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Spiking with recombinant allergens to improve allergen extracts: bene ts and limitations for the use in routine diagnostics
Abstract Essentially, allergen components oer three possi-bilities to improve in vitro IgE diagnostics: a) Allergen components can be used individually for IgE determination. b) Allergen components can be combined as a mix in one test. c) Individual allergen components can be specically
added to the extract. Option (a) is currently being used most extensively in practice, while (b) represents more of a theoreti-cal possibility. e specic addition (“spiking”) of allergen components to an allergy extract (c) has been performed in the past for the ImmunoCAP® tests for latex (09/2001), hazelnut (05/2006) and wasp venom (06/2012). rough this approach under- represented allergen components could be compensated and the analytical sensitivity of the test systems signicantly increased. In combined use with molecular Singleplex tests, these modied testsallow for new diagnostic possibilities. Clear communication from the manufacturer regarding in which test and from what time point on, recom-binant allergens were added – and where this was
not done despite under-represented allergen compo-nents – is important for the interpretation of the test results in routine clinical practice.
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