In vitro allergy testing.

Area of Science:

• Allergy diagnostics
• Immunology
• Clinical laboratory testing

Background:

• Initial allergy evaluation relies on patient history and physical examination.
• Diagnosis confirmation involves skin testing or serum testing for immunoglobulin E (IgE)-mediated reactivity.

Purpose of the Study:

• Review current literature on serum-based testing for allergen-specific IgE (sIgE).
• Identify best practices for sIgE testing based on high-evidence studies and guidelines.

Main Methods:

• Literature review of recent studies on serum-based allergy testing.
• Identification of best practices from physician organization guidelines and high-level evidence.

Main Results:

• Current practices include enzyme-linked immunoassays (ELISA) on extracts or microarrays.
• Testing methods involve purified or recombinant allergens and basophil activation tests.
• Serum testing effectively documents sIgE.

Conclusions:

• Serum testing is an equivalent alternative to skin testing for identifying IgE-mediated sensitivity and specific allergens.
• Limitations include extract availability for certain allergens (foods, drugs, occupational agents).
• Non-IgE mediated mechanisms are a consideration for both testing types.