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Abstract
The initial laboratory approach in the diagnosis of allergies is to detect the type of allergic reaction, i.e. whether the patient’s allergy is mediated
by immunoglobulin E (IgE) or not. For this purpose, the concentration of total serum IgE (tIgE) and specifc IgE (sIgE) are determined. Progress in
laboratory diagnostics is the use of component-resolved diagnosis (CRD) which implies determination of sIgE against purifed native and recombi-
nant allergenic molecules. Component-resolved diagnosis is used in laboratory practice as singleplex and multiplex assays. The choice of allergen
for singleplex assay is based on anamnesis, clinical fndings of a patient and on skin prick test results. Multiplex-microarray assays simultaneously
determine multiple sIgE’s against numerous allergens. The goal of CRD is to distinguish the true allergens from the cross-reactive allergen molecules.
Component-resolved diagnosis allows predicting the risk of severe symptoms, as well as anticipating the development of allergies. Thus, determi-
nation of sIgE against allergenic components may signifcantly improve current diagnostics of allergy. Since this method is applied in laboratory
practice just a few years, it is necessary to acquire new knowledge and experience, to establish good co-operation between specialist in medical
biochemistry and laboratory medicine and the specialist allergologist, so that the method can be applied in a rational manner. Component-resolved
diagnosis will signifcantly improve the diagnostics of IgE-mediated allergy in the future. The aim of this article is to present potentials of CRD in the
laboratory diagnostics of allergy mediated by IgE.
Key words: allergy; IgE; component-resolved diagnosis
Received: November 29, 2017 Accepted: January 28, 2018
The potential of component-resolved diagnosis in laboratory diagnostics of
allergy
Slavica Dodig*, Ivana Čepelak
Department of medical biochemistry and hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb
*Corresponding author: slavica.dodig@zg.t-com.hr
https://doi.org/10.11613/BM.2018.020501 Biochem Med (Zagreb) 2018;28(2):020501
1
Review
Introduction
The initial laboratory approach in the diagnosis of
allergies (such as atopic eczema, food allergy, rhi-
nitis and wheezing disorders) is to detect the type
of allergic reaction, i.e. whether the patient’s aller-
gy is mediated by immunoglobulin E (IgE) or not.
For this purpose, the concentration of serum total
IgE (tIgE) is determined. Today, the determination
of tIgE concentration, as a simple and automated
method, is an integral part of the screening pro-
cess for subjects with atopy (1). Thereafter follows
the procedure for identifcation of allergens which
triggered allergic reaction, by determination of
specifc IgE (sIgE) against possible causative aller-
gens to which the skin test, history and clinical pic-
ture of the patient were pointed out (2,3). Determi-
nation of sIgE concentration over a number of
years implied identifcation of sIgE by allergenic
extract materials derived from natural allergen
source materials. Progress in laboratory diagnos-
tics of IgE-mediated allergy is the use of compo-
nent-resolved diagnosis (CRD) or molecular diag-
nosis of allergies. Component-resolved diagnosis
implies determination of sIgE concentration
against purifed native and recombinant allergenic
molecules (4-6). Natural allergenic molecules may
be purifed by chemical, chromatographic, elec-
trophoretic and/or immunoafnity techniques
from allergen extracts of natural allergen source
materials. Production of a recombinant allergen is
a highly complex process comprising a whole se-