Problems in allergen standardization

Platts‐Mills, Thomas A.E.; Rawle, Frances; Chapman, Martin D.

doi:10.1007/bf02992996

Cited by 36 publications

(33 citation statements)

References 32 publications

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“…Biological activity should ideally be assessed in vivo, with skin testing. [90][91][92] However, the methods used differ from manufacturer to manufacturer, making products from different companies impossible to compare. 93 Non-related allergen mixtures may account for loss of biological potency as a consequence of excessive dilution or enzymatic deterioration of the epitopes.…”

Section: Limitationsmentioning

confidence: 99%

Skin prick tests and allergy diagnosis

Antunes

Borrego

Romeira

et al. 2009

Allergologia et Immunopathologia

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Skin testing remains an essential diagnostic tool in modern allergy practice. A signifi cant variability has been reported regarding technical procedures, interpretation of results and documentation. This review has the aim of consolidating methodological recommendations through a critical analysis on past and recent data. This will allow a better understanding on skin prick test (SPT) history; technique; (contra-) indications; interpretation of results; diagnostic pitfalls; adverse reactions; and variability factors. Skin has an important physiological role in the internal balance homeostasis and constitutes a crucial barrier against external aggressions, with well-known immunological properties. 1 It has been used by allergists for decades as an easily assessed laboratory of the immunological status of the individual.The fi rst skin testing technique was developed by Charles H. Blackley in 1865, a Manchester homeopathic physician with allergic rhinitis. He abraded a quarter-inch area of his skin with a lancet and then applied grass pollen grains. 2 The so-called scratch test was later adopted by Schloss for the diagnosis of food allergy in children. 3 Epicutaneous tests can be divided into scratch tests and prick/puncture tests. The fi rst method, proposed by Blackley 2 , implied a linear scratch without drawing blood and could either be performed fi rst, with the extract then dropped on the abraded skin, or be made through a drop of extract. 4 Although it was used extensively in the past, this technique became progressively obsolete due to patient discomfort, poor reproducibility, possible residual lesions and newer and innocuous procedures. 4 Therefore, scratch test is mentioned here for historical purposes only. It was Sir Thomas Lewis who, in 1924, fi rst applied skin prick tests (SPT). 5 Nevertheless, their generalised use in clinical practice only became a reality about 30 years ago, as a result of technique modifi cations proposed by Pepys. 6 For the purpose of this review and for easier comprehension, skin testing will be referred interchangeably as SPT, whatever device is used for its application.In 1966, Ishizaka's work on immunoglobulin E (IgE) and immediate hypersensitivity reactions 7 established the scientifi c corpus to what was done till then on a strictly empiric basis.As written by Dr Walzer in 1974, "the fact that skin testing has not turned out to be a simple and completely reliable technique does not detract from the fact that, when it is intelligently and skilfully performed, it remains the most effective diagnostic procedure in reaginic allergic disorders". 8 The reliability of skin testing and proper documentation of test results are essential in allergy practice. A recent survey to all physician members and fellows of the American College of Allergy, Asthma and Immunology practicing in the

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Section: Limitationsmentioning

confidence: 99%

Skin prick tests and allergy diagnosis

Antunes

Borrego

Romeira

et al. 2009

Allergologia et Immunopathologia

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“…The World Health Organization (WHO)/International Union of Immunological Societies Allergen Standardization Sub-committee has been influential in coordinating international standardization. The committee established WHO-approved international standards for dust mite, dog hair, and birch, timothy, and short ragweed pollens and produced the WHO position paper that recommended the use of standardized allergen vaccines of defined allergen content for dosing in immunotherapy (Bousquet et al, 1998;Platts-Mills and Chapman, 1991). This approach was also endorsed by a position statement from the American Academy of Allergy, Asthma & Immunology (Cox et al, 2010).…”

Section: International Efforts To Standardized Allergensmentioning

confidence: 99%

“…Since extracts from different producers differ in composition there is no straightforward relationship between potency and response when comparing products from different Manufacturers and their potency cannot be compared in a satisfactory manner. Prick skin testing of human allergic subjects is the prevalent in vivo method for the assessment of allergen extract potency (Platts-Mills and Chapman, 1991) and also constitutes the standard underlying the determination of biological units of allergen extract potency. In this context, criteria of patient selection are obviously crucial, since potency measures will be dependent on pattern of sensitization in the panel of selected patients, Moreover, besides the characteristics of the sensitization to single allergen components, several other in vivo factors have been reported to variably influence prick test readings, such as age, sex, site of pricking, environmental pollution, season of the year (Bordignon and Burastero, 2006).…”

Section: Units and Measurementioning

confidence: 99%

Allergen Extract Analysis and Quality Control

Burastero¹

2011

Quality Control of Herbal Medicines and Related Areas

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“…The crude allergen extracts were prepared from cultured mites, and they probably contained a complex mixture of proteins of which only a few was allergenic. Due to the lack of available methods in measuring allergenic components in the extracts, the potency of these extracts might vary from batch to batch (Platts-Mills and Chapman, 1991). One way to characterize allergen extracts is to measure their major allergen levels with monoclonal antibodies.…”

Section: ─163─mentioning

confidence: 99%

Monoclonal antibodies to recombinant Der p 2, a major house dust mite allergen: specificity, epitope analysis and development of two-site capture ELISA

et al. 1999

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Abstract:House dust mite allergens have been well established as sensitizing agents that are important in the induction of allergic diseases. In order to analyze epitopes of the allergen and to develop a quantitative method of the allergen exposure, monoclonal antibodies against a recombinant Der p 2 (rDer p 2), one of the major allergens of Dermatophagoides pteronyssinus, were produced. Four monoclonal antibodies produced were species-specific and did not cross-react to the D. farinae crude extract. Two of the monoclonal antibodies were found to be IgG1 and the others were IgM. For the analysis of epitopes, a Der p 2 cDNA encoding 126 amino acids (aa) was dissected into three fragments with several overlapping peptides, A (aa residues 1-49), B (44-93), and C fragment (84-126). Three monoclonal antibodies showed reactivities to the recombinant B fragment and to the full-length rDer p 2, but one monoclonal antibody reacted only with the full-length rDer p 2. Two-site capture ELISA was developed using two different monoclonal antibodies for quantitating Der p 2 in house dust. The sensitivity limit was 4 ng/ml with rDer p 2 and 8 µg/ml with the D. pteronyssinus crude extract. The result suggested that the assay using monoclonal antibodies against rDer p 2 could be useful for the environmental studies and for the standardization of mite allergen extracts.

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Problems in allergen standardization

Cited by 36 publications

References 32 publications

Skin prick tests and allergy diagnosis

Skin prick tests and allergy diagnosis

Allergen Extract Analysis and Quality Control

Monoclonal antibodies to recombinant Der p 2, a major house dust mite allergen: specificity, epitope analysis and development of two-site capture ELISA

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