In vitro clinical tests for the diagnosis of food allergy

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  • Kimura Mitsuaki
    Department of Allergy and Clinical Immunology, Shizuoka Children's Hospital

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  • 食物アレルギーのin vitro診断

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Abstract

Measurement of allergen-specific IgE antibody (sIgE) levels is commonly used for the clinical diagnosis of food allergies, and ImmunoCAP is the standard test used to measure sIgE level. sIgE has shown satisfactory accuracy for the diagnosis of hen's egg and cow's milk allergies. Recently, probability curves have been used for the management of children with these allergies. Although the diagnostic precision of sIgE for soy, wheat, or peanut allergies is insufficient, sIgE against purified component proteins of each food, such as Ara h2, may have better diagnostic value. AlaSTAT 3g Allergy, a relatively new method to measure sIgE levels, has been gaining attention. Although the diagnostic accuracy of AlaSTAT seems to be comparable to that of ImmunoCAP, the upper limit of the measurable range of AlaSTAT is higher than that of ImmunoCAP; therefore, it might be useful for the study and management of patients with extremely high sIgE levels. BAT and HRT use basophils to examine IgE-mediated hypersensitivity reactions against foods. The diagnostic accuracy of these tests seems to be comparable to that of ImmunoCAP. Because the individual property of basophils is reflexed in the results of the BAT and HRT, these tests could be used for the diagnosis of patients who are not accurately diagnosed using sIgE. ALST is useful for the diagnosis of gastrointestinal food allergy in neonates and infants, which is a well-known cell-mediated food allergy. Because ALST is performed by a major clinical examination company, the same test and cut off level can be used for diagnosis throughout the country. DLST is not suitable for the diagnosis of cell-mediated food allergy.

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