In vitro testing for allergic and immunologic diseases.

Area of Science:

• Clinical immunology
• Allergy diagnostics

Background:

• In vitro tests are essential for diagnosing allergic and immunologic diseases.
• No single test is pathognomonic for most allergic conditions.
• Allergists commonly use allergen-specific IgE (sIgE) tests for IgE-mediated hypersensitivity.

Purpose of the Study:

• To review the utility of various in vitro and in vivo tests in diagnosing allergic diseases.
• To highlight the importance of laboratory testing in diagnosing primary immunodeficiency diseases.

Main Methods:

• Review of commonly employed in vitro diagnostic assays for allergic diseases, including allergen-specific IgE (sIgE).
• Discussion of complementary tests such as epicutaneous skin tests, total IgE, basophil activation tests (BAT), and serum tryptase.
• Overview of laboratory diagnostic approaches for primary immunodeficiencies, including serum immunoglobulins, lymphocyte immunophenotyping, functional assays, and genetic testing.

Main Results:

• Allergen-specific IgE (sIgE) assays are widely used but lack a standardized approach.
• Epicutaneous skin testing remains a fundamental diagnostic tool for IgE-mediated hypersensitivity.
• A panel of tests, including immunoglobulins, flow cytometry, and functional assays, is vital for diagnosing primary immunodeficiencies.

Conclusions:

• A combination of diagnostic tools is necessary for accurate allergy and immunodeficiency diagnosis.
• Further standardization of in vitro allergy assays could improve diagnostic consistency.
• Genetic testing plays an increasingly important role in diagnosing primary immunodeficiencies.