Molecular evolution in food allergy diagnosis

Traditional allergological diagnostics often provide laboratory data that seem to correspond with similar positive results in different patients. However, with technological developments and the introduction of molecular diagnostics, it is possible to extract and highlight the differences in the serological laboratory data, to obtain detailed specificity on the various allergen components in different clinical settings. Allergological diagnostics prove to be increasingly useful in accurately distinguishing "cross-reactivity" and "cosensitization". This aspect is very important especially in patients who are, with a traditional diagnosis, polysensitized. Molecular diagnosis in allergology has expanded its range of applications thanks to the ability to IgE dose specific (in addition to classic total IgE serum) not only to allergens, food and inhalants, but also to the individual protein components which make up the allergenic source. It is essential to establish a correct diagnosis in order to determine the appropriate therapy. Therefore it is crucial to discern whether a patient is truly allergic because he presents specific IgE for molecules of a species or if the positivity is given from the structural homology between the different proteins. Molecular diagnostics emerges as a valuable tool for the discrimination of allergic patients and to differentiate between "true allergies" and "cross-reactivity". Molecular diagnostics should be used in a targeted manner for an accurate assessment and diagnosis, which would also reduce the use of oral challenges, to predict severe reactions and allergy persistence.