Testing for immediate-type food allergy How far can testing diagnose allergies in children? The progress in testing for allergic disease

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  • Nagakura Ken-ichi
    Department of Pediatrics, National Hospital Organization Sagamihara National Hospital Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan
  • Ebisawa Motohiro
    Department of Allergy, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital

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Other Title
  • 即時型食物アレルギーの検査検査でどこまで子どものアレルギーを診断できるか～アレルギー検査の進歩を知る～

Abstract

<p>The oral food challenge (OFC) is the gold standard for diagnosing an immediate-type food allergy.; however, other tests can be used in combination to reduce the risk of OFC.</p><p>Although probability curves predicting the probability of symptom induction based on specific IgE antibody titers have been reported, they are affected by the target population's age and the OFC method. Recently, allergen component-specific IgE antibody tests have become available for clinical practice, and cutoff values for ovomucoid in hen's egg, ω-5 gliadin in wheat, 2S albumin in seed nuts, Ara h 2 in peanut, Jug r 1 in walnut, and Ana o 3 in cashew nut have been reported.</p><p>A positive skin prick test (SPT) would lead to diagnosis in infants even if the specific IgE antibody test is negative. Additionally, SPT of buckwheat is more useful than the specific IgE antibody test for diagnosis.</p><p>Although advances in immunological testing have improved the diagnostic accuracy of immediate-type food allergy, it cannot be used as a definitive diagnosis at present-the importance of assessing the risk before OFC is increasing. The development of applications to facilitate stratified diagnosis is needed.</p>

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