7. Total IgE levels and asthma prevalence in the US population: Results from the National Health and Nutrition Examination Survey 2005-2006 Gergen JACI 2009;124:447 PREVALENCE OF ATOPY AS DEFINED BY 15 sIgEs 42.5% 45 – 40 – 35 – 30 – 25 – 20 – 15 – 10 – 5 – 0 Prevalence of atopy by the number of positive specific IgE test results.

8. Total IgE levels and asthma prevalence in the US population: Results from the National Health and Nutrition Examination Survey 2005-2006 Gergen JACI 2009;124:447 PREVALENCE OF ATOPY AS DEFINED BY 15 sIgEs 42.5% 45 – 40 – 35 – 30 – 25 – 20 – 15 – 10 – 5 – 0 Prevalence of atopy by the number of positive specific IgE test results. The complete identification of atopic subjects in a population requires a large panel of allergen-specific IgEs.

12. Comparison of skin prick tests with specific serum immunoglobulin E in the diagnosis of fungal sensitization in patients with severe asthma O'Driscoll, CEA 2009;39:1677 50 – 40 – 30 – 20 – 10 – 0 45% 36% 29% 24% 22% % positivity to SPTs and/or sIgE A. fumigatus C. albicans P. notatum C.herbarum A.alternata

13. Comparison of skin prick tests with specific serum immunoglobulin E in the diagnosis of fungal sensitization in patients with severe asthma O'Driscoll, CEA 2009;39:1677 50 – 40 – 30 – 20 – 10 – 0 45% 36% 29% 24% 22% % positivity to SPTs and/or sIgE A. fumigatus C. albicans P. notatum C.herbarum A.alternata Fungal sensitization is common in patients with severe asthma.

14. Comparison of skin prick tests with specific serum immunoglobulin E in the diagnosis of fungal sensitization in patients with severe asthma O'Driscoll, CEA 2009;39:1677 50 – 40 – 30 – 20 – 10 – 0 45% 36% 29% 24% 22% % positivity to SPTs and/or sIgE A. fumigatus C. albicans P. notatum C.herbarum A.alternata It remains necessary to undertake both SPT and specific serum IgE testing to identify all cases of fungal sensitization.

15. Comparison of skin prick tests with specific serum immunoglobulin E in the diagnosis of fungal sensitization in patients with severe asthma O'Driscoll, CEA 2009;39:1677 Specific IgE levels (vertical axis) compared with skin prick test (SPT) weal size (horizontal axis).

16. Comparison of skin prick tests with specific serum immunoglobulin E in the diagnosis of fungal sensitization in patients with severe asthma O'Driscoll, CEA 2009;39:1677 Specific IgE levels (vertical axis) compared with skin prick test (SPT) weal size (horizontal axis). SPTs weal size increased proportional to sIgE level for all fungi except Penicillium and Botrytis

17. Specific allergic sensitization in parents and their 18-year-old offspring in the Suburban Detroit Childhood Allergy Study Tawil Misiak JACI 2009;123:1401 Background: Allergic sensitization is increased among offspring of sensitized parents. Objective: We sought to evaluate whether 18-year-old offspring are likely to have the same allergic sensitizations as their parents.

22. Characterization and comparison of commercially available mite extracts for in vivo diagnosis Brunetto Allergy 2010:65:184 Skin prick test results mean wheal areas (mm 2 ) Der farinae Der pteron

23. Characterization and comparison of commercially available mite extracts for in vivo diagnosis Brunetto Allergy 2010:65:184 Skin prick test results mean wheal areas (mm 2 ) Der farinae Der pteron Immunochemical analysis showed a heterogeneous amount of component/s among mite extracts from different manufacturers. Suggesting that, for some of the patient tested, the absence of relevant allergens could strongly affect the diagnosis .

25. % Clinical Relevance of sensitizations for selected inhalant allergens. A country-specific analysis GA 2 LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe Burbach Allergy 2009:64:1507

26. An overall rate of ≥60% clinically relevant sensitizations was observed in all countries. % Clinical Relevance of sensitizations for selected inhalant allergens. A country-specific analysis GA 2 LEN skin test study II: clinical relevance of inhalant allergen sensitizations in Europe Burbach Allergy 2009:64:1507

28. Adverse reactions to skin prick testing in children. Prevalence and possible risk factors Norrman Pediatr Allergy Immunol 2009:20:273 7.32 FEMALE SEX RR FOR VVR 6.28 AGE <1 YR 16.98 p<0.05 p<0.001 p<0.05 ACTIVE ECZEMA RR FOR GAR 20 – 15 – 10 – 5 – 0 8 – 7 – 6 – 5 – 4 – 3 – 2 – 1 – 0

35. Accuracy of ImmunoCAP® Rapid in the diagnosis of allergic sensitization in children between 1 and 14 years with recurrent wheezing: The IReNE study Diaz-Vazquez Pediatr Allergy Immunol 2009:20:601 ATOPIC 50.7% % Children with sIgE ≥0.35 kU A /L (positive) (+) ONLY TO INHALANT ALLERGENS (+) ONLY TO FOOD ALLERGENS 60 – 50 – 40 – 30 – 20 – 10 – 0 (+) TO FOOD AND INHALANT ALLERGENS 39.1% 6.5% 5.1%

37. Component resolved diagnosis

38. 1) In 1999 the term component-resolved diagnostics (CRD) was proposed by Rudolf Valenta as the concept of using defined allergens (components), as opposed to allergen extracts (mixture of allergens and other non-allergenic components) for diagnosis of Type I allergy. 2) Within an allergen source, such as peanut or cat, the majority of the proteins have no or little allergenic potential. Only a few selected proteins with different functions have allergenic potential. 3) For peanut there are up to now 10 different proteins described with allergenic potential. Application of multiplexed immunoglobulin E determination on a chip in component-resolved diagnostics in allergy Knol CEA 2010;40:190

48. Background: A positive specific IgE (sIgE) result for latex does not always mirror the clinical situation and is frequently found in individuals without overt latex allergy. Objective: We sought to investigate the potential of component-resolved diagnosis ( CRD ) of latex allergy by microarray and to assess whether the technique allows discriminating genuine allergy from asymptomatic sensitization. Component-resolved diagnosis from latex allergy by microarray Ebo CEA 2010;40:348

50. Percentages of positive sIgE results for genuine and cross-reactive latex components, bromelain and horseradish peroxidase (HRP) by traditional singleplexed ImmunoCAP in patients ( True Positive ) and individuals sensitized to natural rubber latex ( False Positive ). Component-resolved diagnosis from latex allergy by microarray Ebo CEA 2010;40:348 By microarray analysis it was demonstrated that latex allergic patients have selective binding of IgE to the latex allergens Hev b 1 (elongation factor), Hev b 3 (small rubber particle protein), Hev b 5 (latex acidic protein) and Hev b 6.02 (hevein). In contrast, sensitized patients without clinical symptoms of latex allergy showed IgE binding to Hev b 8, the latex profilin .

51. Allergy or tolerance in children sensitized to peanut: Prevalence and differentiation using component-resolved diagnostics. Nicolaou JACI 2010:125:191 Background: Not all peanut-sensitized children develop allergic reactions on exposure. Objective: To establish by oral food challenge the proportion of children with clinical peanut allergy among those considered peanut-sensitized by using skin prick tests and/or IgE measurement, and to investigate whether component-resolved diagnostics using microarray could differentiate peanut allergy from tolerance .

54. Identification of Bet v 1-related allergens in fig and other Moraceae fruits * . Hemmer C EA 2010; 40:679 Allergy to fig fruit ( Ficus carica ) has been described in patients allergic to Ficus benjamina or rubber latex but may occur also in pollen-allergic patients. Fig and other Moraceae fruits contain allergens homologous to Bet v 1 and represent clinically relevant birch pollen-associated foods. * Fig ( F. carica ), mulberry ( Morus alba ), jackfruit ( Artocarpus heterophyllus ; all family Moraceae)

57. TAKE HOME INFORMATIONS