Immunological methods for diagnosis and monitoring of IgE-mediated allergy caused by industrial sensitizing agents (IMExAllergy)

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

DOI

  • Xaver Baur, European Society for Environmental and Occupational Medicine
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  • Cezmi A. Akdis, Swiss Institute of Allergy and Asthma Research
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  • Lygia Therese Budnik, University Medical Center Hamburg-Eppendorf
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  • Maria Jesus Cruz, Autonomous University of Barcelona
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  • Axel Fischer, Charité – Universitätsmedizin Berlin
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  • Ulrike Förster-Ruhrmann, Charité – Universitätsmedizin Berlin
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  • Thomas Göen, Lehrstuhl für Theoretische Chemie/Computer Chemie Centrum, Friedrich-Alexander Universität Erlangen-Nürnberg, Germany.
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  • Ozlem Goksel, Ege University
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  • Astrid R. Heutelbeck, Friedrich Schiller University Jena
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  • Meinir Jones, Imperial College London
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  • Harald Lux, Friedrich Schiller University Jena, Charité – Universitätsmedizin Berlin
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  • Piero Maestrelli, University of Padova
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  • Xavier Munoz, Autonomous University of Barcelona
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  • Benoit Nemery, Instituut voor Kern- en Stralingsfysica
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  • Vivi Schlünssen
  • Torben Sigsgaard
  • Claudia Traidl-Hoffmann, Swiss Institute of Allergy and Asthma Research, The Christine Kühne Center for Allergy Research and Education (CK-CARE), Technical University of Munich
  • ,
  • Paul Siegel, National Institute of Occupational Safety and Health

Industrial sensitizing agents (allergens) in living and working environments play an important role in eliciting type 1 allergic disorders including asthma and allergic rhinitis. Successful management of allergic diseases necessitates identifying their specific causes (ie, identify the causative agent(s) and the route of contact to allergen: airborne, or skin contact) to avoid further exposure. Identification of sensitization by a sensitive and validated measurement of specific IgE is an important step in the diagnosis. However, only a limited number of environmental and occupational allergens are available on the market for use in sIgE testing. Accordingly, specific in-house testing by individual diagnostic and laboratory centers is often required. Currently, different immunological tests are in use at various diagnostic centers that often produce considerably divergent results, mostly due to lack of standardized allergen preparation and standardized procedures as well as inadequate quality control. Our review and meta-analysis exhibited satisfactory performance of sIgE detection test for most high molecular weight (HMW) allergens with a pooled sensitivity of 0.74 and specificity of 0.71. However, for low molecular weight (LMW) allergens, pooled sensitivity is generally lower (0.28) and specificity higher (0.89) than for HMW tests. Major recommendations based on the presented data include diagnostic use of sIgE to HMW allergens. A negative sIgE result for LMW agents does not exclude sensitization. In addition, the requirements for full transparency of the content of allergen preparations with details on standardization and quality control are underlined. Development of standard operating procedures for in-house sIgE assays, and clinical validation, centralized quality control and audits are emphasized. There is also a need for specialized laboratories to provide a custom service for the development of tests for the measurement of putative novel occupational allergens that are not commercially available.

Original languageEnglish
JournalAllergy: European Journal of Allergy and Clinical Immunology
Volume74
Issue10
Pages (from-to)1885-1897
Number of pages13
ISSN0105-4538
DOIs
Publication statusPublished - 2019

    Research areas

  • asthma, IgE, occupational allergies, rhinitis, urticaria

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