The fifth class of immunoglobulin, immunoglobulin E (IgE) was discovered in 1967 and has had immense importance for the understanding, diagnosis, and treatment of allergic disease. More than 50 years have passed and efforts to characterize, standardize, and refine allergens with the aim to improve clinical diagnosis and allergen-specific immunotherapy are still ongoing. Another important breakthrough was made in 1999 with the introduction of component-resolved diagnostics (CRD), making it possible to quantify IgE antibodies against individual allergen proteins for diagnostic purposes at a molecular level. The progress and developments made in allergy diagnosis often originate from clinical observations and case studies. Observant physicians and health-care personnel have reported their findings in the medical literature, which in turn has inspired researchers to become involved in clinical research. Allergists continuously encounter new allergies and are often asked by their patients how to prevent new reactions. In the current article, we focus on recent clinical observations that can now be explained by CRD. The examples taken concern allergic reactions toward peanuts, tree nuts, lemon kernels, health drinks, meat, insects, dog dander, cannabis, and semen. We now have an improved understanding of why patients may react in a serious or unexpected way, as illustrated by these examples, yet many other clinical observations remain unexplained. The aim of this review is to highlight the importance of clinical observations among allergic patients, focusing on systemic, or unusual and unexpected allergic reactions, where component-testing has further refined the diagnosis of IgE-mediated allergy.
Int Arch Allergy Immunol

中文翻译：

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分子过敏诊断可以揭示异常和意外的过敏反应


第五类免疫球蛋白，免疫球蛋白 E (IgE) 于 1967 年被发现，对于过敏性疾病的理解、诊断和治疗具有极其重要的意义。 50 多年过去了，为了改善临床诊断和过敏原特异性免疫治疗而对过敏原进行表征、标准化和细化的努力仍在继续。 1999 年，组件解析诊断 (CRD) 的引入取得了另一个重要突破，使得在分子水平上量化针对单个过敏原蛋白的 IgE 抗体以用于诊断目的成为可能。过敏诊断的进步和发展往往源于临床观察和案例研究。细心的医生和卫生保健人员在医学文献中报告了他们的发现，这反过来又激发了研究人员参与临床研究。过敏症专科医生不断遇到新的过敏症，患者经常询问如何预防新的反应。在本文中，我们重点关注最近可以用 CRD 解释的临床观察结果。所举的例子涉及对花生、坚果、柠檬仁、保健饮料、肉类、昆虫、狗皮屑、大麻和精液的过敏反应。正如这些例子所示，我们现在对为什么患者可能会以严重或意外的方式做出反应有了更好的理解，但许多其他临床观察结果仍然无法解释。本综述的目的是强调过敏患者中临床观察的重要性，重点关注全身性或不寻常和意外的过敏反应，其中成分测试进一步完善了 IgE 介导的过敏的诊断。
 Int Arch 过敏免疫