Molecular Allergy Diagnostics Using Multiplex Assays

The availability of single allergens and their use in microarray technology enables the simultaneous determination of specific IgE (sIgE) to a multitude of different allergens (>100) in a multiplex procedure requiring only minute amounts of serum. This allows extensive individual sensitization profiles to be determined from a single analysis. Combined with a patient’s medical history, these profiles (a) simplify identification of cross-reactivity, (b) permit a more accurate estimation of the risk of severe reactions, and (c) enable the indication for specific immunotherapy to be more precisely established, particularly in cases of polysensitization. Strictly speaking, multiplex assays are not a single test but instead more than 100 tests with considerable requirements in terms of production, quality control, and data interpretation. The present chapter describes the multiplex test systems currently available and discusses their characteristics. Performance data are presented, and the sIgE values obtained from multiplex and singleplex assays are compared. Finally, the advantages and limitations of molecular allergy diagnostics using multiplex assays in clinical routine are discussed, and innovative possibilities for clinical research are described.