The purpose of the study was to evaluate current research focusing on specific immunoglobulin E (sIgE) testing and the basophil activation test (BAT) for the diagnosis of IgE-mediated food allergies. The sIgE response to allergen extract or component can predict food reaction. When evaluating if an oral food challenge (OFC) is necessary to diagnose hen’s egg, cow’s milk, wheat, peanut, and cashew nut allergy, the cutoff value based on the positive predictive value (PPV) of sIgE might be considered. PPV, on the other hand, varies according to the patient’s history, OFC technique, challenge meals, and test methodology. Component-resolved diagnostics (CRD) has been used to diagnose food allergies. Ovomucoid and omega-5 gliadin are useful diagnostic indicators for allergic reactions to cooked eggs and wheat. CRD of peanuts, tree nuts, and seeds has lately been studied. Other storage proteins, such as Jug r 1 for walnut, Ana o 3 for cashew nut, Ses I 1 for sesame, and Fag e 3 for buckwheat, are also better indicators than allergen extracts for peanut sensitivity. According to several studies, BAT has a higher specificity than skin prick testing and sIgE testing.
Diagnostic accuracy can be improved using sIgE testing and BAT. CRD offers extra information that can be used to assess if OFCs are necessary to diagnose food allergy.
Reference: https://journals.lww.com/co-allergy/Abstract/2018/06000/How_to_diagnose_food_allergy.9.aspx
