Immunological methods for diagnosis and monitoring of IgE-mediated allergy caused by industrial sensitizing agents (IMExAllergy)
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Immunological methods for diagnosis and monitoring of IgE-mediated allergy caused by industrial sensitizing agents (IMExAllergy). / Baur, Xaver; Akdis, Cezmi A; Budnik, Lygia Therese; Cruz, Maria Jesus; Fischer, Axel; Förster-Ruhrmann, Ulrike; Göen, Thomas; Goksel, Ozlem; Heutelbeck, Astrid R; Jones, Meinir; Lux, Harald; Maestrelli, Piero; Munoz, Xavier; Nemery, Benoit; Schlünssen, Vivi; Sigsgaard, Torben; Traidl-Hoffmann, Claudia; Siegel, Paul.
in: ALLERGY, Jahrgang 74, Nr. 10, 10.2019, S. 1885-1897.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Immunological methods for diagnosis and monitoring of IgE-mediated allergy caused by industrial sensitizing agents (IMExAllergy)
AU - Baur, Xaver
AU - Akdis, Cezmi A
AU - Budnik, Lygia Therese
AU - Cruz, Maria Jesus
AU - Fischer, Axel
AU - Förster-Ruhrmann, Ulrike
AU - Göen, Thomas
AU - Goksel, Ozlem
AU - Heutelbeck, Astrid R
AU - Jones, Meinir
AU - Lux, Harald
AU - Maestrelli, Piero
AU - Munoz, Xavier
AU - Nemery, Benoit
AU - Schlünssen, Vivi
AU - Sigsgaard, Torben
AU - Traidl-Hoffmann, Claudia
AU - Siegel, Paul
N1 - This article is protected by copyright. All rights reserved.
PY - 2019/10
Y1 - 2019/10
N2 - Industrial sensitizing agents (allergens) in living and working environments play an important role in eliciting type 1 allergic disorders including asthma and allergic rhinitis. Successful management of allergic diseases necessitates identifying their specific causes (ie, identify the causative agent(s) and the route of contact to allergen: airborne, or skin contact) to avoid further exposure. Identification of sensitization by a sensitive and validated measurement of specific IgE is an important step in the diagnosis. However, only a limited number of environmental and occupational allergens are available on the market for use in sIgE testing. Accordingly, specific in-house testing by individual diagnostic and laboratory centers is often required. Currently, different immunological tests are in use at various diagnostic centers that often produce considerably divergent results, mostly due to lack of standardized allergen preparation and standardized procedures as well as inadequate quality control. Our review and meta-analysis exhibited satisfactory performance of sIgE detection test for most high molecular weight (HMW) allergens with a pooled sensitivity of 0.74 and specificity of 0.71. However, for low molecular weight (LMW) allergens, pooled sensitivity is generally lower (0.28) and specificity higher (0.89) than for HMW tests. Major recommendations based on the presented data include diagnostic use of sIgE to HMW allergens. A negative sIgE result for LMW agents does not exclude sensitization. In addition, the requirements for full transparency of the content of allergen preparations with details on standardization and quality control are underlined. Development of standard operating procedures for in-house sIgE assays, and clinical validation, centralized quality control and audits are emphasized. There is also a need for specialized laboratories to provide a custom service for the development of tests for the measurement of putative novel occupational allergens that are not commercially available.
AB - Industrial sensitizing agents (allergens) in living and working environments play an important role in eliciting type 1 allergic disorders including asthma and allergic rhinitis. Successful management of allergic diseases necessitates identifying their specific causes (ie, identify the causative agent(s) and the route of contact to allergen: airborne, or skin contact) to avoid further exposure. Identification of sensitization by a sensitive and validated measurement of specific IgE is an important step in the diagnosis. However, only a limited number of environmental and occupational allergens are available on the market for use in sIgE testing. Accordingly, specific in-house testing by individual diagnostic and laboratory centers is often required. Currently, different immunological tests are in use at various diagnostic centers that often produce considerably divergent results, mostly due to lack of standardized allergen preparation and standardized procedures as well as inadequate quality control. Our review and meta-analysis exhibited satisfactory performance of sIgE detection test for most high molecular weight (HMW) allergens with a pooled sensitivity of 0.74 and specificity of 0.71. However, for low molecular weight (LMW) allergens, pooled sensitivity is generally lower (0.28) and specificity higher (0.89) than for HMW tests. Major recommendations based on the presented data include diagnostic use of sIgE to HMW allergens. A negative sIgE result for LMW agents does not exclude sensitization. In addition, the requirements for full transparency of the content of allergen preparations with details on standardization and quality control are underlined. Development of standard operating procedures for in-house sIgE assays, and clinical validation, centralized quality control and audits are emphasized. There is also a need for specialized laboratories to provide a custom service for the development of tests for the measurement of putative novel occupational allergens that are not commercially available.
KW - Journal Article
KW - Review
U2 - 10.1111/all.13809
DO - 10.1111/all.13809
M3 - SCORING: Review article
C2 - 30953599
VL - 74
SP - 1885
EP - 1897
JO - ALLERGY
JF - ALLERGY
SN - 0105-4538
IS - 10
ER -