Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future

Abstract In today’s clinical practice patients’ skin is used as screening organ for diagnosing type 1 allergy. According to European guidelines skin prick testing with a panel of 18 allergen extracts is recommended, in the US between 10 to 50 allergens are used. The specificity and sensitivity of sk...

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Main Authors: E. Jensen-Jarolim, A. N. Jensen, G. W. Canonica
Format: Article
Language:English
Published: Elsevier 2017-09-01
Series:World Allergy Organization Journal
Online Access:http://link.springer.com/article/10.1186/s40413-017-0162-3
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author E. Jensen-Jarolim
A. N. Jensen
G. W. Canonica
author_facet E. Jensen-Jarolim
A. N. Jensen
G. W. Canonica
author_sort E. Jensen-Jarolim
collection DOAJ
description Abstract In today’s clinical practice patients’ skin is used as screening organ for diagnosing type 1 allergy. According to European guidelines skin prick testing with a panel of 18 allergen extracts is recommended, in the US between 10 to 50 allergens are used. The specificity and sensitivity of skin testing is individually highly variable depending on age, body mass, and skin barrier status. In atopic inflammation skin testing gives more false positive results. Smaller skin area and strain limits prick testing in small children. Although the risk for systemic reactions in skin prick testing is very small, emergency medications must be available. Considering the fact that IgE is the only reliable biomarker for type I allergy, upfront IgE screening with ISAC, followed by fewer skin tests to approve positive sensitizations, is proposed. It is time to arrive in the age of molecular allergy diagnosis in daily patient care.
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spelling doaj.art-da14cd3738424667af9bb50e06ff81e92022-12-21T23:41:11ZengElsevierWorld Allergy Organization Journal1939-45512017-09-011011610.1186/s40413-017-0162-3Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the futureE. Jensen-Jarolim0A. N. Jensen1G. W. Canonica2Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of ViennaAllergyCare, Allergy Diagnosis and Study CenterPersonalized Medicine Asthma & Allergy Clinic, Humanitas University & Research HospitalAbstract In today’s clinical practice patients’ skin is used as screening organ for diagnosing type 1 allergy. According to European guidelines skin prick testing with a panel of 18 allergen extracts is recommended, in the US between 10 to 50 allergens are used. The specificity and sensitivity of skin testing is individually highly variable depending on age, body mass, and skin barrier status. In atopic inflammation skin testing gives more false positive results. Smaller skin area and strain limits prick testing in small children. Although the risk for systemic reactions in skin prick testing is very small, emergency medications must be available. Considering the fact that IgE is the only reliable biomarker for type I allergy, upfront IgE screening with ISAC, followed by fewer skin tests to approve positive sensitizations, is proposed. It is time to arrive in the age of molecular allergy diagnosis in daily patient care.http://link.springer.com/article/10.1186/s40413-017-0162-3
spellingShingle E. Jensen-Jarolim
A. N. Jensen
G. W. Canonica
Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future
World Allergy Organization Journal
title Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future
title_full Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future
title_fullStr Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future
title_full_unstemmed Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future
title_short Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future
title_sort debates in allergy medicine molecular allergy diagnosis with isac will replace screenings by skin prick test in the future
url http://link.springer.com/article/10.1186/s40413-017-0162-3
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