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Background: The measurement of specific IgE to allergenic extracts and molecules in patients with allergic rhinitis (AR) is crucial for a precise diagnosis and further immunotherapy. Companies providing in vitro diagnostic methods in allergology continuously strive for the optimization and modernization of such methods. A new generation of automated allergy tests based on chemiluminescence detection and paramagnetic microparticles is now available, with possible advantages in sample volume, cost‐effectiveness and avoidance of sample‐related interference. Objectives: To test whether sIgE antibody levels obtained with a new singleplex chemiluminescent method have a good agreement with the corresponding results obtained with a "gold standard" test. Methods: We tested sera from 368 AR patients. Specific IgE sera levels (kU/L) to a comprehensive panel of 15 allergen extracts and 6 molecules were tested with ImmunoCAP® (Thermo Fisher Scientific Inc, Phadia AB, Uppsala, Sweden) and NOVEOS™ (HYCOR® Biomedical, Garden Grove, CA, USA). We evaluated the qualitative and quantitative performance of the new NOVEOS system in matching the outcome of ImmunoCAP to each of the examined allergens. Results: In relation to ImmunoCAP, the overall diagnostic sensitivity and specificity of sIgE tests with NOVEOS were 90.8% (95% CI = 88.6–92.7) and 96.2% (95% CI = 93.9–97.8), respectively. These values were higher when only molecules were considered (sensitivity = 98.7% [95% CI = 96.4%–99.7%]; specificity = 94.2% [95% CI = 88.4%–97.6%]) and lower when only extracts were considered (sensitivity = 87.6% [95% CI = 84.7%–90.2%]; specificity = 97% [95% CI = 94.4%–98.6%]). Spearman's correlation between the data set of both methods for a ≥ 0.1 kU/L cut‐off was 0.84 (p <.001). Conclusions: The new singleplex NOVEOS system presented good results for qualitative and quantitative comparisons when testing specific serum IgE antibodies against a range of 21 allergens. This novel immunoassay system using only 4 µl of sample per test appears to be robust and reliable and can, therefore, be used as an aid in allergy diagnosis. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis and asthma are highly prevalent chronic inflammatory diseases leading to restrictions in the patient's quality of life and high costs for healthcare systems. Both diseases are associated with the presence of specific IgE (sIgE) against aeroallergens. This review aims to examine the importance of molecular allergy diagnostics in the assessment and management of these disorders. Content: The "U-shaped" approach, proposed by the European Academy of Allergy and Clinical Immunology, combines conventional allergy diagnostics with the benefits of component-resolved diagnosis (CRD) and offers important additional information regarding the patient's sensitization pattern, especially in complex clinical cases such as polysensitization or idiopathic reactions, thus avoiding overuse of in vitro and in vivo IgE diagnostics. CRD may help the clinician to identify the cause of an allergy and, in the case of complex polysensitization, uncover possible cross-reactivity. Polysensitization, especially to inhalant allergens, is associated with the clinical appearance of asthma and allergic rhinitis; important risk factors for the latter are the major allergens Fel d 1 and Can f 1. Importantly, information on molecular sensitization patterns significantly influences the choice of specific immunotherapy and reduces its overprescription. Conclusion: At present, allergy diagnostics largely rely on clinical history, physical examination, and in vivo IgE testing. However, in vitro diagnostics including CRD are currently finding their way into the clinical routine and can offer additional information on the patient's sensitization profile and treatment responsiveness. [ABSTRACT FROM AUTHOR]

The article discusses use of allergen‐specific immunotherapy (AIT) to cure allergic diseases by attacking their antigen‐specific immunologic mechanisms. Topics include better standardization of allergen products for diagnosis and therapy with molecular allergology, selection of molecules in order to identify genuine sensitization to the allergen, and producing recombinant molecules with hybrid technology.