, Molecular Diagnosis, A New Step in Combating Allergies

Molecular Diagnosis, A New Step in Combating Allergies

To successfully treat allergies, detailed diagnosis is required. What is the specific nature of the disease? The complex of diagnostic measures includes the preparation of anamnesis (a picture of the disease based on the patient’s questions), the study of clinical symptoms, and the examination of the patient. To identify the stimulus (or group of stimuli), skin tests are performed or a blood test is done for the so-called immunoglobulin E (IgE).

Skin tests are an intradermal introduction (into the skin layer) of small amounts of drugs with the content of the suspected allergen. Samples are made on the inner surface of the forearm, sometimes on the back. Inflammatory reaction to a given drug makes it possible to identify the allergen to which the patient is sensitive. German doctors call this procedure Sensibilisierung, that is, “sensitive effect.” Another name is also used: Haut-Prick-Test.

A blood test for IgE reveals specific antibodies that cause an allergic reaction.

In some cases, a blood test is performed in addition to skin tests – if they do not work. However, the analysis too can not give a result, because it is conducted, like skin tests, using a finite set of putative substances-allergens.

And if the patient reacts to other substances?

Or the “opposite” question: what if he reacts to several very different substances? How in this case to understand, which biochemical component is the true culprit of the allergic reaction?

What is the advantage of the New Method?

Molecular diagnostics, which are offered today by allergological centers, is based on the study of the molecular composition of potential allergens, on the detection in the molecular composition of the so-called allergen component. In other words, the new technique makes it possible to identify the “same” molecule in the immunoglobulins (IgE), to which, in fact, the patient reacts. In this case, the positive result of testing for various allergens will not confuse doctors, because they understand the allergen component that combines these substances. By type it is one and the same molecule, “painful” for the patient, which is present in different substances.

The advantages of the method:

–  reliability of quality (allergens are standardized and pass several levels of quality control);

– convenience of the method for the patient (a wide range of single allergens and mixts (panels for multiple screening);

– high accuracy and sensitivity of the method (specific IgE and IgG are determined even in minimal concentrations);

– the ability to reliably diagnose various forms of allergies:

– polyvalent (when allergic to several allergens);

– latent (hidden);

– cross reactions between different groups of allergens.

In short, the molecular diagnosis is highly differentiated, the most accurate.

It allows, in particular, to delineate in detail the monoallergic and allergic reactions that cross. Monoallergic – a reaction to a single specific allergen. Crossing is a reaction to different allergens. In the case of a crossed reaction, molecular diagnostics can reveal the true “culprit”. Based on this, you can make full predictions: contact with what substances will cause the patient an allergic reaction. These are those substances in the molecular structure of which there is an identified allergen component.

Finally, on the basis of detailed analysis, the most effective treatment can be prescribed.

Specific and cross-reactive allergen components

Allergen components are proteins or elements of protein molecular chains that, due to their similarity to other proteins, are present in different protein families.

Depending on how often or rarely they are present in different protein families, the allergen components are divided into specific and overlapping. Specific are presented, as a rule, in a single allergen. Crossing – in different.

A test for molecular allergy with 150 allergic substances with 100 allergic components can reveal allergies to 287 substances, by identifying allergies to these components.

Molecular testing of allergy is a very complex test for allergies. In this complex test, more than 150 allergies and more than 100 allergens were detected. Molecular testing of an allergy can reveal some sort of allergy map.

What Does It Give For Treatment?

Examples are given with several specific and cross-reactive allergen components.

Thus, allergen components Bet v 2 and Bet v 4 are present in the pollen of birch earrings, Ara h 1, Ara h 2, Ara h 3, Ara h 9 – in nuts, Gly m 5, Gly m 6 – in soy. But allergen components Bet v 1, Ara h 8, Gly m 4 are present in the pollen of birch earrings, in nuts, and in soy.

Let’s say you have an allergic reaction – to birch pollen, nuts, and soy products. The former diagnostic methods (skin tests, blood tests) are able to “just” confirm this fact. But molecular diagnostics will show whether your body reacts to Bet v 1, Ara h 8 or Gly m 4.

In accordance with this, specific immunotherapy (SIT) will be prescribed, the purpose of which is the development of a protective reaction of the organism against a specific allergen component.

Dangerous and Safe Products

The prognosis of the danger or safety of certain food products, made based on the results of molecular diagnostics, is also specific.

If the patient reacts to cross-reactive allergen components, then on the basis of previous diagnostic techniques it is possible for him to outline the circle of potentially dangerous products. Some of them are really dangerous, others are not. Why? Because different allergen components belong to different protein families. In some products, these families are insignificantly represented, they are easily decomposed by heating and in fact do not pose a hazard. These are labile proteins, they are almost safe. In other products, the same families are present in large numbers and very stable. These are stable proteins that cause a strong allergic reaction, up to anaphylactic shock.

Since molecular diagnostics accurately identifies cross-allergen components, to which the patient is sensitive, then the forecast of the danger of food is just as accurate. Depending on the lability or stability of the corresponding protein families, doctors conclude: these products represent a slight allergic danger, these are elevated, and these are extremely dangerous!

Which experts should evaluate the molecular test for allergy?

Molecular allergy is a newly developed one. It would be useful to evaluate this in children from specialists in pediatric allergy and adults from specialists in adult allergies. In order to evaluate this test correctly, it is necessary to undergo training in evaluating this test.

The Istanbul Allergic Allergy Center performs molecular test for allergies. A small amount of blood sent abroad, to identify response takes about a week. We are very pleased to provide in Turkey services to conduct a molecular allergy test that provides detection of 287 allergens and components.

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