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CHaPtEr 95  Assessment of Human Allergic Diseases                1293


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           activated with anti-IgE or bee/Vespid venoms.  Fifteen minutes   REFERENCES
           after stimulation, basophils from 15 wasp-sensitized patients
           upregulated  CD203c  expression  from  4.2-fold  to  13.5-fold.   1.  Prausnitz C, Kustner H. Studine uber die Ueberemfindlichkeil. Zentralbl
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           Cytometric Assays                                       6.  Barbee RA, Halomen M, Lebowitz M, et al. Distribution of IgE in a
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           blood must be received within 24 hours by the laboratory, where   7.  Kleine-Tebbe J, Poulsen LK, Hamilton RG. Quality management in
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           extracts lack potency estimates and can often be cytotoxic. Thus   11.  Saini SS, Bindslev-Jensen C, Maurer M, et al. Efficacy and safety of
           each stimulating allergen needs to be prequalified with basophils   omalizumab in patients with chronic idiopathic/spontaneous urticaria
           from well-characterized  patients  before use. Fourth,  criteria   who remain symptomatic on H1 antihistamines: a randomized,
                                                                    placebo-controlled study. J Invest Dermatol 2015;135:67–75.
           for defining positive assay results vary among the laboratories   12.  Wide L, Bennich H, Johansson SGO. Diagnosis by an in vitro test for
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           even the same manufacturer can have variable potency. Fifth,   13.  Hamilton RG, Matsson PNJ, Chan S, et al. Analytical performance
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           most important, when the performance characteristics were   specificities. 3rd ed. I/LA20-A3, International CLSI-Guideline. Wayne, PA:
           directly compared in clinical studies to puncture skin test results,   Clinical Laboratory Standards Institute; 2016.
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               On tHE HOrIZOn                                       Pract 2015;3:871–6.
                                                                  17.  Hamilton RG. Allergic sensitization is a key risk factor for but not
            New trends in laboratory methodology for the assessment of human
            allergic diseases include the following:                synonymous with allergic disease. J Allergy Clin Immunol
            •  Although there is a transition from the use of crude allergen extracts   2014;134:360–1.
              to allergenic components in immunoglobulin E (IgE) antibody serological   18.  Hamilton RG. Diagnostic in vivo and in vitro methods in insect allergy.
              assays, extracts will remain the principal allergen reagent source for   In: Freeman T, Tracy J, editors. Stinging insect allergy: a clinician’s guide.
              the foreseeable future because of their comprehensive nature.  NY: Springer Science; 2017. p. 85–99.
            •  Multiplexing platforms are being increasingly developed to allow rapid   19.  Guerin B, Watson RD. Skin tests. Clin Rev Allergy 1988;6:211.
              simultaneous detection of IgE antibodies to many allergenic components   20.  Mirela Chiriac A, Bousquet J, Demoly P, et al. In vivo methods for study
              using microliter quantities of serum; however, due to their semiquantita-  and diagnosis of allergy: skin tests, techniques and interpretation. In:
              tive nature, fixed panel of specificities, and lower analytical sensitivity,   Adkinson NF Jr, Bochner BS, Burks AW, et al, editors. Middleton’s allergy:
              single-plex assays will remain the most cost-effective and widely used   principles and practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014.
              assay format for the foreseeable future.              p. 1119.
            •  Qualitative  “point of care” IgE antibody assays to rapidly assess   21.  Lewis T, Grant R. Vascular reactions of the skin to injury. Part II. The
              sensitization to aeroallergens during the patient’s visit will be slow to   liberation of a histamine-like substance in injured skin, the underlying
              be adopted because of their limited/fixed allergen menus, lower   cause of factitious urticaria and of wheals produced by burning; and
              diagnostic sensitivity, and concern about potential patient misinterpreta-  observations upon the nervous control of certain skin reactions. Heart
              tion of results.                                      1924;209:1924.
                                                                  22.  Pepys J. Skin testing. Br J Hosp Med 1975;14:412–25.
           Please check your eBook at https://expertconsult.inkling.com/   23.  Tversky JR, Chelladurai Y, McGready J, et al. Performance and pain
           for self-assessment questions. See inside cover for registration   tolerability of current diagnostic allergy skin prick test devices. J Allergy
           details.                                                 Clin Immunol Pract 2015;3:888–93.
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