Novel Painless Test Massively Simplifies Diagnosis of Allergies and Predicts Success of Immunotherapy

Although allergies are widespread, their diagnosis is complex and, depending on the type of allergy, the prospects of success with therapy are not always clear. Skin tests so far have been unpleasant, time-consuming and associated with a certain risk of triggering an allergic overreaction. Researchers have now developed a novel test that massively simplifies the diagnosis of allergies and can reliably predict the success of a therapy.

The allergy test developed by researchers at the University of Bern (Switzerland) not only greatly simplifies diagnosis, but can also reliably predict the success of immunotherapy. Type I allergy occurs when the body produces immunoglobulin E (IgE) class antibodies in response to allergens. The IgE antibodies are bound by IgE receptors on the surface of specialized immune cells in the body called mast cells. Subsequent contact with the same allergens then leads to activation of the mast cells and therefore to the release of inflammatory mediators such as histamine or leukotrienes, which are responsible for the allergic symptoms.

For their novel allergy test, the researchers developed a new in vitro cell culture which, with the help of a few molecular biological techniques, can generate almost any desired number of mature mast cells – and this within a few days. These mast cells contain IgE receptors on their surface and behave very similarly to mast cells in the human body when they are exposed to IgE and allergens. In the test, these mast cells are brought into contact with blood serum from allergic individuals – thereby binding the IgE antibodies from the serum to the cells – and then stimulated with the allergens to be tested. At this point, the activation of the cells can be quantified very easily and quickly using so-called flow cytometry.

In order to be able to perform a large number of tests, the researchers have developed a high-throughput approach in which up to 36 conditions can be measured in a single test tube. This makes possible the testing of either multiple allergens with one blood serum or multiple sera together for the same allergen. In addition to the initial diagnosis of allergies, the researchers hope the test will have other major applications. According to the researchers, the test also has great potential for monitoring therapeutic success and the duration of action for new allergy medications in clinical trials, as well as for determining possible allergic reactions and for quality control of food products.

"We are confident that with our test we will be able to measure within a few months after the start of an immunotherapy whether the therapy is effective and to what extent," said Thomas Kaufmann from the Institute of Pharmacology at the University of Bern. "This would be an important aid in the decision-making process for the allergologist treating the patient, whether it makes sense to continue the therapy or not."

"Another important advantage is that the test works with serum, which is very stable and can be stored frozen for a long time, which also allows retrospective tests and studies. In contrast, other comparable tests use whole blood, which cannot be stored and must be processed within hours," added Alexander Eggel from the Department for BioMedical Research (DBMR) at the University of Bern and the Department of Rheumatology and Immunology, Inselspital, Bern University Hospital.

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