Food Allergy as Defined by Component Resolved Diagnosis
Cristoforo Incorvaia, Andrea Rapetti, Maria Aliani, Corrado Castagneto, Nicoletta Corso, Massimo Landi, Daniele Lietti, Nicolangelo Murante, Lionello Muratore, Marina Russello, Elena Varin, Eleni Makrì, Nicola Fuiano and Enrico Scala
Affiliation: Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, via Bignami 1, Milan, Italy.
Keywords: Allergen immunotherapy, component resolved diagnosis, cross-reacting allergens, diagnostic tests, food allergy,
genuine sensitizers, management.
The diagnosis of food allergy, as assessed by skin tests or in vitro tests with allergen extracts, has insufficient
diagnostic performance and needs to be confirmed by food challenges. However, the availability of molecular allergens
(recombinant or highly purified) for laboratory methods has profoundly changed the diagnostic approach to food allergy.
In fact, the allergy diagnosis conducted at the molecular level, which is defined internationally as component resolved diagnosis
(CRD), allows to characterize more precisely the sensitization profile of the individual patient, distinguishing the
sensitizations to allergens that are strongly associated with a given source (genuine sensitizers) from those to molecules
that are common to many sources (panallergens) or cross-react with other components from the same family or from other
families. This review provides an update on the allergen molecules from foods, including plant foods and animal foods,
and on the techniques to detect them, by means of a single reagent (singleplex) or an array of molecules tested at the same
time (multiplex). Such testing offers detailed information on the sensitization profile of patients and enables the physician
to suitably manage their allergy. Moreover, identifying the real causative allergens will be crucial when allergen immunotherapy
for food allergy will be introduced in the near future. We also address patents concerning food allergens in this
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