Molecular allergology place in allergen-specific immunotherapy

Laboratory methods of allergy diagnosis are an essential tool in the allergist daily practice. Molecular allergodiagnostics is an advanced examination method that allows detecting the patient individual allergocomponents sensitization. The risk prediction of the severe allergic reactions is the main area of its application, as well as the personalized dietary recommendations creation for food allergy patients. In the determining the appointment of allergen immunotherapy indications clinical and anamnesis data are fundamental, supplemented by the results of traditional methods of allergy examination (skin prick tests or the specific IgE level to whole allergens). The widespread use of such resource-intensive examination as molecular allergodiagnostics for all patients is unjustified before the prescribing allergen immunotherapy. In addition, decisions on the allergen immunotherapy continue or the termination cannot be made based on the change data in the level of clinically relevant specific IgE. At the same time, its use as a third-line diagnostic method can help in solving difficult clinical tasks related to the identification of a causally significant allergen in patients with respiratory allergy symptoms during the seasons of simultaneous dusting of several plants, as well as differentiate the true from the cross-sensitization in polysensitized patients. The molecular allergodiagnostics use will be mandatory in the case of the recombinant therapeutic allergen prescribing, due to the need for a personalized choice of the drug.