What Is Immunocap Allergy Testing

What The Apt Shows

APT can provide useful information for managing eosinophilic disorders and atopic dermatitis, as well as monitoring Food Protein-Induced Enterocolitis Syndrome . These conditions can be caused, in part, by an underlying food allergy. Your allergist and/or specialist will use the results of APT to help direct dietary changes for these conditions.

What Is The Quest Diagnostics Difference

New tools are now available to assist physicians with the diagnosis and management of URD. We at Quest Diagnostics are excited to help you incorporate this technology into your practice. ImmunoCAP Specific IgE blood test will help you better manage patients presenting with allergy-like symptoms. Only ImmunoCAP provides the accuracy needed to assist you in these diagnoses, and Quest Diagnostics is proud to be the only national laboratory providing this superior technology to you. To further support your practice, we provide physicians with the following materials: ImmunoCap® Specific IgE Blood Test Regional Profiles

Visit the PubMed site to read the following abstracts:

What Happens During The Apt

• First, we will use a special tape to place a prepared panel of food extracts on your back.
• You will be required to keep this panel dry, and in place on your back, for 48 to 72 hours.
• We will schedule a return appointment in our clinic so your allergist can remove the panel and obtain the test results.

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What Does The Test Measure

This in vitro quantitative assay measures allergen specific IgE in human serum. It is intended for in vitro diagnosis use as an aid in the clinical diagnosis of IgE mediated allergic disorders in conjunction with other clinical findings. ImmunoCAP assays can be performed on hundreds of allergens such as weeds, trees, pollens, mold, food, and animal dander.

Eligibility Criteria For Selecting Studies

We included diagnostic test accuracy studies comparing ISAC component results as the index test with oral food challenge as the reference test, in people of any age suspected of IgE mediated food allergy to milk, egg, peanut, shrimp, hake, apple, peach, kiwi, melon, walnut, hazelnut, wheat or pineapple. Risk of bias was evaluated using the QUADAS-2 tool.

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What Is The Immunocap Specific Ige Blood Test

A laboratory test to rule in or rule out atopy in patients with allergy-like symptoms. ImmunoCAP provides a clinically relevant means of confirming or excluding the presence of atopic disease in patients with upper respiratory disease. These allergy-like symptoms are very difficult to differentiate. ImmunoCAP will also accurately identify specific allergen sensitivities in patients with confirmed allergy.

Who Should Be Tested

Anyone presenting with nasal or other allergy-like symptoms is a candidate for specific IgE testing. However, ImmunoCAP Specific IgE blood test should be strongly considered for patients with

• recurrent or chronic URD, i.e., rhinitis, sinusitis, allergic-rhinitis
• unseasonal allergy-like symptoms
• seasonal or perennial allergy-like symptoms
• recurrent otitis media
• exogenous asthma and other conditions in which IgE mediation is suspected

The test can be run on patients of any age and regardless of skin condition. There is no need to stop current medications prior to drawing a blood sample.

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Preparing For Your Apt

• APT will require a series of visits to our clinic over a few days.
• About a month before the first appointment, you’ll need to stop taking certain medications, including oral steroids. Your allergist and/or food allergy nurse will go over this with you in detail, so you understand which medications to stop and when to stop them.

What Is The Role Of This Test In Diagnosing And Managing Upper Respiratory Disease

Causes of nasal symptoms associated with upper respiratory disease can range from aspirin intolerance to pregnancy. The exact etiology of allergy-like symptoms is often difficult to determine definitively. The origin could be allergic, bacterial, viral, or pathological and is virtually impossible to establish with an empirical assessment alone. Compounding this, consumer awareness is at an all-time high. Patients often come in with a pre-determined self-diagnosis and request for therapy. History and physical are important, but further inquiry is often necessary to provide an evidence-based diagnosis and treatment regimen. ImmnoCAP Specific IgE blood test can definitively rule in or rule out atopic disease as the cause of or contributing factor to these symptoms.

Once a definitive diagnosis is reached, regardless of the presence or absence of atopy, appropriate treatment options can be employed. When atopy proves to be a factor in URD, avoidance is considered the primary therapeutic approach by all leading professional allergy associations. This test can identify the specific causative allergens.

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Isac Test 112 Allergy Tests In One Tiny Blood Sample

Many people in the UK suffer from symptoms related to food allergy or intolerance. Some of the most common questions that our patients ask us after theyve had a severe reaction and suspect that food was the cause are:

• Was it an allergic reaction to food?
• Which particular food was it?
• Is it going to happen again?
• What food do I need to avoid?

An allergy is not the same as an intolerance and it is important to seek advice from a healthcare professional to determine exactly what your symptoms are caused by. Intolerance can be diagnosed by the exclusion of foods one by one, with further reintroduction in a blinded manner, confirming the absence or return of the symptoms.

The finger prick test is not suitable for children under 6. . Once you have completed the questionnaire, the results are screened by our Allergy Consultant. If an ImmunoCAP® ISAC allergy test is recommended, you will receive an email with further details.

What The Rast Shows

A negative RAST is as reliable as a negative SPT in ruling out a true food allergy. However, RAST has a slightly higher false positive rate than SPT, making it less reliable for confirming an allergy. If you have been diagnosed with a true food allergy, RAST can be useful in monitoring IgE values. If your RAST level falls below a given point, your allergist may recommend an Oral Food Challenge in our clinic, to determine if you still have an allergy.

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What Is An Allergy

Allergy is an abnormal response of the immune system to one or more allergens with the consequent production of IgE antibodies and the onset of symptoms ranging from mild to severe and which may include anaphylactic shock.

The symptoms vary depending on whether it is a food allergy, respiratory allergy or contact allergy but the most frequent are:

• headache

• Where is the ISAC Test done?

Preparing For Your Ofc

• The Food Allergy Clinic allergist will develop a plan for your OFC based on your individual medical needs. A few weeks before your OFC appointment, our food allergy nurse will call to discuss this testing plan with you.
• The nurse will go over medications to stop, and the type of food that will be used to deliver a suspected allergen. You may be asked to bring it with you or to provide a recipe.
• They nurse can also address any other considerations or concerns you may have.

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List Of Allergens Tested In One Test From A Single Blood Sample From A Finger Prick

Proteins stable to heat and digestion causing reactions also to cooked foods. often associated with systemic and more severe reactions in addition to OAS. Proteins found in nuts and seeds serving as source material during the growth of a new plant.

LTP

Proteins stable to heat and digestion causing reactions also to cooked foods. often associated with systemic and more severe reactions in addition to OAS. Associated with allergic reactions to fruit and vegetables especially in regions where peach and closely related fruits are cultivated.

Pr-10 protein, Bet v 1 homologue

most PR-10 proteins are sensitive to heat and digestion and cooked foods are often tolerated. often associated with local symptoms such as oral allergy syndrome . Associated with allergic reactions to pollens, fruits and vegetables.

Proflin

Proteins sensitive to heat and digestion and cooked foods are often tolerated. Seldom associated with clinical symptoms but may cause local and even severe reactions in some patients. Profilins ae present in all pollen and plant foods.

CCD

A marker for sensitization to cross-reactive carbohydrate determinants. Rarely causes allergic reactions, but may produce positive in-vitro test results to CCd-containing allergens from pollen, plant foods, insects and venoms.

Tropomyosin

Parvalbumin

Serum albumin

What You Need To Know About Food Allergy Testing And Diagnosis

A good analysis will make a much more clear answer whether or not you have a food allergy, says Dr. Marshall Plaut, who is chief of the food allergy, atopic dermatitis and allergic mechanisms section for the National Institute of Allergy and Infectious Diseases .

Following is a guide to the different forms of food allergy tests, largely based on the most recent NIAID guidelines for food allergy and leading experts.

Physical Exam and Patient History

All forms of allergy testing, even when the results seem to be strong, must be considered together with a physical exam and a detailed patient history both of which can help narrow down what food might be the trigger.

You have to look at all the pieces of the puzzle because none of the tests by themselves are predictive enough of a diagnosis of a clinical allergy, Plaut says.

The physical exam and patient history also provide important clues, such as symptoms that could indicate whether or not the allergy is mediated by IgE antibodies. These are important for determining which tests to get.

Skin-Prick Test

Then its a waiting game. The patients skin may react by forming a reddish hive, or wheal, at specific prick spots, indicating that the IgE antibodies in the skin responded to the food allergen in that serum.

Blood Test

Component Testing

This relatively new form of IgE blood test looks at the specific proteins of an allergen that cause a reaction, rather than the allergen as a whole.

Atopy Patch Test

Intradermal Testing

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What Do The Test Results Mean

The ImmunoCAP blood test will typically come back as normal for the average person. Having a low result is not typically bothersome because low levels of IgE that is allergen-specific will not cause the upper respiratory symptoms which may be difficult to handle for certcain patients.

It is the high levels of IgE levels that are of concern. For the vast majority of patients, the presence of high levels of IgE is typically a result of the presence of an allergy. Any time histamines are created because of an allergy exposure, there will be a high or positive result from the ImmunoCAP blood test. The benefit of this test is that it can provide quantitative measurements of the severity of an allergy to let people know that they have allergies to specific items.

Preparing For Allergy Test

Preparing for the Allergy test is as simple as performing it. The procedure for performing the test, but may vary, as per the type of allergy that needs to be detected. Before conducting the final evaluation, your health practitioner will investigate about your family history, lifestyle, and other factors. The doctor will even suggest you to stop consuming certain medications as these may affect the Allergy test results. You need to stop intake:

• Medications for heartburn
• Tricyclic antidepressants

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The Immunocap Test Menu: Sophisticated Solutions For Broad Diagnostic Needs

The ImmunoCAP test menu includes sIgE, sIgG, and sIgG4, and biomarkers for eosinophilic inflammation and mast cell activation. All available on the same reliable automated Phadia instruments. Our specific IgE test menu covers a broad range of more than 550 allergens with allergen mixes, whole allergens, and more than 100 allergen components. Specific IgE tests are provided as single tests, multiplex, and even point-of-care tests.

To date the most commonly used system to determine allergen-specific IgE is the ImmunoCAP system considered as the gold standard for the in vitro diagnosis of allergic conditions.

GLOBAL ATLAS OF ALLERGY, EAACI1

Why Should I Incorporate This Test In My Practice

Your daily practice routinely includes patients who present with URD: rhinitis, sinusitis, and allergic rhinitis. The source of their symptoms may be viral, bacterial, or allergic, making definitive diagnosis an essential step in determining appropriate treatment. More than a nuisance, these conditions affect tens of millions of Americans, have a significant impact on quality of life, and result in billions of dollars in direct and indirect costs. Allergy awareness among the general population is at an all-time high, and patients and clinicians want to get to the cause of respiratory distress. Now more than ever, URD management is an important part of the primary care practice. ImmunoCAP provides quantitative evidence that clearly demonstrates the appropriateness and value of your patient’s treatment plan. The right treatment decisions, based on clinical evidence, mean appropriate use of antibiotics, antihistamines, and intranasal steroids, fewer repeat office visits, and fewer unnecessary referrals.

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Evidence On Management Using Immunocap Isac

Discontinuation of restrictive diets

4.22 Two studies investigated using ImmunoCAP ISAC to guide discontinuation of restrictive diets in children with food allergies . Both studies were only reported as conference abstracts and so gave only limited study details and results.

4.23 Hermansson et al. used a database to identify 199 schoolchildren in Harkatie, Finland, having special diets in school catering. The details of this study are confidential at the time of writing this document. No information on clinical outcomes after changes to dietary management was reported.

4.24 Noimark et al. investigated 12 children selected from people attending an east London allergy clinic . Participants were investigated using skin prick testing with or without single specificIgE testing, and an unspecified version of ImmunoCAP ISAC. The authors reported that ImmunoCAP ISAC testing helped with potential food reintroductions , in addition to those indicated by single specificIgE testing alone the numbers of potential reintroductions based on standard diagnostic workup were not reported. No details were given on which single specificIgE tests or skin prick tests were done or which ISAC components were assessed. The number of food reintroductions that happened after testing, or clinical outcomes after any changes to dietary management were not reported.

Value of additional information

Changes in specific immunotherapy prescriptions

Who Are Allergy Tests For

Some 20 to 30 %of Canadians suffer from some form of allergy and recent research indicates that one in thirteen has a significant food allergy. Early screening and rapid intervention, especially for children, is the best way to prevent eventual complications from an allergy. The diagnosis of an allergy should be made by a health professional who specializes in this area.

Any diagnosis of allergy is based primarily on detailed observation. The type of symptoms and the circumstances of the reaction will enable the specialist to determine the appropriate tests: a combination of skin tests and blood IgE assays.

Biron provides innovative tests, which are timely and precise, covering over 650 allergens. These help to prevent your allergy from transforming into a chronic disease.

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What Happens During The Rast

• You will have blood drawn at the lab. The amount needed will depend upon the number of foods being tested for.
• The lab will send your blood sample out to be tested. Your allergist will call you to discuss the results as soon as they are available, usually in about two weeks.
• The Food Allergy Clinic uses a specific type of RAST called ImmunoCAP, which has been studied more than others for its use in food allergy. ImmunoCAP allows Food Allergy Clinic allergists to compare your test results with known values and ranges that show the relative likelihood of a food allergy, which can help your allergist make a diagnosis.

What Happens During The Spt

• First, we place a drop of liquid extract containing a small amount of the suspected food allergen on your forearm.
• Then, with a device similar to a plastic toothpick, we gently scratch the skin so that a tiny amount of the extract is absorbed.
• Over the next 10 to 20 minutes, we monitor the skin for a localized reactionredness, swelling or a measurable bump, called a wheal.
• Afterwards, we wipe off the skin and apply or administer antihistamine as needed. There is no bleeding, so you won’t need a bandage. SPT can be mildly uncomfortable for some people, but the discomfort is usually brief.

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Gold Standard Testing Technology You Can Trust

As pioneers in allergy diagnostics we have more than 50 years of experience in allergen production and specific IgE product development Our products are documented in more than 6,000 publications2 and referenced in multiple health guidelines. These may be some of the reasons for ImmunoCAP being acknowledged as the gold standard technology1 for specific IgE blood testing.

Calculation Of Test Performance

We calculated the detection rate of a test as the percentage of test results that confirmed the patient’s clinical diagnosis as determined by the patient’s history. We did not perform any statistical tests of the difference between the detection rate of 1 diagnostic test and another in view of the absence of the gold standard result of challenge testing. The sensitivities and specificities of SPT, ImmunoCAP and ISAC were calculated for patients in each diagnostic category, as shown in Table 1. We did not calculate these 2 parameters for combinations of tests as, for some patients, diagnostic tests gave conflicting results. In these instances, it would be difficult to categorise outcomes adjudged to give false-positive or false-negative results.

Table 1

Sensitivity and specificity of different tests

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