Mediators in allergy diagnosis
Staffan Ahlstedt
Allergy and Clinical Immunology International, Vol. 10, No. 2,
1998
Development of Allergic Disease—"Allergy March"
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The
development of allergic disease and allergic symptoms is
a genetically determined, dynamic process involving IgE antibody
formation, inflammatory reactions, and hyperresponsiveness to
different stimuli. These pathologies must be taken into consideration
for a correct diagnosis.
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Allergic disease and prevalence of allergic symptoms are
evolutionary, beginning in infancy and showing changing patterns
in relation to age - referred to as the "allergy
march."
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Presence of allergic disease may precede symptoms; therefore,
identifying the "allergy march" may be
useful in predicting or perhaps even reversing allergy or allergy-related
or allergy-complicated diseases.
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There may be clinical usefulness of diagnostic tests
in daily work for identifying the onset of allergic disease in
different age groups.
Determining Presence of Mediators in Allergy
Though there are a number of mediators in allergy, determination of specific
IgE antibodies is the most widely used diagnostic clinical routine.
In Vitro vs. In Vivo for Measuring IgE Antibodies
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Presence of IgE antibodies can be demonstrated with in vitro and
in vivo tests; however, to achieve accurate measurements,
all components in a test system have to be standardized separately,
as well as in combination, and be reproducible over time.
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Variation of allergen concentrations in skin test solutions,
as well as other factors, can shift results from more specific
and less sensitive to more sensitive and less specific.
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For practical, routine work, current in vitro immunoassay
systems may be the most convenient tools for determining IgE
antibodies because they are better standardized and may be more
useful for examining the "allergy march."
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Accurate and reproducible detection of specific IgE antibodies
by
in vitro testing with ImmunoCAP technology is demonstrated
to correspond better to clinical diagnosis by allergy specialists
than by
in vivo skin prick testing.
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