7. Prick test…
• High sensibility and specificity
• Immediate response
• Low cost (?)
• Influenced by therapies and skin conditions
• Need of allergist or experienced physician
• Contra-indications
• Time-consuming
8. In vitro IgE tests…
• High sensibility and specificity
• Not influenced by therapies and
skin conditions
• No contra-indications of in vivo tests
• Need of a lab and equipment
• Expensive
• Not immediate response
9. Allergy Tests: a very long road…
1880: ProvocationTesting
1967: Characterization of IgE
’70s: RAST
1995: Recombinant Allergens
2001: Allergen Microarray
26. Case 3: foods…
A young patient with hazelnut allergy…
…she tolerates other kind of nuts even if
discouraged to eat them…
27. This is her prick test for food allergens:
• Hazelnut +++
• Walnut(+/-)
Case 3: foods…
28. Case 3: foods…
Total IgE (RIST): 37 kU/l
Specific IgE for respiratory allergens: < 0.10 kUI/l
Specific IgE for food allergens:
• Hazelnut 3,07 kUI/l
• Walnut 0,12 kUI/l
29. Case 3: foods…
Cor a 1: Bet v 1-homologue (PR-10)
Cor a 2: profilin (homologue to Bet v 2)
Cor a 8: LTP
Cor a 9: 11S globulin (homologue to Ara h 3)
30. Case 3: foods…
Hazelnut allergy in Europe:
- Cor a 1: 75% (100% north europe, 17% south europe)
- Cor a 2: 42% (profilin)
- Cor a 8: 28% (5-15% north europe, 71% south europe)
Cor a 1 + Cor a 8 = 96%
31. Case 3: foods…
What’s the patient allergic to?
Cor a 1
Cor a 8
Cor a 2
Cor a 9
None!
32. Case 3: foods…
…because 103 molecular allergens are a lot…
…but nature has many more…
=
we still need “traditional” testing with allergen
extracts too…
36. …what’s the role for young
allergists?
Molecular allergology and CRD are highly
active “Works in Progress” fields
No need to change perspective:
learn CRD at the same time of “traditional
diagnostics” to get the most out of them
