Molecular allergology place in allergen-specific immunotherapy

Abstract

Laboratory methods of allergy diagnosis are an essential tool in the allergists daily practice. Molecular allergodiagnostics is an advanced examination method that detects individual allergocomponent sensitization. The risk prediction of severe allergic reactions is the main area of its application, as well as the creation of personalized dietary recommendations for patients with food allergies. Clinical and anamnesis data are fundamental, supplemented by the results of traditional methods of allergy examination (skin prick tests or the specific immunoglobulin E level to whole allergens), in determining the appointment of allergen immunotherapy indications. The widespread use of such resource-intensive examination as molecular allergodiagnostics for all patients is unjustified before prescribing allergen immunotherapy. Additionally, decisions on the allergen immunotherapy continue or the termination cannot be made based on the change data in the level of clinically relevant specific IgE. Concurrently, its use as a third-line diagnostic method can help in solving difficult clinical tasks related to the identification of a causally significant allergen in patients with respiratory allergy symptoms during the seasons of the simultaneous dusting of several plants, as well as differentiate the true from the cross-sensitization in polysensitized patients. The use of molecular allergodiagnostics will be mandatory in prescribing recombinant therapeutic allergens, due to the need for a personalized choice of the drug.