Current issues relating to in vitro testing for allergen-specific IgE: a workshop repotr

Annals of Allergy, Asthma, and Immunology; May 1999

Purpose of Workshop
To discuss the current status of in vitro testing for allergen-specific IgE and to examine various applications of this technology in routine clinical practice. Workshop panelists consisted of a distinguished group of physicians and scientists and known thought leaders in the areas of allergy and immunology. Combined, this auspicious group has published 792 articles in this field.

Use of IgE in Clinical Practice

• Patient history is not enough for specific allergen identification, which is necessary for appropriate treatment.

• Well standardized in vitro tests are an alternative to skin testing and there are special situations where in vitro testing may be preferable or specifically indicated.

• Every physician who is seeing a suspected allergic patient should consider testing for allergen specific IgE to identify the specific cause.

• In vitro testing by generalist physicians (family practitioners, internists, pediatricians) is appropriate to effectively manage and properly refer patients. They suggest initial screening with a basic panel based on patient history.

In vitro (Blood) Testing vs. Skin Testing

• NIH guidelines for asthma recommend either in vivo or in vitro to identify specific allergen sensitivities.

• "Compared with skin testing, in vitro testing may be easier to standardize and performance characteristics can be defined."

Comparison of in vitro Technology

• Results from proficiency testing surveys suggest that not all in vitro tests for IgE perform equally well; further, they acknowledged that
  in vitro technology has significantly advanced since its inception.

• Specific IgE Assay Calibrators should be standardized against the WHO Reference Preparation for IgE for true quantitative results.

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