Skin tests are the main diagnostic tool of the allergist. They are done painlessly, giving a safe picture of the “allergic” antibodies of the body in a few minutes. Contrary to popular belief, skin tests are very reliable even at a very young age – in anyone over 2 months old. Of course, it is necessary that the allergy in question be antibody-mediated, as is the case with respiratory allergies, but also with food allergies with immediate symptoms after eating. They are also useful in immediate (rapid) type drug allergies, as well as in cases of allergy to bee and wasp venom.
With the help of molecular diagnostic tests, it is now possible, with a simple blood test, to distinguish the characteristics of an allergy more accurately, since we can know not only to which food the body has developed “allergic” antibodies, but also to which specific food molecules. Take the example of a nut allergy, each containing dozens of individual allergens. Traditionally, a patient with a positive allergy test would not know exactly what any of their positive results mean: do they mean they can eat several fruits at a time without any symptoms other than a slight itchy mouth, or that the patient is at risk of an anaphylactic shock upon contact with even traces of a particular fruit? Is it safe to eat raw fruits or stick to cooked ones? Is it an allergy that will pass or is it a long and persistent disease?
This information is now given by knowing the responsible allergenic molecule in the food, which can be “hard” or “soft”, in which case the allergy fits the respective characteristics. Molecular methods are available for most food allergies (in nuts, fruits and vegetables, cereals, eggs and milk, fish, and seafood), but the usefulness of molecular diagnostics does not end there: it helps to better identify the protein responsible, in case of allergic asthma and allergic rhinitis. Like so, the results of conventional RAST tests can be refined, especially where many positive values appear, such as in patients sensitized to more than one pollen. This helps to better select patients for immunotherapy with environmental allergens, it acts as an effective filter so that only patients with a reasonable expected benefit receive immunotherapy. This contributes to the choice of the most appropriate immunotherapy regimen, based on the content of various molecular allergens in various preparations. Thus, the effectiveness of immunotherapy in a particular patient is increased. Clarifies the responsible molecular allergen in case of allergy to Hymenoptera (bees, wasps). And here the advantage lies in more effective immunotherapy compared to classical research methods.