Antibodies allergen sensitization tests

Review any diagnostic data (e.g., skin test and serum IgE-antibody immunoassay) to determine to which allergens the patient is sensitized. 

Treatment with omalizumab, the monoclonal humanized anti-IgE antibody, is reserved for patients with chronic severe asthma inadequately controlled by high-dose inhaled corticosteroid plus long-acting B-agonist combination treatment (eg, fluticasone 500 meg plus salmeterol 50 meg inhaled twice daily). This treatment reduces lymphocytic, eosinophilic bronchial inflammation and effectively reduces the frequency and severity of exacerbations. It is reserved for patients with demonstrated IgE-mediated sensitivity (by positive skin test or radioallergosorbent test [RAST] to common allergens) and an IgE level within a range that can be reduced sufficiently by twice-weekly subcutaneous injections. 

Diagnostic methods include SPT and quantification of specific IgE antibodies can be done using assays such as the ImmunoCAP or allergen-microarray. However, positive test results do not necessary confirm clinical sensitivity. Possible crossreactivity between tropomyosin from crustacean and mollusks with tropomyosin from insects and mites may have clinical significance and is discussed below. Sampson and Ho (1997) attempted to establish IgE values to predict clinical... 

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