Lecture
New development in food allergy diagnostics
- at -
- ICM Saal 4a
- Type: Lecture
Lecture description
M. Berkefeld, Frankfurt am Main/DE, K. Bluemchen, Frankfurt am Main/DE
Food allergies are an increasing health concern worldwide, especially in the pediatric population. Precise diagnostic strategies are needed to prevent severe allergic reactions, but also to avoid overdiagnosis and unnecessary dietary restictions. Guided by clinical history, double-blind, placebo-controlled food challenges (DBPCFCs) using objective stopping criteria, remain the gold standard in food allergy diagnostics. However, recent advances in analytical and molecular diagnostic methods have substantially transformed food allergy assessment [1].
Component-resolved diagnostics (CRD), using purified and recombinant allergen molecules instead of whole extracts, improve discrimination between primary allergy and clinically irrelevant cross-reactive sensitization. Retrospective analyses of food challenge results have determined more precise CRD cut-off values to rule out or confirm suspected diagnoses [2]. The combination of different diagnostic markers, including skinprick tests and clinical factors, further increases specificity and sensitivity [3]. Promising new biomarkers, such as the basophil and mast cell activation test, T-cell assays, transcriptomics and metabolomics are available, but their clinical feasibility remains limited [4]. Beyond diagnostic confirmation, the prediction of reaction severity and risk stratification continues to be an important focus of current research [5].
The aim of this presentation is to summarize these findings and their translation into pediatric clinical practice. The potential of novel diagnostic algorithms to avoid unnecessary food challenges and dietary restrictions and thus improving the quality of life of patients and their families will be evaluated.
Literature:
[1] EAACI guidelines on the diagnosis of IgE-mediated food allergy Santos AF, Allergy. 2023 Dec;78(12):3057-3076.
[2] Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy Riggioni C, Allergy. 2024 Feb;79(2):324-352.
[3] Highly accurate prediction of food challenge outcome using routinely available clinical data DunnGalvin A, J Allergy Clin Immunol. 2011 Mar;127(3):633-9.e1-3.
[4] Novel Biomarkers and Diagnostic Tools in Food Allergy Bunyavanich S, Allergy. 2025 Nov 5.
[5] Global Allergy, Asthma European Network (GA2LEN) Food Allergy Guideline Group. Risk factors for severe reactions in food allergy: Rapid evidence review with meta-analysis. Turner PJ, Allergy. 2022 Sep;77(9):2634-2652.
Food allergies are an increasing health concern worldwide, especially in the pediatric population. Precise diagnostic strategies are needed to prevent severe allergic reactions, but also to avoid overdiagnosis and unnecessary dietary restictions. Guided by clinical history, double-blind, placebo-controlled food challenges (DBPCFCs) using objective stopping criteria, remain the gold standard in food allergy diagnostics. However, recent advances in analytical and molecular diagnostic methods have substantially transformed food allergy assessment [1].
Component-resolved diagnostics (CRD), using purified and recombinant allergen molecules instead of whole extracts, improve discrimination between primary allergy and clinically irrelevant cross-reactive sensitization. Retrospective analyses of food challenge results have determined more precise CRD cut-off values to rule out or confirm suspected diagnoses [2]. The combination of different diagnostic markers, including skinprick tests and clinical factors, further increases specificity and sensitivity [3]. Promising new biomarkers, such as the basophil and mast cell activation test, T-cell assays, transcriptomics and metabolomics are available, but their clinical feasibility remains limited [4]. Beyond diagnostic confirmation, the prediction of reaction severity and risk stratification continues to be an important focus of current research [5].
The aim of this presentation is to summarize these findings and their translation into pediatric clinical practice. The potential of novel diagnostic algorithms to avoid unnecessary food challenges and dietary restrictions and thus improving the quality of life of patients and their families will be evaluated.
Literature:
[1] EAACI guidelines on the diagnosis of IgE-mediated food allergy Santos AF, Allergy. 2023 Dec;78(12):3057-3076.
[2] Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy Riggioni C, Allergy. 2024 Feb;79(2):324-352.
[3] Highly accurate prediction of food challenge outcome using routinely available clinical data DunnGalvin A, J Allergy Clin Immunol. 2011 Mar;127(3):633-9.e1-3.
[4] Novel Biomarkers and Diagnostic Tools in Food Allergy Bunyavanich S, Allergy. 2025 Nov 5.
[5] Global Allergy, Asthma European Network (GA2LEN) Food Allergy Guideline Group. Risk factors for severe reactions in food allergy: Rapid evidence review with meta-analysis. Turner PJ, Allergy. 2022 Sep;77(9):2634-2652.
