A new framework for the interpretation of IgE sensitization tests

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Title: A new framework for the interpretation of IgE sensitization tests
Authors: Roberts, G
Ollert, M
Aalberse, R
Austin, M
Custovic, A
DunnGalvin, A
Eigenmann, PA
Fassio, F
Grattan, C
Hellings, P
Hourihane, J
Knol, E
Muraro, A
Papadopoulos, N
Santos, AF
Schnadt, S
Tzeli, K
Item Type: Journal Article
Abstract: IgE sensitization tests, such as skin prick testing and serum specific IgE, have been used to diagnose IgE-mediated clinical allergy for many years. Their prime drawback is that they detect sensitization which is only loosely related to clinical allergy. Many patients therefore require provocation tests to make a definitive diagnosis; these are often expensive and potentially associated with severe reactions. The likelihood of clinical allergy can be semi-quantified from an IgE sensitization test results. This relationship varies though according to the patients’ age, ethnicity, nature of the putative allergic reaction and co-existing clinical diseases such as eczema. The likelihood of clinical allergy can be more precisely estimated from an IgE sensitization test result, by taking into account the patient's presenting features (pre-test probability). The presence of each of these patient specific factors may mean that a patient is more or less likely to have clinically allergy with a given test result (post-test probability). We present two approaches to including pre-test probabilities in the interpretation of results. These approaches are currently limited by a lack of data to allow us to derive pre-test probabilities for diverse setting, regions and allergens. Also, co-factors, such as exercise, may be necessary for exposure to an allergen to result in an allergic reaction in specific IgE positive patients. The diagnosis of IgE-mediated allergy is now being aided by the introduction of allergen component testing which may identify clinically relevant sensitization. Other approaches are in development with basophil activation testing being closest to clinical application.
Issue Date: 15-Aug-2016
Date of Acceptance: 23-May-2016
URI: http://hdl.handle.net/10044/1/33194
DOI: https://dx.doi.org/10.1111/all.12939
ISSN: 1398-9995
Publisher: Wiley
Start Page: 1540
End Page: 1551
Journal / Book Title: Allergy
Volume: 71
Issue: 11
Copyright Statement: This is the peer reviewed version of the following article: Roberts G, Ollert M, Aalberse R, Austin M, Custovic A, DunnGalvin A, Eigenmann PA, Fassio F, Grattan C, Hellings P, Hourihane J, Knol E, Muraro A, Papadopoulos N, Santos AF, Schnadt S, Tzeli K. A new framework for the interpretation of IgE sensitization tests. Allergy 2016; 71: 1540–1551, which has been published in final form at https://dx.doi.org/10.1111/all.12939.  This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Keywords: IgE sensitization tests
clinical allergy
serum-specific IgE
skin prick testing
1107 Immunology
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine

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