Usefulness of specific IgE antibody tests: a progress report

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This article is from this month's Annals of Allergy, Asthma, & Immunology. Unfortunately you cannot access the journal without a subscription.

Allison

Usefulness of specific IgE antibody tests: a progress report [CME Review article] Williams, P Brock PhD

University of Missouri Medical School, Kansas City, Missouri, and University of Cincinnati Medical School, Cincinnati, Ohio. Supported by an unrestricted grant from AstraZeneca LP Received for publication February 10, 2003. Accepted for publication in revised form June 4, 2003. Requests for reprints should be addressed to: P. Brock Williams, PhD; 11840 Woodland Rd; Olathe, KS 66061; E-mail: [email]pbrockwil@aol.com[/email]

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Abstract Learning Objectives: To enable the readers to recognize some of the history, problems, progress, interpretation, and present status of assays for specific IgE (s-IgE) antibodies.

Data Sources: Peer-reviewed literature in the field.

Study Selection: Key articles were selected by the author.

Results: Clinical and analytical studies have differed widely in their conclusions as to the performance of tests for s-IgE. Study conclusions depend on the testing method used, the allergen(s) studied, patient selection, and, most importantly, the standards used for comparison. Today, only a handful of the once commercially developed assays still exist, and some of these still do not compare well to an analytical ideal standard. However, with the extent of regulation and economic pressures, most of the surviving s-IgE tests are considerably improved over what had existed before them.

Conclusions: Allergic diseases with multiple symptom patterns seem to be increasing in modern societies. Objective methods are needed to differentiate allergic origins from other mechanisms that cause similar symptoms. Accurate, quantitative, and objective methods for s-IgE measurement are now available and can be used effectively in clarifying allergic diagnoses when interpreted in conjunction with the clinical history.

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INTRODUCTION Largenumbers of anecdotal reports in the medical literature indicate that specific factors in the serum are largely responsible for allergic symptoms. This article aims to enable readers to recognize some of the history, problems, progress, interpretation, and present status of assays for specific IgE (s-IgE) antibodies. Key articles were selected from the peer-reviewed literature in the field. This article includes a short history of how and why s-IgE assays were developed, the origin and explanation of several controversies in this field, and where these tests stand today. In addition, a review and update of test result interpretation with an emphasis of the advantages of treating patients with allergic disease using quantitative s-IgE tests are included.

HISTORY History records a number of anecdotal reports that have reinforced the idea that specific factors in the serum are largely responsible for allergic symptoms, such as hay fever, asthma, and anaphylaxis. The classic Prausnitz-Kustner experiment (P-K reaction) and a series of follow-up experiments by De Besche in 1921 provided the first unequivocal proof of this. 1,2 The exact nature of this serum factor was elusive until the middle 1960s. At that time, a variety of studies had shown that the postulated

On Apr 5, 2004

Thank you.

On Apr 6, 2004

For those of you who do not want to read the entire article, the "Interpretation" section (about 2/3 of the way down) talks about what the numbers mean and about its application for diagnosing food allergies.

Allison

On Apr 6, 2004

Hi Allison,

Thanks for posting the article... I plan to read it soon... it looks interesting [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Apr 6, 2004

Allison, Thanks for posting! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Apr 8, 2004

>> ACKNOWLEDGMENTS Because of space limitations, all relevant studies in this field could not be cited. I apologize for any omissions. Comments regarding this article should be addressed to people with names such as Talmadge, Farr, Claman, DeWitt, Selner, Nelson, Sullivan, and Norman, whose addresses can be found in the list of great mentors.

I have one comment only...

Can those aforementioned people explain this to me, because trying to read this is giving me a throbbing headache. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Jason

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