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Quest Diagnostics

Allergen component testing

Gain additional allergy insights with reflex to component testing

Positive results for whole allergen testing is not the end of the story. Reflex testing can streamline component testing by requiring only 1 blood draw and automatically performing available component tests when the whole allergen is positive. Prepare a more informed, comprehensive action plan with results from precise allergen component testing.

Whole allergen testing determines whether there is sensitization to an allergen

Component testing provides protein-level detail of whole allergen sensitization to help understand symptom risk

With 1 simple blood draw, reflex testing can help manage patient care

  • Helps identify true allergies vs sensitivities without the risk of anaphylactic shock from an oral food challenge1,2
  • Informs severity of reaction to determine personalized patient management
  • Provides more information up front to make management and referral decisions
  • Helps manage patient costs; component testing is only performed if whole allergen is positive
  • Determines risk of systemic reaction and cross-reactivity to improve diagnosis3-13

Interpreting component test results

Specific protein markers can help predict the risk of a systemic reaction as well as the likelihood of allergy persistence. Pinpointing exactly which protein an individual is sensitized to helps optimize diagnosis and management. 

With food allergens, depending on the specific component targets(s) of IgE reactivity, a patient may be at low, variable, or high risk of a true allergy to the food of concern. Structural similarities of proteins within food families may enable IgE cross-reactivity. Component testing can help determine the likelihood that a patient who is allergic to one food will also react to other potentially cross-reactive foods. Read more about interpreting food allergen component test results.

When it comes to furry pet allergens, the identification of IgE antibodies to component proteins can help confirm that patients are sensitized to the animal in question and that the positive extract result is not due to cross-reactivity. The presence of reactivity to multiple components increases the likelihood that the patient is truly allergic. Read more about interpreting furry pet allergen component test results.

Is it a food or respiratory allergy?

ImmunoCAPTM IgE reflex panels test for the most common environmental and food allergens while automatically reflexing to available component testing to simplify your approach to allergy care. Certain symptoms call for specific panels. It is important to assess and document patient symptoms before choosing the type of panel that is most clinically relevant.

Precise food allergen component testing for better outcomes

of patients sensitized to peanut may not be at risk for a systemic reaction3

of children who are allergic to 1 tree nut are allergic to another tree nut14

of children with egg allergy can tolerate baked egg15

of children with milk allergy can tolerate baked milk16

ImmunoCAPTM allergen component testing measures specific IgE to provide an objective assessment of your patient's sensitization to specific proteins and the risk of an allergic reaction to peanuts, tree nuts (Brazil nut, hazelnut, walnut, cashew), egg white, and cow's milk.

Read more about component testing and results interpretation for food allergens
Food and Tree Nut Allergy Panel with Reflex to Components
Childhood and Tree Nut Allergy Panel with Reflex to Components
Furry friend or furry foe? Confidently diagnose and manage allergies to cat and dog dander

Quest now offers ImmunoCAPTM allergen component testing for dog, cat, and horse. While whole allergen testing for dog and cat dander is a valuable screening tool, identifying specific IgE antibodies to component proteins can provide information that helps assess the risk, potential severity, and type of allergic response to dog and/or cat.

Read more about component testing and results interpretation for furry pet allergens
Dog Dander (e5) IgE with Reflex to Component Panel
Cat Dander (e1) IgE with Reflex to Component Panel
Horse Dander (e3) IgE with Reflex to Component Panel

Reflex testing for dog and cat components has also been added to select regional respiratory allergy profiles and childhood allergy panels—this means that a positive whole allergen result for dog and/or cat will automatically reflex to the respective component proteins.

Have questions about Quest's allergy test menu? Send us a message!

References

 

  1. Kattan JD, Sicherer SH. Optimizing the diagnosis of food allergy. Immunol Allergy Clin North Am. 2015;35(1):61-76. doi:10.1016/j.iac.2014.09.0092
  2. Sampson HA, Aceves S, Bock SA, et al. Food allergy: A practice parameter update—2014. J Allergy Clin Immunol. 2014;134(5):1016-1025. doi:10.1016/j.jaci.2014.05.013
  3. Nicolaou N, Poorafshar M, Murray C, et al. Allergy or tolerance in children sensitized to peanut: prevalence and differentiation using component-resolved diagnostics. J Allergy Clin Immunol. 2010;125(1):191-197. doi:10.1016/j.jaci.2009.10.008
  4. Bradshaw N. Go molecular! A clinical reference guide to molecular allergy. Part 1: The basics. ThermoFisher Scientific. 2021. Accessed January 30, 2024. https://www.thermofisher.com/diagnostic-education/dam/commercial/temp/library-resources/Go-Molecular-2021-Part-1-The-Basics-NEW-2.pdf
  5. Katelaris CH: Food allergy and oral allergy or pollen-food syndrome. Curr Opin Allergy Clin Immunol. 2010;10(3):246-251. doi:10.1097/ACI.0b013e32833973fb.
  6. Asarnoj A, Nilsson C, Lidholm J, et al. Peanut component Ara h 8 sensitization and tolerance to peanut. J Allergy Clin Immunol. 2012;130(2):468-472. doi:10.1016/j.jaci.2012.05.019
  7. Nucera E, Mezzacappa S, Arunanno A, et al. Hypersensitivity to major panallergens in a population of 120 patients. Postepy Dermatol Alergol. 2015;32(4):255-261.
  8. Mittag D, Akkerdaas J, Ballmer-Weber BK, et al. Ara h 8, a Bet v 1-homologous allergen from peanut, is a major allergen in patients with combined birch pollen and peanut allergy. J Allergy Clin Immunol. 2004;114(6):1410-1417. doi:10.1016/j.jaci.2004.09.014
  9. Lauer I, Dueringer N, Pokoj S, et al. The nonspecific lipid transfer protein, Ara h 9, is an important allergen in peanut. Clin Exp Allergy. 2009;39(9):1427-1437. doi:10.1111/j.1365-2222.2009.03312.x
  10.  Sastre J: Molecular diagnosis in allergy. Clin Exp Allergy. 2010;40(10):1442-60. doi:10.1111/j.1365-2222.2010.03585.x
  11. Movérare R, Ahlstedt S, Bengtsson U, et al. Evaluation of IgE antibodies to recombinant peanut allergens in patients with reported reactions to peanut. Int Arch Allergy Immunol. 2011;156(3):282-290. doi:10.1159/000323891
  12. Peeters KA, Koppelman SJ, van Hoffen E, et al. Does skin prick test reactivity to purified allergens correlate with clinical severity of peanut allergy? Clin Exp Allergy. 2007;37(1):108-115. doi:10.1111/j.1365-2222.2006.02628.x
  13. Asarnoj A, Movérare R, Östblom E, et al. IgE to peanut allergen components: relation to peanut symptoms and pollen sensitization in 8-year-olds. Allergy. 2010;65(9):1189-1195. doi:10.1111/j.1398-9995.2010.02334.x
  14. McWilliam V, Peters R, Tang MLK, et al. Patterns of tree nut sensitization and allergy in the first 6 years of life in a population-based cohort. J Allergy Clin Immunol. 2019;143(2):644-650.e5. doi:10.1016/j.jaci.2018.07.038
  15. Lemon-Mulé H, Sampson HA, Sicherer SH, et al. Immunologic changes in children with egg allergy ingesting extensively heated egg. J Allergy Clin Immunol. 2008;122(5):977-983. doi:10.1016/j.jaci.2008.09.007
  16. Nowak-Wegrzyn A, Bloom KA, Sicherer SH, et al. Tolerance to extensively heated milk in children with cow’s milk allergy. J Allergy Clin Immunol. 2008;122(2):342-347, 347.e1-2. doi:10.1016/j.jaci.2008.05.043

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