%0 Journal Article
%T Component-Resolved Diagnosis in Pediatrics
%A Ole D. Wolthers
%J ISRN Pediatrics
%D 2012
%R 10.5402/2012/806920
%X Component resolved diagnosis is a new concept in the investigation of pediatric allergic disease. The aim of the present paper is to review the available data on component resolved diagnosis with respect to implications for investigation of children with allergic disease. In most conditions head-to-head comparisons of component resolved diagnosis with traditional IgE testing have not been performed. Rather than alternatives the molecular methods should be seen as adjuncts to the cheaper traditional specific IgE tests. It may be appropriate to determine IgE antibodies to components as part of the diagnostic work-up in selected cases of peanut and birch pollen allergy and in hymenoptera allergy. However, cost benefit analyses of component resolved diagnosis compared with traditional work-up of allergy are needed. Prospectively planned protocols for assessment of the extent to which component resolved diagnosis may be able to improve the selection of children to immunotherapy and, thus, the efficacy of immunotherapy, are needed. Finally, studies of component resolved diagnosis with microarray technology in screening panels with hundreds of components should be undertaken before it can be determined to which extent such panel screening, if at all, may be helpful in children. 1. Introduction Traditionally, diagnosis of pediatric allergic disease is based on a careful and thorough history, skin prick testing, and assessment of specific IgE antibodies to allergens in the blood, and on provocation or elimination-provocation-elimination tests. By means of molecular methods over the last few years, it has become possible to measure IgE antibodies to specific components of allergens. The methods are designated as component-resolved diagnosis [1¨C4]. The molecular structures of many allergens have been characterized and are commercially available as recombinant products. This has focused attention on the need for assessment of the clinical application of the methods in pediatric populations; however, guidelines or consensus on their use have not been defined. The aims of this paper is to introduce the concept of component resolved diagnosis, to identify conditions in which the new diagnostic tool may be helpful in pediatric allergic disease, and to discuss conditions in which more evidence should be provided before large-scale use of the methods may be warranted. 2. Allergens and Components All protein component material possesses a potential for development of allergy. Proteins in allergen sources (e.g., peanuts, pollen, and hymenoptera) often contain several
%U http://www.hindawi.com/journals/isrn.pediatrics/2012/806920/