Molecular allergy diagnostics: a new level of accuracy in allergen detection
Allergy is a complex and multifactorial disease that can manifest itself in the form of skin rashes, swelling, runny nose, cough, shortness of breath or even anaphylaxis. Classic diagnostic methods - skin tests and determination total IgE — do not always allow us to accurately determine the cause of an allergic reaction. That is why modern allergology is increasingly using molecular diagnostics of allergies — a highly accurate method that allows you to detect the body's reaction to specific protein components of allergens.
What is molecular allergy diagnostics?
Molecular allergy diagnostics (component-resolved diagnostics, CRD) is a laboratory analysis method that allows you to determine sensitivity to individual allergen molecules, and not just their mixtures. For example, instead of simply determining whether you are allergic to birch pollen, you can find out which protein (Bet v 1, Bet v 2, etc.) the immune system is reacting to.
This approach allows:
avoid false positive or cross-reaction results
to evaluate severity of potential reaction
to choose more precisely allergen-specific immunotherapy (ASIT)
to determine risk of anaphylaxis with food allergies
Main advantages of molecular analysis
| Advantage | Importance for the patient |
|---|---|
| High specificity | Tests not the general allergen, but individual proteins in its composition |
| Detection of cross-reactions | Helps avoid mistakes in diet or treatment |
| Predicting the severity of a reaction | Allows you to assess the risk of severe allergies |
| ASIT Optimization | Allows you to exclude unnecessary components from therapy |
| Lifestyle recommendations | Provides personalized information about safe products |
Who is recommended for molecular testing?
Patients with suspected polyvalent allergy
People from severe or atypical manifestations allergies
In preparation for allergen-specific immunotherapy
In case allergies to products containing cross-linked proteins (nuts, apples, seafood)
Children with suspected food allergy
At history of anaphylaxis
How the analysis is done
Material: venous blood
Preparation: analysis is in progress without the need to discontinue medication, on an empty stomach or after a light breakfast
Execution time: 3 to 10 days depending on the panel
Result: contains list of allergen components, levels of specific IgE to each and their clinical significance
Examples of allergenic components
| Source of allergen | Basic molecules | Clinical significance |
|---|---|---|
| Birch | Bet v 1, Bet v 2 | Bet v 1 is a major protein associated with severe allergies |
| Peanut | Ara h 1, Ara h 2 | Ara h 2 is an indicator of high risk of anaphylaxis |
| Apple | Mal d 1 | Associated with cross-allergy to birch pollen |
| Milk | Bos d 8 (casein) | Resistant to heat treatment, causes severe reactions |
| Cat | Fel d 1, Fel d 4 | Fel d 1 is the main allergen, causing chronic rhinitis |
What is important to know about interpreting results
Molecular diagnostics are not a substitute for clinical evaluation. Results should be examined by an allergist taking into account symptoms, history, and concomitant diseases.
Positive test result does not always mean there will be a reaction upon contact with an allergen. Some proteins are weak or inactive in everyday life but positive in the laboratory.
How is it different from classical methods?
Classic tests (skin tests, total IgE) can give false positive results, especially if there is a cross-reaction — for example, a person has symptoms only to pollen, but the test will show an allergy to apple as well.
Molecular diagnostics allows us to separate true sensitization і cross-reaction, which is critically important to avoid unreasonable dietary or therapeutic restrictions.
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Molecular Diagnosing allergies is not easy accuracy, but a new level of understanding of your own body. It allows you to focus not on restrictions, but on effective allergy management.
Director of Medi Lab Plus LLC, a doctor of the highest category. Has over 45 years of practical experience in medicine and laboratory diagnostics. Founder and head of the laboratory since 2007. More details…