title: Making the Most of In Vitro Tests to Diagnose Food Allergy.
abstract: Various in vitro tests assess different aspects of the underlying immune mechanism of IgE-mediated food allergy. Some can be used for diagnostic purposes; specific IgE to allergen extracts is widely available; specific IgE to allergen components is used in most specialist centers, and the basophil activation test is becoming increasingly used clinically. IgE to allergen peptides, T-cell assays, allergen-specific/total IgE ratios, and allergen-specific IgG4/IgE ratios are currently reserved for research. Different factors can modulate the likelihood of IgE-mediated food allergy of a given allergy test result, namely, the patients' age, ethnicity, previous allergic reaction to the identified food, concomitant atopic conditions, and geographical location, and need to be taken into account when interpreting the allergy test results in the clinic. The importance of the specific food, the clinical resources available, and patient preferences are additional aspects that need to be considered when deciding whether an oral food challenge is required to reach an accurate diagnosis of IgE-mediated food allergy.
authors.affiliation: Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, London, United Kingdom; Children's Allergy Service, Guy's and St Thomas' Hospital, London, United Kingdom. Electronic address: alexandra.santos@kcl.ac.uk.
authors.forename: Alexandra F
authors.initials: AF
authors.lastname: Santos
authors.affiliation: Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, London, United Kingdom; Children's Allergy Service, Guy's and St Thomas' Hospital, London, United Kingdom.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Brough
mesh_terms: D000367:Age Factors; D000485:Allergens / Q000276:immunology*; D015549:Basophil Degranulation Test; D005512:Food Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007159:Immunologic Tests; D057240:Patient Preference
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: Basophil activation test; Component-resolved diagnosis; Diagnosis; Food allergy; IgG4/IgE ratio; In vitro tests; Peptide microarray; Specific IgE; Specific/total IgE ratio; T-cell assay