PMID- 27069839 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231111 IS - 2197-0378 (Print) IS - 2197-0378 (Electronic) IS - 2197-0378 (Linking) VI - 24 DP - 2015 TI - Molecular allergy diagnostics using IgE singleplex determinations: methodological and practical considerations for use in clinical routine: Part 18 of the Series Molecular Allergology. PG - 185-197 AB - Allergen molecules (synonyms: single allergens, allergen components) open up new horizons for the targeted allergen-specific diagnostics of immunoglobulin E (IgE) in singleplex determination. The following rationales support the targeted use of allergen molecules and, more importantly, improve test properties: (1) increased test sensitivity ("analytical sensitivity"), particularly when important allergens are under-represented or lacking in the extract; (2) improved test selectivity (analytical specificity), particularly when the selected IgE repertoire against an allergen yields additional information on: (a) potential risk, (b) possible cross-reactivity, or (c) primary (species-specific) sensitization. However, the appropriate indication for the use of single allergens can only be established on a case-by-case basis (depending on the clinical context and previous history) and in an allergen-specific manner (depending on the allergen source and the single allergens available), rather than in a standardized way. Numerous investigations on suspected food allergy, insect venom allergy, or sensitization to respiratory allergens have meanwhile demonstrated the successful use of defined molecules for allergen-specific singleplex IgE diagnosis. Specific IgE to single allergens is limited in its suitability to predict the clinical relevance of sensitivity on an individual basis. In food allergies, one can at best identify the relative risk of a clinical reaction on the basis of an IgE profile, but no absolutely reliable prediction on (future) tolerance can be made. Ultimately, the clinical relevance of all IgE findings depends on the presence of corresponding symptoms and can only be assessed on an individual basis (previous history, symptom log, and provocation testing with the relevant allergen source where appropriate). Thus, also in molecular allergology, the treating physician and not the test result should determine the clinical relevance of diagnostic findings. ELECTRONIC SUPPLEMENTARY MATERIAL: Supplementary material is available for this article at 10.1007/s40629-015-0067-z and is accessible for authorized users. FAU - Kleine-Tebbe, Jorg AU - Kleine-Tebbe J AD - Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Ackermann & Kleine-Tebbe, Spandauer Damm 130, Haus 9, 14050 Berlin, Germany. FAU - Jakob, Thilo AU - Jakob T AD - Allergy Department and Allergy Research Group, Department of Dermatology and Venereology, Freiburg University Hospital, Freiburg, Germany, Berlin, Germany. LA - eng PT - Journal Article PT - Review DEP - 20150928 PL - Germany TA - Allergo J Int JT - Allergo journal international JID - 101659261 PMC - PMC4792337 OTO - NOTNLM OT - Component-based diagnostics OT - IgE - Allergen OT - In-vitro test OT - Molecular allergy diagnostics EDAT- 2015/01/01 00:00 MHDA- 2015/01/01 00:01 PMCR- 2015/09/28 CRDT- 2016/04/13 06:00 PHST- 2015/05/04 00:00 [received] PHST- 2015/05/26 00:00 [accepted] PHST- 2016/04/13 06:00 [entrez] PHST- 2015/01/01 00:00 [pubmed] PHST- 2015/01/01 00:01 [medline] PHST- 2015/09/28 00:00 [pmc-release] AID - 67 [pii] AID - 10.1007/s40629-015-0067-z [doi] PST - ppublish SO - Allergo J Int. 2015;24:185-197. doi: 10.1007/s40629-015-0067-z. Epub 2015 Sep 28.