Source:Journal of Allergy and Clinical Immunology
Author(s): Marianne van Hage, Carl Hamsten, Rudolf Valenta
Allergen-specific IgE measurements together with the clinical history are the cornerstones of allergy diagnosis. During the past decades not only characterization and standardization of allergen extracts have improved but also assay technology. Here we discuss the uses, advantages, misinterpretations and limitations of ImmunoCAP IgE assays (Thermo Fisher Scientific/Phadia, Uppsala, Sweden) in the field of allergology. They can be performed as singleplex (ImmunoCAP) and since a decade also as multiplex (ISAC). The major benefit of ImmunoCAP is the obtained quantified allergen-specific IgE antibody level and the lack of interference from allergen-specific IgG antibodies. However, ImmunoCAP allergen extract are limited to the composition of the extract. The introduction of allergen molecules has had major impact on the analytical specificity and allergy diagnosis. They are utilized in both singleplex ImmunoCAP and multiplex ImmunoCAP ISAC assays. The major advantage of ISAC is the comprehensive IgE pattern obtained with a minute amount of serum. The shortcomings are its semiquantitative measurements, lower analytical sensitivity and cost per assay. With respect to assay performance ImmunoCAP allergen extracts are good screening tools, but allergen molecules dissect the IgE response on a molecular level and put allergy research on the map of precision medicine.
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