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There are two broad mechanisms for a drug allergy to occur: IgE or non-IgE mediated. In IgE-mediated reactions, also known as immunoglobulin E mediated reactions, drug allergens bind to IgE antibodies, which are attached to mast cells and basophils, resulting in IgE cross-linking, cell activation and release of preformed and newly formed mediators.
Specific IgE testing is the proven test for allergy detection; evidence does not show that indiscriminate IgE testing or testing for immunoglobulin G (IgG) can support allergy diagnosis. [ 34 ] Drugs targeting the IgE pathway
In type I hypersensitivity, B cells are stimulated (by CD4 + T h 2 cells) to produce IgE antibodies specific to an antigen. The difference between a normal infectious immune response and a type 1 hypersensitivity response is that in type 1 hypersensitivity, the antibody is IgE instead of IgA, IgG, or IgM.
An allergen is an otherwise harmless substance that triggers an allergic reaction in sensitive individuals by stimulating an immune response.. In technical terms, an allergen is an antigen that is capable of stimulating a type-I hypersensitivity reaction in atopic individuals through immunoglobulin E (IgE) responses. [1]
According to this system, known as the Gell and Coombs classification [6] or Gell-Coombs's classification, [7] there are four types of hypersensitivity, namely: type I, which is an Immunoglobulin E (IgE) mediated immediate reaction; type II, an antibody-mediated reaction mainly involving IgG or IgM; type III, an immune complex-mediated reaction ...
Actually, it takes two or more bound antigens to cross-link the IgE antibodies, which signals the mast cell to degranulate and release a bunch of pro-inflammatory molecules called mediators that ultimately causes the effects seen in an allergic reaction. One of the major mediators released in an allergic reaction is histamine.
The RAST is a radioimmunoassay test to detect specific IgE antibodies to suspected or known allergens for the purpose of guiding a diagnosis about allergy. [10] [11] IgE is the antibody associated with Type I allergic response: for example, if a person exhibits a high level of IgE directed against pollen, the test may indicate the person is allergic to pollen (or pollen-like) proteins.
The updated version, the ImmunoCAP Specific IgE blood test, is the only specific IgE assay to receive Food and Drug Administration approval to quantitatively report to its detection limit of 0.1kU/L. [159]