[Molecular diagnosis of food allergy--do we know more?].Postepy Hig Med Dosw (Online) 2014; 68:754-67PH
Component-resolved diagnostics (CRD) is the research method that allows to determine the concentrations of specific immunoglobulin E against a particular allergenic components. The paper discusses the importance of CRD in the food allergy diagnosis to common animal and vegetable allergens. The capabilities of the method and its limitations in the application are presented. One of the main advantages of the CRD is to obtain information on the potential allergen cross-reactivity regarding inhalant allergens and food, which are exhibiting structural similarity within the epitopes. CRD explains on the molecular level allergens cross-reactivity. It allows to distinguish cross-reactions occurring after ingestion of food in patients with hypersensitivity that occurs primarily to pollen from the coexistence of inhaled and food allergies. It is also possible to use the method of the CRD for selected allergens to predict the severity of allergic reactions after ingestion of allergic food in patients with symptoms of food allergy. In addition, in small children component-resolved diagnostics can be helpful in predicting achieve in food tolerance to certain allergens. Due to the present limitations, practical conclusions and guidance should be drawn with a caution. This method does not replace clinical observation and double-blind placebo-controlled food challenge, which is still the gold standard in the diagnosis of food allergy. Due to the geographic diversity resulting in different exposure to pollen and dietary factors researches on allergen components in populations living in different climatic zones give different results. This allows to observe that the diagnostic and prognostic inference based on the analysis of CRD results is limited and should always be considered in the clinical context. Especially in situations of estimating the risk of severe allergic reactions. Despite these limitations, the CRD method is a modern tool to the current diagnosis of allergy deserving of its popularisation. It provides information on allergenic components at the molecular level, allowing better understanding of symptoms and patient adjusted procedures.