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Component-resolved diagnosis in anaphylaxis

Cardona, Victoria; Ansotegui, Ignacio J.

Current Opinion in Allergy and Clinical Immunology: June 2016 - Volume 16 - Issue 3 - p 244–249
doi: 10.1097/ACI.0000000000000261
OUTCOME MEASURES: Edited by Henry Milgrom and René Maximiliano Gómez
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Purpose of review Component-resolved diagnosis (CRD) is an advanced tool capable of aiding the clinician in fine tuning the diagnosis of the causal allergens of a reaction with the added value of providing information of severity risk, potential cross-reactivity, and subsequently, guiding management measures. This review will focus on the advantages of CRD of anaphylaxis in clinical practice.

Recent findings Research is continuously providing insight to which molecules are associated with genuine sensitization and/or potential severity risk for hymenoptera venom (Api m1, Ves v 1, Ves v 5, and Pol d 5), food allergy (seed storage proteins and nonspecific lipid transfer proteins), cofactor-enhanced food allergy (ω-5-gliadine, nonspecific lipid transfer proteins), red meat delayed anaphylaxis (α-gal), latex allergy (Hev b 1, Hev b 3, Hev b 5, and Hev b 6), and Anisakis allergy (Ani s 1, Ani s 4, Ani s 7, and Ani s 13); other molecules are primary associated with nonclinically relevant sensitizations, cross-reactivity, or mild reactions (carbohydrate determinants and profilins). New molecules, some minor allergens, are being identified as new potential biomarkers of severity.

Summary The usefulness of CRD in anaphylaxis is self-evident, since it improves the recognition of sensitization profiles associated with specific clinical outcomes and provides information to guide further management.

aDepartment of Internal Medicine, Allergy Section, Allergy Research Group, Institut de Recerca Vall d’Hebron, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona

bDepartment of Allergy and Immunology, Hospital Quirón Bizkaia, Carretera de Leioa-Unbe, Erandio, Bizkaia, Spain

Correspondence to Victoria Cardona, MD, PhD, Department of Internal medicine, Allergy Section, Allergy Research Group, Institut de Recerca Vall d’Hebron, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Ps. Vall d’Hebron 119-129, 08035 Barcelona, Spain. Tel: +34 93 2746169; e-mail: vcardona@vhebron.net

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