The purpose of determining specific IgE (sIgE) in serum-based allergy diagnosis is assigning the allergen(s) that cause(s) notable allergic symptoms. This attractively simple principle is, however, perturbed by the occurrence of clinically insignificant IgEs 1. A number of candidates for these interfering IgEs have been identified and classified into IgEs that bind to peptide epitopes and IgEs that bind to carbohydrate epitopes 1. Weighting of these different reasons has never been made. The extraordinarily wide distribution of a particular carbohydrate epitope was addressed three decades ago, when the now well-known term ‘cross-reactive carbohydrate determinant’ (CCD) was coined 2. The structural basis of CCDs is complex-type Asn-linked oligosaccharides on glycoproteins 3,4. In particular, it is the presence of core-α1,3-linked fucose that implants the same epitope onto glycoproteins from insect venoms, plant pollens, vegetable foodstuffs and even latex 5–9. Consequently, a patient who develops IgE against CCDs on whichever allergen reacts with other allergens that contain typical plant or insect glycosylation. Up to a quarter of all patients undergoing sIgE testing show these multiple reactions 1,8,10–12. The problem is that anti-CCD IgE, from what we know today, has no clinical significance 1,11,13–18. The picture was further complicated around 2001 as multivalent CCD-containing proteins displayed relevant biological potency in in vitro histamine release tests 12,19,20. Since then, no patient has been presented who reacted against CCDs in a way clearly addressable as an allergic reaction. Thus, it appears prudent to adhere to the notion that anti-CCD IgE has no clinical significance. While we can only speculate about the reasons for this remarkable circumstance 4, the serious consequence is that for a large cohort of patients, any sIgE test will return a positive result, which will, however, be false positive for most or all of the allergens. The severity of the problem may have been underestimated in single allergen testing, where only small numbers of allergens carefully selected on the basis of anamnesis are tested, for example, with the ImmunoCAP system. Positive results are expected, and false positives escape notice as they do not raise suspicion. By contrast, array tests return a multitude of positive results for CCD-positive patients. The problem has been known for several years, and more or less promising solutions have been suggested. Some laboratories determine anti-CCD IgE with a MUXF-CAP (Thermo Scientific/Phadia; ‘MUXF’ is explained in Fig. Fig.2).2). This identifies problematic results, but cannot help to discriminate false from truly positive results. Removal of anti-CCD IgE with immobilized CCDs has also been suggested 15, but dismissed as too laborious for routine application 21. The German guideline on allergy diagnosis 14 as well as newer literature 22 mentions inhibition of anti-CCD IgE but does not state how the inhibition should be achieved. A mixture of natural plant glycoproteins to be used for CCD inhibition is available from Mediwiss Analytics (Moers, Germany). Natural glycoproteins could contain peptide epitopes that cause unwanted inhibitions. For many years, our group has used a semisynthetic CCD blocker consisting of bromelain glycopeptides coupled to bovine serum albumin (BSA) 20,23,24. The proteolytic digestion of the starting material ensures the destruction of peptide epitopes. However, only rudimentary glycopeptide purification has been performed and BSA may itself bind IgE in patients who are allergic to meat or milk. Figure 2 Preparation of the CCD blocker. Highly purified glycopeptides containing core α1,3-fucose and xylose are chemically coupled to human serum albumin (HSA). The glycopeptides contain 2-4 amino acids at maximum, which is verified by MALDI-TOF MS (panel ... In the present work, we used a new, highly pure and specific version of our CCD blocker to determine sIgEs in single allergen tests as well as on multi-allergen strips and component arrays. For several patients, laboratory diagnosis was augmented by skin prick tests.