ImmunoCAP®
TECHNICAL UPDATE

ImmunoCAP®

DESCRIPTION/BACKGROUND INFORMATION:

Causes of nasal symptoms associated with upper respiratory disease (URD) can range from aspirin intolerance to pregnancy. More than a nuisance, these conditions affect tens of million of Americans, have a significant impact on quality of life, and result in billions of dollars in direct and indirect costs.

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 only an empirical assessment. Relying on consideration of clinical history alone leads to more treatment for allergies than the results of clinical testing for allergies supports. Patient history and physical are important, but further inquiry is often necessary to provide an evidence-based diagnosis and treatment regimen.

The ImmunoCAP® Specific IgE blood test can confirm or exclude atopic disease as the cause of allergy-like symptoms and identify specific allergen sensitivities in patients with confirmed allergies. This validates the approach of a specific treatment plan, including prescription of antibiotics, antihistamines, and intranasal steroids, and leads to fewer office visits and referrals.

CLINICAL APPLICATION:

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 asthmas and other conditions in which IgE mediation is suspected.

The test can be run on patients of any age irregardless of skin condition. There is no need to stop current medications prior to drawing a blood sample. Once a definitive diagnosis is reached, regardless of the presence of 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.

ImmunoCAP® assays can be performed on hundreds of allergens such as weeds, trees, pollens, molds, foods, and animal dander. To minimize costs, the most prevalent allergens were selected, and immunological cross-reactions were taken into consideration. If there are particular allergens the clinician would like to have tested, additional allergen testing can be ordered.

METHODOLOGY:

The technology used in ImmunoCAP® is a vast improvement over earlier blood allergy testing (RAST®). The unique technology employed provides high binding capacity of clinically relevant allergen proteins, including those present in very low levels. This provides both accurate results and increased sensitivity, specificity, and reproducibility, equaling the most advanced in vitro allergy testing available today. While you can choose from hundreds of allergens, most patients presenting with nasal symptoms can be tested effectively with a regional Upper Respiratory Allergy Profile consisting of approximately 12 of the most common inhalant allergens specific to that region, along with total IgE.

TEST NAME & NUMBER:

• 2274 Immunoglobulin E (IgE)
• 80800 Upper Respiratory Profile
• 80802 Pediatric Profile
• 80801 Adult Food Profile

REFERENCES:

1. Szeinbach S, et al. Precision and accuracy of commercial laboratories' ability to classify positive and/or negative allergen-specific results. Ann Allergey Asthma Immunol. 2001; 86(4).373-381.
2. Williams PB, et al. Efficacy of a single diagnostic test for sensitization to common inhalant allergens. Ann Allergy Asthmas Immunol. 2001; 86(2):196-202.
3. Roland P, McCluggage CM, Schneider GW. Evaluation and management of allergic rhinitis: a guide for family physicians. Austin (TX): Texas Academy of Family Physicians; 2001.
4. Dykewicz MS, Fineman S, ed. Diagnosis and management of rhinitis: complete guidelines of the joint task force on practice parameters in allergy, asthma and immunology. Ann Allergy Asthma Immunol. 1998; 81:478-518.
5. Perelmutter, L and Emanuel, I. (1985). Assessment of in vitro IgE testing to diagnose allergic disease. Ann of Allergy; 55(6), 762-766.