Editorial
CROATIAN GUIDELINES FOR IN VITRO DIAGNOSIS OF IGE MEDIATED HYPERSENSITIVITY
ASJA STIPIĆ MARKOVIĆ
orcid.org/0000-0003-2767-2088
; Sveti Duh University Hospital, Department of Clinical Immunology, Pulmonology and Rheumatology, Referral Center for Clinical Allergology, Zagreb, Croatia
IRENA IVKOVIĆ-JUREKOVIĆ
; Zagreb Children’s Hospital, Department of Clinical Immunology, Allergology, Pulmonology and Rheumatology, Zagreb, Croatia
SLAVICA DODIG
; Srebrnjak Children’s Hospital, Department of Clinical and Laboratory Diagnosis, Referral Center for Clinical Allergology in Childhood, Zagreb, Croatia
IRENA BATIŠTA
; Sveti Duh University Hospital, Laboratory of Immunology, Zagreb, Croatia
RENATA ZRINSKI-TOPIĆ
; Srebrnjak Children’s Hospital, Department of Clinical and Laboratory Diagnosis, Referral Center for Clinical Allergology in Childhood, Zagreb, Croatia
MONIKA BARBERIĆ
; Sveti Duh University Hospital, Laboratory of Immunology, Zagreb, Croatia
IVA TOPALUŠIĆ
; Sveti Duh University Hospital, Department of Clinical Immunology, Pulmonology and Rheumatology, Referral Center for Clinical Allergology, Zagreb, Croatia
ŽELJKA BUKOVEC MEGLA
; Sestre milosrdnice University Hospital Center, Clinical Department of Oncology and Nuclear Medicine, Laboratory of Endocrinology, Zagreb, Croatia
VESNA ŽIŽIĆ
; Zagreb Children’s Hospital, Department of Laboratory Diagnosis, Zagreb, Croatia
Abstract
In vitro diagnostic procedure in allergology includes determination of serum levels of total and allergen speciic IgE antibodies, allergen speciic IgG antibodies, plasma tryptase, eosinophil cationic protein (ECP) and basophil activation test (BAT). In vitro tests should be used according to clinical history, physical examination, and in vivo methods for allergy testing. Clinical relevance of elevated total IgE in allergy diagnosis is modest, since it can be caused by other conditions. Elevated serum levels of allergen speciic IgE antibodies, together with positive medical history, are indicative of clinically relevant allergy. A recommendedlaboratory method for total and speciic IgE concentration measurement is the sandwich-type luoroimmunoassay ImmunoCAP, considered as an ideal immunoassay. Serum levels of allergen speciic IgG antibodies have no proved clinical relevance in food allergy diagnosis. They can be useful to monitor venom immunotherapy success, as well as to estimate the risk of venom induced anaphylaxis. Elevated plasma tryptase (subtype ) level is an indication of mast cell activation caused by speciic allergen. It should be obtained within 4 hours after an anaphylactic episode. Elevated level of ECP can be detected in patient blood during late phase of allergic reaction. It can be used to monitor patients with chronic allergenic and inlammatory conditions in which eosinophils play a central role. BAT includes measurement of CD 63 (cluster of differentiation) and CD 203 antigens of the molecular surface by low cytometry. It is useful in the diagnosis of venom, food and drug allergy, estimation of severity of allergic disease and natural tolerance to allergens. In vitro tests based on allergen extracts can be used for in vitro diagnosis in monosensitized patients with clear medical history and symptomatic treatment. Molecular allergy diagnosis should be performed in special clinical indications such as diagnosis of cross reactivity, prescription of speciic immunotherapy (especially in polysensitized patients with complex symptoms), diagnosis of idiopathic or cofactor induced anaphylaxis, latex allergy, and assessment of the risk of allergic reaction to speciic allergen.
Keywords
IgE; plasma tryptase; eosinophil cationic protein; basophil activation test; molecular allergy diagnosis
Hrčak ID:
147979
URI
Publication date:
4.11.2015.
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