Upcoming diagnostic modalities: Basophil activation test, CRD, and nasal challenge test

Abstract

We know that the skin prick allergy test is the gold standard test in allergy diagnosis, especially with respect to aeroallergens. However, it still remains as an immunological test and not as a diagnostic test. Challenge tests such as nasal provocation tests are useful in diagnosing local allergic rhinitis which may be missed in skin prick test. It is always beneficial to look at newer diagnostic modalities to help better the scope of allergy management. Alternate tests such as basophil activation test, component resolved diagnostics (CRD), nasal challenge test, basophil histamine test, micro-RNA assay, mast cell activation test, and gene level testing are a few of the newer methods which gives very useful information on risk stratification. These tests are either still under research or not yet standardized in clinical practice but will definitely play a role in improving the process of allergy evaluation. Of all these tests, CRD is already available for clinical utility in India.