Researchers conducted a study to assess new findings on the causal role of particular IgE antibodies, as well as the performance of IgE diagnostic tests, in allergic occupational asthma caused by high (HMW) or low (LMW) agents. To document allergy to most HMW allergens and certain LMW agents, skin prick testing (SPT) and specific IgE tests were effective. However, the absence of standardized and widely accessible reagents limited the scope of these assays. The quality of occupational allergen extracts used for SPT varied widely, and the sensitivity of some SPT solutions was poor. Furthermore, many people with allergen-specific serum IgE and/or positive SPT to particular HMW allergens lacked clinical symptoms. Sensitization or allergic cross-reactivity to allergens or epitopes from unrelated sources interfered with IgE-mediated allergy detection, resulting in false-positive findings, especially when cross-reactive carbohydrate determinants (CCDs) were involved. Immune responses to these ubiquitous structures may impede occupational allergy diagnosis. To identify individual molecules responsible for these illnesses and circumvent false-positive in-vitro test findings, component-resolved diagnosis of IgE-mediated allergy diseases employing panels of native or recombinant allergens, or micro-arrayed allergens, had been proposed.
It was strongly advised to improve and standardize SPT solutions for occupational allergens. More sophisticated diagnostic methods were being developed than specific IgE measurements, such as inhibition studies of IgE binding to CCDs with particular carbohydrate molecules and component-resolved diagnosis.