Serological (In Vitro) Testing Methods in the Diagnosis of Human Allergic Disease

Abstract

This chapter examines the state of in vitro assays used in the detection and quantification of immunoglobulin E (IgE) antibody in human serum. The diagnosis of human allergic disease begins with a thorough clinical history and physical examination. IgE was identified as the fifth human immunoglobulin isotype in 1967. By 1974, the first immunoassay for the detection of allergen-specific IgE antibody in human serum was introduced into clinical testing. Children who had been referred for a food allergy evaluation were serologically evaluated for IgE antibodies to egg, milk, peanut, soy, wheat, and fish. In an attempt to replicate Sampson’s observations, multiple other groups have performed similar IgE antibody versus food challenge studies and have reported different predictive confidence intervals for failing an oral food challenge. The total IgE concentration in serum is highly age dependent and thus interpretation of total IgE levels need to be made in relation to an age-adjusted nonallergic reference population.