IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper

Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, c...

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Published in:	The World Allergy Organization journal Vol. 13; no. 2; p. 100080
Main Authors:	Ansotegui, Ignacio J., Melioli, Giovanni, Canonica, Giorgio Walter, Caraballo, Luis, Villa, Elisa, Ebisawa, Motohiro, Passalacqua, Giovanni, Savi, Eleonora, Ebo, Didier, Gómez, R. Maximiliano, Luengo Sánchez, Olga, Oppenheimer, John J., Jensen-Jarolim, Erika, Fischer, David A., Haahtela, Tari, Antila, Martti, Bousquet, Jean J., Cardona, Victoria, Chiang, Wen Chin, Demoly, Pascal M., DuBuske, Lawrence M., Ferrer Puga, Marta, Gerth van Wijk, Roy, González Díaz, Sandra Nora, Gonzalez-Estrada, Alexei, Jares, Edgardo, Kalpaklioğlu, Ayse Füsun, Kase Tanno, Luciana, Kowalski, Marek L., Ledford, Dennis K., Monge Ortega, Olga Patricia, Morais Almeida, Mário, Pfaar, Oliver, Poulsen, Lars K., Pawankar, Ruby, Renz, Harald E., Romano, Antonino G., Rosário Filho, Nelson A., Rosenwasser, Lanny, Sánchez Borges, Mario A., Scala, Enrico, Senna, Gian-Enrico, Sisul, Juan Carlos, Tang, Mimi L.K., Thong, Bernard Yu-Hor, Valenta, Rudolf, Wood, Robert A., Zuberbier, Torsten
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01.02.2020 Elsevier BV Elsevier World Allergy Organization
Subjects:	Allergens Allergies Allergy Anaphylaxis Chronic fatigue syndrome Diagnostic strategies Disease Food allergies IgE Immunotherapy In vitro tests Life Sciences Medical diagnosis Precision medicine Skin tests Urticaria Allergy Diagnostic strategies AU/mL Anti-IgE LAMP-3 SPT IDT NMBAs EIA AEC In vitro tests EAACI CaFE MRGPRX2 SCAR AIT AP IVD FEIA FcεRI AAAAI Skin tests DBPCFC NPA ELISA ABA PPA sIgE FDA CBA IgE HPO FACS CDER PPT NSAIDs MBAD w/v ENPP-3 BAU/mL EMEA CCD CL H1 H2 pNPP NIH ISAC mAb ACAAI IUIS BAT RAST kUA/L NMBAs, NeuroMuscular Blocking Agents EIA, Enzyme Immune Assay RAST, Radio Allergo Sorbent Test FEIA, Fluorescent Enzyme Immunoassays NSAIDs, Non-Steroidal Anti-Inflammatory Drugs NPA, Negative Percent Agreement H2, Histamine 2 receptor AEC, Allergen Exposure Chambers ELISA, Enzyme Linked Immuno Sorbent Analysis ENPP-3, EctoNucleotide Pyrophosphatase/Phosphodiesterase 3 DBPCFC, Double-Blind Placebo-Controlled Food Challenge mAb, Monoclonal Antibody FDA, Food and Drug Administration (U.S. Department of Health and Human Services) SCAR, severe cutaneous adverse drug reactions pNPP, p-Nitrophenylphosphate sIgE, specific IgE ABA, Allergen Bead Array ACAAI, American College of Allergy Asthma and Immunology FcεRI, High affinity IgE receptor CaFE, Calibrated Fluorescence Enhancement IDT, Intradermal Test ISAC, Immuno-Solid phase Allergen Chip MBAD, Molecule Based Allergy Diagnostics kUA/L, kilo Units of Allergen/Liter for allergen-specific IgE antibody assays BAU/mL, Biologic Allergenic Units milliLiter BAT, Basophil Activation Test LAMP-3, Lysosomal-Associated Membrane Protein CL, Chemiluminescence EAACI, European Academy of Allergy and Immunology IUIS, International Union of Immunological Societies CCD, Cross-reactive Carbohydrate Determinants NIH, National Institutes of Health (USA) HPO, Horseradish Peroxidase AAAAI, American Academy of Allergy Asthma and Immunology AU/mL, Allergenic Units milliLiter MRGPRX2, Mas-related G protein receptor 2 w/v, weight /volume FACS, Fluorescence-Activated Cell Sorting EMEA, European MEdicine Agencies IgE, immunoglobulin E PPT, Prick-Prick Test AIT, allergen immunotherapy H1, Histamine 1 receptor SPT, Skin prick test AP, Alkaline Phosphatase CDER, Center for Drug Evaluation and Research (USA) IVD, in vitro diagnostic tool CBA, Cytometric Bead Array Anti-IgE, Antibody against IgE PPA, Positive Percent Agreement In vitro tests
ISSN:	1939-4551, 1939-4551
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Summary:	Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 PMCID: PMC7044795 These authors equally contributed to this manuscript
ISSN:	1939-4551 1939-4551
DOI:	10.1016/j.waojou.2019.100080