Allergic diseases, affecting one in four people, are diagnosed through the demonstration of an abnormal immune response (sensitization) to a trigger (allergen) inducing a clinical hypersensitivity response. Allergen-induced immune responses can be demonstrated using in vivo (skin and challenge), or in vitro tests. The occurrence and severity of hypersensitivity reactions are influenced by mast cell disorders, such as hereditary alpha-tryptasemia, which is found in up to 8% of general population by means of serum tryptase measurement. The place of in vitro tests has considerably expanded since the beginning of the century, thanks to progress in multiple fields including allergen biochemistry, pathophysiological research, methodological innovation, cohort studies, and statistics tools. 21st century in vitro tools are exquisitely quantitative and standardized, allowing for reliable comparison and follow-up of allergic patients. They are also miniaturized, with hundreds or even thousands of biomarkers assayed in minute volumes of biological fluids, and they are increasingly non-invasive or minimally invasive, allowing for better testing of children. Moreover, new regulation applicable to in vivo tests tends to decrease the available number of preparations, while newly commercialized allergens are often available as in vitro tests.
The first aim of the current Research Topic is to provide an overview of currently available in vitro diagnostic tests for allergic and mast cell-related disorders, and describe their contribution to the prediction, diagnosis and management of patients with a suspected or confirmed allergic or mast cell disorder. The second aim is to provide the reader with the pathophysiological and methodological explanation of in vitro diagnostic tools, enabling better understanding of future developments in the field for improved diagnosis and management. The third aim is to set a platform for future directions in the field of in vitro diagnosis of allergic and mast cell disorders, based on currently unmet needs and ongoing research with point-of care, non-invasive, miniaturized, artificial intelligence, e-health and other innovative in vitro diagnostic tools. Finally, the reader will be invited to reflect on the debate over the preferred diagnostic work-up approach: top-down starting with clinical history and examination, followed by targeted in vitro tests, or bottom-up starting with extensive assessment of allergen sensitization followed by clinical interpretation.
All types of manuscripts are welcome for this Research Topic. We encourage authors to share their Protocols, Methods, Original Articles, Brief Research reports, Clinical trial results, Case reports, narrative or systematic reviews, Opinion articles, and any other manuscript format within the frame of Frontiers in Allergy submissions, addressing the topic of in vitro diagnosis of allergic and mast cell-related disorders.
Disclosure: Dr. Joana Vitte has received speaker and consultancy fees in the past 5 years from Meda Pharma (Mylan), Novartis, Sanofi, Thermo Fisher Scientific. Is president of the Scientific Committee of the French Society for Allergology. Is a member of the Board of the EAACI Working Group "Infection" and chair of the EAACI Task Force "Diagnosis and management of allergic bronchopulmonary aspergillosis".
Allergic diseases, affecting one in four people, are diagnosed through the demonstration of an abnormal immune response (sensitization) to a trigger (allergen) inducing a clinical hypersensitivity response. Allergen-induced immune responses can be demonstrated using in vivo (skin and challenge), or in vitro tests. The occurrence and severity of hypersensitivity reactions are influenced by mast cell disorders, such as hereditary alpha-tryptasemia, which is found in up to 8% of general population by means of serum tryptase measurement. The place of in vitro tests has considerably expanded since the beginning of the century, thanks to progress in multiple fields including allergen biochemistry, pathophysiological research, methodological innovation, cohort studies, and statistics tools. 21st century in vitro tools are exquisitely quantitative and standardized, allowing for reliable comparison and follow-up of allergic patients. They are also miniaturized, with hundreds or even thousands of biomarkers assayed in minute volumes of biological fluids, and they are increasingly non-invasive or minimally invasive, allowing for better testing of children. Moreover, new regulation applicable to in vivo tests tends to decrease the available number of preparations, while newly commercialized allergens are often available as in vitro tests.
The first aim of the current Research Topic is to provide an overview of currently available in vitro diagnostic tests for allergic and mast cell-related disorders, and describe their contribution to the prediction, diagnosis and management of patients with a suspected or confirmed allergic or mast cell disorder. The second aim is to provide the reader with the pathophysiological and methodological explanation of in vitro diagnostic tools, enabling better understanding of future developments in the field for improved diagnosis and management. The third aim is to set a platform for future directions in the field of in vitro diagnosis of allergic and mast cell disorders, based on currently unmet needs and ongoing research with point-of care, non-invasive, miniaturized, artificial intelligence, e-health and other innovative in vitro diagnostic tools. Finally, the reader will be invited to reflect on the debate over the preferred diagnostic work-up approach: top-down starting with clinical history and examination, followed by targeted in vitro tests, or bottom-up starting with extensive assessment of allergen sensitization followed by clinical interpretation.
All types of manuscripts are welcome for this Research Topic. We encourage authors to share their Protocols, Methods, Original Articles, Brief Research reports, Clinical trial results, Case reports, narrative or systematic reviews, Opinion articles, and any other manuscript format within the frame of Frontiers in Allergy submissions, addressing the topic of in vitro diagnosis of allergic and mast cell-related disorders.
Disclosure: Dr. Joana Vitte has received speaker and consultancy fees in the past 5 years from Meda Pharma (Mylan), Novartis, Sanofi, Thermo Fisher Scientific. Is president of the Scientific Committee of the French Society for Allergology. Is a member of the Board of the EAACI Working Group "Infection" and chair of the EAACI Task Force "Diagnosis and management of allergic bronchopulmonary aspergillosis".
