin test responses to 10 common allergens in the US population: results from the third National Health and Nutrition Examination Survey.
35.
Liu AH, Jaramillo R, Sicherer SH, Wood RA, Bock SA, Burks AW, et al. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005–2006. J Allergy Clin Immunol. 2010;126:798–806.PubMedCentralPubMedCrossRef
36.
Nicolaou N, Poorafshar M, Murray C, Simpson A, Winell H, Kerry G, et al. Allergy or tolerance in children sensitized to peanut: prevalence and differentiation using component-resolved diagnostics. J Allergy Clin Immunol. 2010;125:191–7.PubMedCrossRef
37.
Nicolaou N, Murray C, Belgrave D, Poporafshar M, Simpson A, Custovic A. Quantification of specific IgE to whole peanut extract and peanut components in prediction of peanut allergy. J Allergy Clin Immunol. 2011;127:684–5.PubMedCrossRef
38.
Dang TC, Tang M, Choo S, Licciardi PV, Koplin JJ, Martin PE, et al. Increasing the accuracy of peanut allergy diagnosis by using Ara h 2. J Allergy Clin Immunol. 2012;129:1056–63.PubMedCrossRef
39.•
Lieberman JA, Glaumann S, Batelson S, Borres MP, Sampson HA, Nilsson C. The utility of peanut components in the diagnosis of IgE-mediated peanut allergy among distinct populations. J Allergy Clin Immunol: Pract. 2013;1:75–82. This study gives a stepwise approach to testing may provide clinicians with a way to minimize the need for peanut challenges.CrossRef
40.•
Beyer K, Grabenhenrich L, Beder A, Kalb B, Ziegert M, Finger A, et al. Predictive values of component-specific IgE for the outcome of peanut and hazelnut food challenges in children. Allergy. 2015;70:90–8. This is the first study to determine receiver operating characteristic curves predicting positive challenge outcome for peanut (Ara h 1,2,3 and 8) and hazelnut (Cor a 1,8,9,and 14).PubMedCrossRef
41.
Klemans RJB, Liu X, Knulst AC, Knol MJ, Gmelig-Meyling F, Borst E, et al. IgE binding to peanut components by four different techniques: Ara h 2 is the most relevant in peanut allergic children and adults. Clin Exp Allergy. 2013;43:967–74.PubMedCrossRef
42.
Keet CA, Johnson K, Savage JH, Hamilton RG, Wood RA. Evaluation of Ara h 2 IgE thresholds in the diagnosis of peanut allergy in a clinical population. J Allergy Clin Immunol Pract. 2013;1:101–3.PubMedCentralPubMedCrossRef
43.•
Klemans RJ, van Os-Medendorp H, Blankestijn M, Bruijnzeel-Koomen CA, Knol EF, Knulst AC. Diagnostic accuracy of specific IgE to components in diagnosing peanut allergy: a systematic review. Clin Exp Allergy. 2014. A systematic review summarizing recent literature to assess the diagnostic value of sIgE to peanut components in diagnosing peanut allergy.
44.
Ebisawa M, Movérare R, Sato S, Maruyama N, Borres MP, Komata T. Measurement of Ara h 1-, 2-, and 3-specific IgE antibodies is useful in diagnosis of peanut allergy in Japanese children. Pediatr Allergy Immunol. 2012;23:573–81.PubMedCrossRef
45.
Eller E, Bindslev-Jensen C. Clinical value of component-resolved diagnostics in peanut-allergic patients. Allergy. 2013;68:190–4.PubMedCrossRef
46.
Glaumann S, Nopp A, Johansson SG, Rudengren M, Borres MP, Nilsson C. Basophil allergen threshold sensitivity, CD-sens, IgE-sensitization and DBPCFC in peanut-sensitized children. Allergy. 2012;67:242–7.PubMedCrossRef
47.
Bernard H, Paty E, Mondoulet L, Burks AW, Bannon GA, Wal JM, et al. Serological characteristics of peanut allergy in children. Allergy. 2003;58:1285–92.PubMedCrossRef
48.
de Oliveira LC L, Aderhold M, Brill M, Schulz G, Rolinck-Werninghaus C, Clare Mills EN, et al. The value of specific IgE to peanut and its component Ara h 2 in the diagnosis of peanut allergy. J Allergy Clin Immunol Pract. 2013;1:394–8.CrossRef
49.
Asarnoj A, Nilsson C, Lidholm J, Glaumann S, Ostblom E, Hedlin G, et al. Peanut component Ara h8 sensitization and tolerance to peanut. J Allergy Clin Immunol. 2012;130:468–72.PubMedCrossRef
50.
Ebo DG, Bridts CH, Verweij MM, De Knop KJ, Hagendorens MM, De Clerck LS, et al. Sensitization profiles in birch pollen-allergic patients with and without oral allergy syndrome to apple: lessons from multiplexed component-resolved allergy diagnosis. Clin Exp Allergy. 2010;6:339–47.CrossRef
51.
Nicolaou N, Custovic A. Molecular diagnosis of peanut and legume allergy. Curr Opin Allergy Clin Immunol. 2011;6:222–8.CrossRef
52.
Glaumann S, Nopp A, Johansson SG, Rudengren M, Borres MP, Nilsson C. Basophil allergen threshold sensitivity, CD-sens, IgE-sensitization and DBPCFC in peanut-sensitized children. Allergy. 2012;6:242–7.CrossRef
53.
Sastre J. Molecular diagnosis in allergy. Clin Exp Allergy. 2010;6:1442–60.CrossRef
54.
Movérare R, Ahlstedt S, Bengtsson U, Borres MP, van Hage M, Poorafshar M, et al. Evaluation of IgE antibodies to recombinant peanut allergens in patients with reported reactions to peanut. Int Arch Allergy Immunol. 2011;156:282–90.PubMedCrossRef
55.
Tolkki L, Alanko K, Petman L, Skydtsgaard MB, Milvang PG, Seppälä U, et al. Clinical characterization and IgE profiling of birch (Betula verrucosa)-allergic individuals suffering from allergic reactions to raw fruits and vegetables. J Allergy Clin Immunol Pract. 2013;1:623–31.PubMedCrossRef
56.
De Knop KJ, Verweij MM, Grimmelikhuijsen M, Philipse E, Hagendorens MM, Bridts C, et al. Age-related sensitization profiles for hazelnut (Corylus avellana) in a birch-endemic region. Pediatr Allergy Immunol. 2011;22:e139–49.PubMedCrossRef
57.
Masthoff LJN, Mattsson L, Zuidmeer-Jongejan L, Lidholm J, Andersson K, Akkerdaas JH, et al. Sensitization to Cor a 9 and Cor a 14 is highly specific for hazelnut allergy with objective symptoms in Dutch children and adults. J Allergy Clin Immunol. 2013;132:393–9.PubMedCrossRef
58.
Hansen KS, Ballmer-Weber BK, Sastre J, Lidholm J, Andersson K, Oberhofer H, et al. Component-resolved in vitro diagnosis of hazelnut allergy in Europe. J Allergy Clin Immunol. 2009;123:1134–41.PubMedCrossRef
59.
Kattan JD, Sicherer SH, Sampson HA. Clinical reactivity to hazelnut may be better identified by component testing than traditional testing methods. J Allergy Clin Immunol Pract. 2014;2:633–4.PubMedCrossRef
60.
Faber MA, De Graag M, Van Der Heijden C, Sabato V, Hagendorens MM, Bridts CH, et al. Cor a 14: missing link in the molecular diagnosis of hazelnut allergy? Int Arch Allergy Immunol. 2014;164:200–6.PubMedCrossRef
61.
Masthoff LJ, Pasmans SG, van Hoffen E, Knol MJ, Bruijnzeel-Koomen CA, Flinterman AE, et al. Diagnostic value of hazelnut allergy tests including rCor a 1 spiking in double-blind challenged children. Allergy. 2012;67:521–7.PubMedCrossRef
62.••
Leung NYH, Wai CYY, Shu S, Wang J, Kenny TP, Chu KH, et al. Current immunological and molecular biological perspectives on seafood allergy: a comprehensive review. Clinic Rev Allerg Immunol. 2014;46:180–97. A review of the molecular identification of seafood allergens, allergenic epitopes, cross reactivity and factors affecting allergenicity of seafood.CrossRef
63.
Reese G, Schicktanz S, Lauer I, Randow S, Lüttkopf D, Vogel L, et al. Structural, immunological and functional properties of natural recombinant Pen a 1, the major allergen of brown shrimp, Penaeus aztecus. Clin Exp Allergy. 2006;36:517–24.PubMedCrossRef
64.
Villalta D, Tonutti E, Visentini D, Bizzaro N, Roncarolo D, Amato S, et al. Detection of a novel 20 kDa shrimp allergen showing cross-reactivity to house dust mites. Eur Ann Allergy Clin Immunol. 2010;42:20–4.
65.
Gamez C, Sanchez-Garcia S, Ibanez MD, Lopez R, Aguado E, Lopez E, et al. Tropomyosin IgE-positive results are a good predictor of shrimp allergy. Allergy. 2011;66:1375–83.PubMedCrossRef
66.
Yang AC, Arruda K, Santos ABR, Barbosa MCR, Chapman MD, Galvao CES, et al. Measurement of IgE antibodies to shrimp tropomyosin is superior to skin prick testing with commercial extract and measurement of IgE to shrimp for predicting clinically relevant allergic reactions after shrimp ingestion. J Allergy Clin Immunol. 2010;125:872–8.PubMedCrossRef
67.
Holzhauser T, Wackermann O, Ballmer-Weber BK, Bindslev-Jensen C, Scibilia J, Perono-Garoffo L, et al. Soybean (Glycine max) allergy in Europe: Gly m 5 (B-conglycinin) and Gly m 6 (glycinin) are potential diagnostic markers for severe allergic reactions to soy. J Allergy Clin Immunol. 2009;123:452–8.PubMedCrossRef
68.
Ito K, Sjolander S, Sato S, Moverare R, Tanaka A, Soderstrom L, et. al. IgE to Gly m 5 and Gly m 6 is associated with severe allergic reactions to soybean in Japanese children.
69.
Vissers YM, Jansen APH, Ruinemans-Koerts, Wichers HJ, Savelkoul HFJ. IgE component-resolved allergen profile and clinical symptoms in soy and peanut allergic patients. Allergy. 2011;66:1125–6.PubMedCrossRef
70.
Berneder M, Bublin M, Hoffman-Sommergruber K, Hawranek T, Lang R. Allergen chip diagnosis for soy-allergic patients: Gly m 4 as a marker for severe food-allergic reactions to soy. Int Arch Allergy Immunol. 2013;161:229–33.PubMedCrossRef
71.
Kosma P, Sjolander S, Landgren E, Borres MP, Hedlin G. Severe reactions after the intake of soy drink in birch pollen-allergic children sensitized to Gly m 4. Acta Paediatr. 2011;6:305–6.CrossRef
Metadaten
Titel
Utility of Component-Resolved Diagnostics in Food Allergy
verfasst von
Karen S. Tuano
Carla M. Davis
Publikationsdatum
01.06.2015
Verlag
Springer US
Erschienen in
Current Allergy and Asthma Reports / Ausgabe 6/2015
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-015-0534-0

Weitere Artikel der Ausgabe 6/2015

Current Allergy and Asthma Reports 6/2015 Zur Ausgabe

Food Allergy (T Green, Section Editor)

Review of Environmental Impact on the Epigenetic Regulation of Atopic Diseases

Rhinosinusitis (J Mullol, Section Editor)

Remodeling and Repair in Rhinosinusitis

Asthma (WJ Calhoun and S Peters, Section Editors)

The Complex Type 2 Endotype in Allergy and Asthma: From Laboratory to Bedside

Immunotherapy and Immunomodulators (B Vickery, Section Editor)

An Examination of Clinical and Immunologic Outcomes in Food Allergen Immunotherapy by Route of Administration

Allergic Skin Diseases (L Fonacier, Section Editor)

The Other Itch That Rashes: a Clinical and Therapeutic Approach to Pruritus and Skin Picking Disorders

Allergic Skin Diseases (L Fonacier, Section Editor)

Urticaria Guidelines: Consensus and Controversies in the European and American Guidelines

Neu im Fachgebiet HNO

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Eingreifen von Umstehenden rettet vor Erstickungstod

15.05.2024 Fremdkörperaspiration Nachrichten

Wer sich an einem Essensrest verschluckt und um Luft ringt, benötigt vor allem rasche Hilfe. Dass Umstehende nur in jedem zweiten Erstickungsnotfall bereit waren, diese zu leisten, ist das ernüchternde Ergebnis einer Beobachtungsstudie aus Japan. Doch es gibt auch eine gute Nachricht.

Real-World-Daten sprechen eher für Dupilumab als für Op.

14.05.2024 Rhinosinusitis Nachrichten

Zur Behandlung schwerer Formen der chronischen Rhinosinusitis mit Nasenpolypen (CRSwNP) stehen seit Kurzem verschiedene Behandlungsmethoden zur Verfügung, darunter Biologika, wie Dupilumab, und die endoskopische Sinuschirurgie (ESS). Beim Vergleich der beiden Therapieoptionen war Dupilumab leicht im Vorteil.

Schwindelursache: Massagepistole lässt Otholiten tanzen

14.05.2024 Benigner Lagerungsschwindel Nachrichten

Wenn jüngere Menschen über ständig rezidivierenden Lagerungsschwindel klagen, könnte eine Massagepistole der Auslöser sein. In JAMA Otolaryngology warnt ein Team vor der Anwendung hochpotenter Geräte im Bereich des Nackens.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen
Bildnachweise