Critique on the quantitative nature of IgE antibody measurements

• Published in: The journal of allergy and clinical immunology in practice (Cambridge, MA) Vol. 3; no. 6; pp. 973 - 975
• Main Authors: Merkel, Patricia A., MS, O'Sullivan, Michael D., MBBS, Ridge, Cynthia, BS, MT(ASCP), Knight, Vijaya, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2015; Elsevier Limited
• Subjects: Allergy and Immunology; Dilution; Food; Food allergies; Food Hypersensitivity - blood; Food Hypersensitivity - immunology; Humans; Immunoglobulin E - blood; Immunoglobulin E - immunology; Immunoglobulins; Internal Medicine; Medical laboratories; Milk; Multiple myeloma
• ISSN: 2213-2198; 2213-2201
• DOI: 10.1016/j.jaip.2015.06.004

Diagnosis of IgE-mediated allergic disease involves clinical review and testing for allergen-specific IgE antibodies (sIgE).1 Higher levels of sIgE are associated with increasing likelihood of an allergic reaction following exposure.2 Although sIgE levels alone do not determine the decision for a food challenge, accurate quantitation of sIgE is important as changes in serial measurements may predict resolution of some food allergies,3 and individual measurements may contribute to overall assessment of the likelihood of reaction to challenge or prognosis for resolution of food allergy.4 To increase the sensitivity of sIgE assays by broadening allergen representation, heterogeneous allergen preparations supplemented with recombinant or native allergens are utilized. [...]to reduce potential effects of excess antigen on assay performance, samples with sIgE > 100 kUA/L were excluded from the analysis. Because minor allergens are in limited supply on the solid phase, IgE idiotypes specific for those minor allergens may be in excess in undiluted samples, and are therefore detected in greater proportions with sample dilution.