Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic Review

In this systematic review, we have discussed the role of component-resolved diagnostics (CRD) in the diagnosis of immunoglobulin E (IgE)-mediated food allergies; IgE-mediated food allergies are adverse reactions to food caused by an immunologic mechanism involving specific IgE (sIgE) antibodies. Whi...

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Main Authors: Shambo S Samajdar, Shatavisa Mukherjee, Sourya Ghosh, Santanu Munshi, Santanu K Tripathi, Saibal Moitra, Pudupakkam Vedanthan
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2023-08-01
Series:Bengal Physician Journal
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Online Access:https://www.apibpj.com/doi/BPJ/pdf/10.5005/jp-journals-10070-8016
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author Shambo S Samajdar
Shatavisa Mukherjee
Sourya Ghosh
Santanu Munshi
Santanu K Tripathi
Saibal Moitra
Pudupakkam Vedanthan
author_facet Shambo S Samajdar
Shatavisa Mukherjee
Sourya Ghosh
Santanu Munshi
Santanu K Tripathi
Saibal Moitra
Pudupakkam Vedanthan
author_sort Shambo S Samajdar
collection DOAJ
description In this systematic review, we have discussed the role of component-resolved diagnostics (CRD) in the diagnosis of immunoglobulin E (IgE)-mediated food allergies; IgE-mediated food allergies are adverse reactions to food caused by an immunologic mechanism involving specific IgE (sIgE) antibodies. While self-reported food adverse reactions are common, the prevalence of confirmed food allergies through oral food challenge (OFC) is estimated to be around 1%. The conventional diagnostic process for food allergies involves clinical history, <italic>in vivo</italic> and/or <italic>in vitro</italic> tests, and OFC. However, many components used in these tests are irrelevant to the diagnostic process. Component-resolved diagnostics is a diagnostic technique that uses purified allergens to detect sIgE antibody responses against individual allergenic molecules. It aims to enhance the specificity of IgE testing and differentiate between genuine sensitization and cross-reactivity-induced sensitization. Component-resolved diagnostics also helps in stratifying the clinical risk associated with sensitization patterns and predicting OFC outcomes. However, CRD cannot replace the OFC as the gold standard due to insufficient sensitivity and specificity levels. Proper interpretation is crucial to avoid unnecessary elimination diets and auto-injector prescriptions that may impact patients’ quality of life. Component-resolved diagnostics plays a significant role in the diagnostic work-up of food allergies by identifying and characterizing allergenic compounds causing allergic responses. It enables differentiation between primary and secondary sensitization, predicts disease progression and clinical risk, and aids in stratifying OFC results. However, there are gaps in research and clinical practice. Commercial diagnostic tests are only available for a limited number of allergens, CRD is costly compared to other tests, and it lacks sufficient sensitivity and specificity to replace the OFC. Further research and initiatives are necessary to address these gaps and improve the use of CRD in food allergy diagnosis.
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spelling doaj-art-1110e09f50b044498e028ded5bdc46282025-08-20T02:27:50ZengJaypee Brothers Medical PublisherBengal Physician Journal2582-12022023-08-01102294210.5005/jp-journals-10070-80162Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic ReviewShambo S Samajdar0https://orcid.org/0000-0002-9199-0905Shatavisa Mukherjee1Sourya Ghosh2Santanu Munshi3Santanu K Tripathi4Saibal Moitra5Pudupakkam Vedanthan6Shambo S Samajdar, Allergy & Asthma Treatment Centre; Department of Clinical Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, India, Phone: + 91 9831892425Department of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, IndiaDepartment of Pharmacy, NSHM Knowledge Campus, Kolkata, West Bengal, IndiaDepartment of Clinical and Experimental Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, IndiaPrincipal & Department of Pharmacology, Netaji Subhas Medical College and Hospital, Patna, Bihar, IndiaDivision of Allergy and Immunology, Apollo Multispeciality Hospitals, Kolkata, West Bengal, IndiaDepartment of Medicine, University of Colorado at Anschutz Medical Campus City, Aurora, Colorado, United States of AmericaIn this systematic review, we have discussed the role of component-resolved diagnostics (CRD) in the diagnosis of immunoglobulin E (IgE)-mediated food allergies; IgE-mediated food allergies are adverse reactions to food caused by an immunologic mechanism involving specific IgE (sIgE) antibodies. While self-reported food adverse reactions are common, the prevalence of confirmed food allergies through oral food challenge (OFC) is estimated to be around 1%. The conventional diagnostic process for food allergies involves clinical history, <italic>in vivo</italic> and/or <italic>in vitro</italic> tests, and OFC. However, many components used in these tests are irrelevant to the diagnostic process. Component-resolved diagnostics is a diagnostic technique that uses purified allergens to detect sIgE antibody responses against individual allergenic molecules. It aims to enhance the specificity of IgE testing and differentiate between genuine sensitization and cross-reactivity-induced sensitization. Component-resolved diagnostics also helps in stratifying the clinical risk associated with sensitization patterns and predicting OFC outcomes. However, CRD cannot replace the OFC as the gold standard due to insufficient sensitivity and specificity levels. Proper interpretation is crucial to avoid unnecessary elimination diets and auto-injector prescriptions that may impact patients’ quality of life. Component-resolved diagnostics plays a significant role in the diagnostic work-up of food allergies by identifying and characterizing allergenic compounds causing allergic responses. It enables differentiation between primary and secondary sensitization, predicts disease progression and clinical risk, and aids in stratifying OFC results. However, there are gaps in research and clinical practice. Commercial diagnostic tests are only available for a limited number of allergens, CRD is costly compared to other tests, and it lacks sufficient sensitivity and specificity to replace the OFC. Further research and initiatives are necessary to address these gaps and improve the use of CRD in food allergy diagnosis.https://www.apibpj.com/doi/BPJ/pdf/10.5005/jp-journals-10070-8016component-resolved diagnostics; food allergysensitizationspecific immunoglobulin e
spellingShingle Shambo S Samajdar
Shatavisa Mukherjee
Sourya Ghosh
Santanu Munshi
Santanu K Tripathi
Saibal Moitra
Pudupakkam Vedanthan
Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic Review
Bengal Physician Journal
component-resolved diagnostics; food allergy
sensitization
specific immunoglobulin e
title Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic Review
title_full Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic Review
title_fullStr Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic Review
title_full_unstemmed Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic Review
title_short Component-resolved Diagnostics in Allergy Practice Focusing on Food Allergy: A Systematic Review
title_sort component resolved diagnostics in allergy practice focusing on food allergy a systematic review
topic component-resolved diagnostics; food allergy
sensitization
specific immunoglobulin e
url https://www.apibpj.com/doi/BPJ/pdf/10.5005/jp-journals-10070-8016
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