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Chapter 106 : In Vivo Diagnostic Allergy Testing

Authors: Derek A. Damin, R. Stokes, Jr. Peebles
Content Type: Reference
Publication Year: 2006

Category: Immunology

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Abstract:

Prick-puncture and intradermal skin testing are the most commonly used methods for the diagnosis of immediate hypersensitivity in allergic disease, while airway challenges may be used in the evaluation of rhinitis and asthma. This chapter describes the technique and utility of in vivo skin testing, intranasal allergen challenge, and specific and nonspecific lower airway challenge testing. These tools provide clinically useful information in the evaluation of the atopic patient. Allergen skin testing is considered to be the most convenient, least expensive, and most specific screening method in the diagnosis of allergic diseases. General principles that relate to in vivo examination are discussed in this chapter. Several methods have been developed to test the effect of antigen exposure on the nasal mucosal surface in allergic reactions. First, a specific antigen is identified by a combination of history consistent of allergic symptoms upon exposure to the antigen and positive skin testing, followed by intranasal challenge with that antigen. The two most commonly used methods of intranasal challenge include instillation of antigen into the nares either by spray pump or by nebulizer. The contraindications for methacholine and histamine challenges are essentially the same as for whole-lung antigen challenge. Persons exposed to oxidizing pollutants, smokers, and cystic fibrosis patients may also have increased reactivity based on methacholine and histamine challenges. Challenge procedures can be extremely useful in the investigation of allergy.

Citation: Damin D, Peebles R. 2006. In Vivo Diagnostic Allergy Testing, p 948-954. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch106
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In Vivo Diagnostic Allergy Testing
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Citation: Damin D, Peebles R. 2006. In Vivo Diagnostic Allergy Testing, p 948-954. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch106
/content/10.1128/9781555815905.ch106.ch106fig01
FIGURE 1
Graph of the change of FEV1 that occurs in an allergic asthmatic subject during a typical whole-lung challenge to which the subject is sensitive. Protein nitrogen units (PNU) are one measure of allergen quantity.
10.1128/9781555815905/f0952-01_thmb.gif
10.1128/9781555815905/f0952-01.gif
Image of FIGURE 1
FIGURE 1

Graph of the change of FEV1 that occurs in an allergic asthmatic subject during a typical whole-lung challenge to which the subject is sensitive. Protein nitrogen units (PNU) are one measure of allergen quantity.

Citation: Damin D, Peebles R. 2006. In Vivo Diagnostic Allergy Testing, p 948-954. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch106
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References

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1. Almind, M.,, A. Dirksen,, N. H. Nielsen, and , U. G. Svendsen. 1988. Duration of the inhibitory activity on histamine-induced skin weals of sedative and non-sedative antihistamines. Allergy 43: 593– 596.
2. Bernstein, I. L., and , W. W. Storms. 1995. Practice parameters for allergy diagnostic testing. Joint Task Force on Practice Parameters for the Diagnosis and Treatment of Asthma. The American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology. Ann. Allergy Asthma Immunol. 75: 543– 625.
3. Blackley, C. H. 1873. Experimental researches on the causes and nature of Catarrhus Aestivus (hay fever or hay-asthma). Balliere, Tindall and Cox, London, England.
4. Cockcroft, D. W.,, R. E. Ruffin,, P. A. Frith,, A. Cartier,, E. F. Juniper,, J. Dolovich. and , E. E. Hargreave. 1979. Determinants of allergen-induced asthma: dose of allergen, circulating IgE antibody concentration, and bronchial responsiveness to inhaled histamine. Am. Rev. Respir. Dis. 120: 1053– 1058.
5. Crapo, R. O.,, R. Casaburi,, A. L. Coates,, P. L. Enright,, J. L. Hankinson,, C. G. Irvin,, N. R. Maclntyre,, R. T. McKay,, J. S. Wanger,, S. D. Anderson,, D. W. Cockcroft,, J. E. Fish, and , P. J. Sterk. 2000. Guidelines for methacholine and exercise challenge testing—1999. Am. J. Respir. Crit. Care Med. 161: 309– 329.
6. De Meer, G.,, D. J. J. Heederik,, B. Brunekreef, and , D. S. Postma. 2001. Repeatability of bronchial hyperresponsive-ness to adenosine-5’-monophosphate (AMP) by a short dosimeter protocol. Thorax 56: 362– 365.
7. De Meer, G.,, G. B. Marks, and , D. S. Postma. 2004. Direct or indirect stimuli for bronchial challenge testing: what is the relevance for asthma epidemiology? Clin. Exp. Allergy 34: 9– 16.
8. Doyle, W. J.,, D. P. Skoner,, J. T. Seroky, and , P. Fireman. 1995. Reproducibility of the effects of intranasal ragweed challenges in allergic subjects. Ann. Allergy Asthma Immunol. 74: 171– 176.
9. Gadde, J.,, M. Spence,, B. Wheeler, and , N F Adkinson, Jr. 1993. Clinical experience with penicillin skin testing in a large inner-city STD clinic. JAMA 270: 2456– 2463.
10. Golden, D. B.,, J. M. Tracy,, T. M. Freeman, and , D. R. Hoffman; Insect Committee of the American Academy of Allergy, Asthma and Immunology. 2003. Negative venom skin test results in patients with histories of systemic reaction to a sting. J. Allergy Clin. Immunol. 112: 495– 498.
11. Grier, T.,, D. Hazelhurst,, E. Duncan, and , R. Esch. 2001. Stability, compatibility, and cross-reactivity of allergens: immunochemical reactivities and practical considerations. Presented at ACAAI Annual Meeting, 16 to 20 November 2001, Orlando, Fla.
12. Hopp, R. J.,, A. K. Bewtra,, N. M. Nair, and , R. G. Townley. 1984. Specificity and sensitivity of methacholine inhalation challenge in normal and asthmatic children. J. Allergy Clin. Immunol. 74: 154– 158.
13. Lewis, T., and , R. T. Grant. 1924. Vascular reactions of the skin to injury. Part II. The liberation of a histamine-like substance in injured skin, the underlying cause of factitious urticaria and of wheals produced by burning; and observations upon the nervous control of certain skin reactions. Heart 11: 209– 265.
14. Lin, H.,, K. M. Boesel,, D. T. Griffith,, C. Prussin,, B. Foster,, F. A. Romero,, R. Townley, and , T. B. Casale. 2004. Omalizumab rapidly decreases nasal allergic response and FcepsilonRI on basophils. J. Allergy Clin. Immunol. 113: 297– 302.
15. Majchel, A. M.,, F. Baroody,, A. Kagey-Sobotka,, L. M. Lichtenstein, and , R. M. Naclerio. 1993. Effect of oxymetazoline on the early response to nasal challenge with antigen. J. Allergy Clin. Immunol. 92: 767– 770.
16. McCann, W. A., and , D. R. Ownby. 2002. The repro-ducibility of the allergy skin test scoring and interpretation by board-certified/board-eligible allergists. Ann. Allergy Asthma Immunol. 89: 368– 371.
17. Nelson, H. S. 2004. Preparing and mixing allergen vaccines. Clin. Allergy Immunol. 18: 457– 479.
18. Nelson, H. S.,, D. Ikle, and , A. Buchmeier. 1996. Studies of allergen extract stability: the effects of dilution and mixing. J. Allergy Clin. Immunol. 98: 382– 388.
19. Nelson, H. S.,, J. Knoetzer, and , B. Bucher. 1996. Effect of distance between sites and region of the body on results of skin prick tests. J. Allergy Clin. Immunol. 97: 596– 601.
20. Nelson, H. S.,, C. Kolehmainen,, J. Lahr,, J. Murphy, and , A. Buchmeier. 2004. A comparison of multiheaded devices for allergy skin testing. J. Allergy Clin. Immunol. 113: 1218– 1219.
21. Nelson, H. S.,, J. Lahr,, A. Buchmeier, and , D. McCormick. 1998. Evaluation of devices for skin prick testing. J. Allergy Clin. Immunol. 101: 153– 156.
22. Nelson, H. S.,, J. Oppenheimer,, A. Buchmeier,, T. R. Kordash, and , L. L. Freshwater. 1996. An assessment of the role of intradermal skin testing in the diagnosis of clinically relevant allergy to timothy grass. J. Allergy Clin. Immunol. 97: 1193– 1201.
23. Peebles, R. S., Jr.,, E. M. Wagner,, M. C. Liu,, D. Proud,, R. G. Hamilton, and , A. Togias. 2001. Allergen-induced changes in airway responsiveness are not related to indices of airway edema. J. Allergy Clin. Immunol. 107: 805– 811.
24. Rosen, J. P.,, J. E. Selcow,, L. M. Mendelson,, M. P. Grodofsky,, J. M. Factor, and , H. A. Sampson. 1994. Skin testing with natural foods in patients suspected of having food allergies: is it a necessity? J. Allergy Clin. Immunol. 93: 1068– 1070.
25. Ryan, G.,, M. B. Dolovich,, R. S. Roberts,, P. A. Frith,, E. F. Juniper,, F. E. Hargreave, and , M. T. Newhouse. 1981. Standardization of inhalation provocation tests: two techniques of aerosol generation and inhalation compared. Am. Rev. Respir. Dis. 123: 195– 199.
26. Sampson, H. A. 1988. Comparative study of commercial food antigen extracts for the diagnosis of food hypersensitivity J. Allergy Clin. Immunol. 2: 718– 726.
27. Sampson, H. A. 2004. Update on food allergy. J. Allergy Clin. Immunol. 113: 805– 819.
28. Sicherer, S. H., and , H. A. Sampson. 1999. Food hyper-sensitivity and atopic dermatitis: pathophysiology, epidemiology, diagnosis, and management. J. Allergy Clin. Immunol. 104: S114– S122.
29. Simons, F. E.,, X. Gu, and , K. J. Simons. 2001. Epinephrine absorption in adults: intramuscular versus subcutaneous injection. J. Allergy Clin. Immunol. 108: 871– 873.
30. Slater, J. E. 2004. Recombinant allergens in the US. Methods 32: 209– 211.
31. Sogn, D. D.,, R. Evans III,, G. M. Shepherd,, T. B. Casale,, J. Condemi,, P. A. Greenberger,, R F. Kohler,, A. Saxon,, R. J. Summers,, P. P. VanArsdel,, J. G. Massicot,, W. C. Blackwelder, and , B. B. Levine. 1992. Results of the National Institute of Allergy and Infectious Diseases Collaborative Clinical Trial to test the predictive value of skin testing with major and minor penicillin derivatives in hospitalized adults. Arch. Intern. Med. 152: 1025– 1032.
32. Turkeltaub, P. C. 2000. Percutaneous and intracutaneous diagnostic tests of IgE-mediated diseases (immediate hyper-sensitivity). Clin. Allergy Immunol. 15: 53– 87.
33. Wood, R. A.,, W Phipatanakul,, R. G. Hamilton, and , P. A. Eggleston. 1999. A comparison of skin prick tests, intradermal skin tests, and RASTs in the diagnosis of cat allergy. J. Allergy Clin. Immunol. 103: 773– 779.
34. Woolcock, A. J.,, K. Yan, and , C. Salome. 1983. Methods for assessing bronchial reactivity. Eur. J. Respir. Dis. 64(Suppl. 128): 181– 194.
35. Wubbel, C.,, M. J. Asmus,, G. Stevens,, S. E. Chesrown, and , L. Hendeles. 2004. Methacholine challenge testing: comparison of the two American Thoracic Society-recommended methods. Chest 125: 453– 458.
36. Yunginger, J. W,, S. Ahlstedt,, P. A. Eggleston,, H. A. Homburger,, H. S. Nelson,, D. R. Ownby,, T. A. Platts-Mills,, H. A. Sampson,, S. H. Sicherer,, A. M. Weinstein,, P. B. Williams,, R. A. Wood, and , R. S. Zeiger. 2000. Quantitative IgE antibody assays in allergic diseases. J. Allergy Clin. Immunol. 105: 1077– 1084.

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