Overview of component resolved diagnostics

Component-resolved diagnostics (CRD) utilize purified native or recombinant allergens to detect IgE sensitivity to individual allergen molecules and have become of growing importance in clinical investigation of IgE-mediated allergies. This overview updates current developments of CRD, including multiarray test systems. Cross-reactions between allergens of known allergen families (i.e. to Bet v 1 homologues) are emphasised. In pollinosis as well as in allergy to hymenoptera venoms or to food, CRD allows to some extent discrimination between clinically significant and irrelevant sIgE results and the establishing of sensitisation patterns with particular prognostic outcomes (i.e. sensitisations to storage proteins which correlate with clinically severe reactions in peanut allergy). Further promising improvements in diagnostics are expected from additional, not yet commercially available, recombinant allergen diagnostics identifying particular molecules of risk. Overall, CRD may decrease the need for provocation testing and may also improve the specificity of allergen-specific immunotherapy.