IgG to foods: a test not ready for prime time.
نویسندگان
چکیده
In 1988, the Practice Standards Committee of the American Academy of Allergy and Immunology (now the American Academy of Allergy, Asthma and Immunology) examined the published literature related to the theory that assays measuring circulating foodimmune complexes (IgG or IgE antibodies to food antigens) were useful as tests for sensitivity to specific foods [1]. The Practice Standards Committee concluded that the value of the measurement of food-immune complexes toward the diagnosis of food allergy remained unproven and did not have a place in current clinical practice. During the 1990s, several commercial laboratories continued to offer assays for detection of food immune complexes, but the test of the current decade is the measurement of specific IgG to foods. Such tests are claimed to identify non-IgE-mediated hypersensitivity to foods that may be associated with a myriad of disorders, from fatigue and myalgia to obesity and irritable bowel syndrome. Currently, there is direct-to-consumer advertising for panels of IgG to foods, and direct marketing by some companies to primary care physicians to order these tests. In the United States and several European countries, ‘mainstream’ allergy diagnostic laboratories now offer IgG assays to foods, though these may not be covered by a patient’s medical insurance. The assays may measure total IgG, all subclasses, just IgG4, or some combination thereof. Some companies also construct a ‘rotary diet’ for the patient to follow at home, which limits intake of foods from identified food groups to only once per cycle after a pathologist on staff has reviewed the tests, though most laboratories do not get involved in the practice of medicine in this way. Such dietary prescriptions can be hard to follow [2], and are without proven benefit, as no double-blind, placebo-controlled series have been published that critically evaluate their effectiveness [3].
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ورودعنوان ژورنال:
- Current opinion in allergy and clinical immunology
دوره 7 3 شماره
صفحات -
تاریخ انتشار 2007