WordNet

undergo a test; "She doesnt test well"
any standardized procedure for measuring sensitivity or memory or intelligence or aptitude or personality etc; "the test was standardized on a large sample of students" (同)mental test, mental testing, psychometric test
the act of undergoing testing; "he survived the great test of battle"; "candidates must compete in a trial of skill" (同)trial
the act of testing something; "in the experimental trials the amount of carbon was measured separately"; "he called each flip of the coin a new trial" (同)trial, run
a hard outer covering as of some amoebas and sea urchins
put to the test, as for its quality, or give experimental use to; "This approach has been tried with good results"; "Test this recipe" (同)prove, try, try out, examine, essay
achieve a certain score or rating on a test; "She tested high on the LSAT and was admitted to all the good law schools"
determine the presence or properties of (a substance)
show a certain characteristic when tested; "He tested positive for HIV"
an examination of the characteristics of something; "there are laboratories for commercial testing"; "it involved testing thousands of children for smallpox"
the act of subjecting to experimental test in order to determine how well something works; "they agreed to end the testing of atomic weapons"
tested and proved useful or correct; "a tested method" (同)tried, well-tried
tested and proved to be reliable (同)time-tested, tried, tried and true

PrepTutorEJDIC

(人の能力などの)『試験』,考査,テスト / (物事の)『試験』,検済,試錬,実験《+of+名》 / 化学分析;試薬 / =test match / …‘を'『試験する』,検査する / …‘を'化学分析する / (…の)試験を受ける,試験をする《+for+名》
testis の複数形

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/12 05:39:04」(JST)

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A radioallergosorbent test (RAST) is a blood test used to determine the substances a subject is allergic to. This is different from a skin allergy test, which determines allergy by the reaction of a person's skin to different substances.

Because there are other tests that help with confirmation, results are best interpreted by a doctor. Since at least 2010, health organizations have recommended that the RAST be abandoned as a diagnostic test for allergy in favor of more sensitive fluorescence enzyme-labeled assays^{[citation needed]}.

Medical uses

The two most commonly used methods of confirming allergen sensitization are skin testing and allergy blood testing. Both methods are recommended by the NIH guidelines and have similar diagnostic value in terms of sensitivity and specificity.^[1]^[2]

Advantages of the allergy blood test range from: excellent reproducibility across the full measuring range of the calibration curve, it has very high specificity as it binds to allergen specific IgE, and extremely sensitive too, when compared with skin prick testing. In general, this method of blood testing (in-vitro, out of body) vs skin-prick testing (in-vivo, in body) has a major advantage: it is not always necessary to remove the patient from an anthihistamine medication regimen, and if the skin conditions (such as eczema) are so widespread that allergy skin testing cannot be done. Allergy blood tests, such as ImmunoCAP, are performed without procedure variations, and the results are of excellent standardization.^[3]

Adults and children of any age can take an allergy blood test. For babies and very young children, a single needle stick for allergy blood testing is often more gentle than several skin tests. However, skin testing techniques have improved. Most skin testing does not involve needles and typically skin testing results in minimal patient discomfort.

Drawback to RAST and ImmunoCAP techniques do exist. Compared to skin testing, ImmunoCAP and other RAST techniques take longer to perform and are less cost effective.^[4] Several studies have also found these tests to be less sensitive than skin testing for the detection of clinically relevant allergies.^[5] False positive results may be obtained due to cross-reactivity of homologous proteins or by cross-reactive carbohydrate determinants (CCDs).^[6]

In the NIH food guidelines issued in December 2010 it was stated that “The predictive values associated with clinical evidence of allergy for ImmunoCAP cannot be applied to other test methods.”^[7] With over 4000 scientific articles using ImmunoCAP and showing its clinical value, ImmunoCAP is perceived as “Gold standard” for in vitro IgE testing^[8]^[9]

Method

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. A person who has outgrown an allergy may still have a positive IgE years after exposure.

The suspected allergen is bound to an insoluble material and the patient's serum is added. If the serum contains antibodies to the allergen, those antibodies will bind to the allergen. Radiolabeled anti-human IgE antibody is added where it binds to those IgE antibodies already bound to the insoluble material. The unbound anti-human IgE antibodies are washed away. The amount of radioactivity is proportional to the serum IgE for the allergen.^[12]

RASTs are often used to test for allergies when:

a physician advises against the discontinuation of medications that can interfere with test results or cause medical complications;
a patient suffers from severe skin conditions such as widespread eczema or psoriasis; or
a patient has such a high sensitivity level to suspected allergens that any administration of those allergens might result in potentially serious side effects.

Scale

The RAST is scored on a scale from 0 to 6:

RAST rating	IgE level (kU/l)	comment
0	< 0.35	ABSENT OR UNDETECTABLE ALLERGEN SPECIFIC IgE
1	0.35 – 0.69	LOW LEVEL OF ALLERGEN SPECIFIC IgE
2	0.70 – 3.49	MODERATE LEVEL OF ALLERGEN SPECIFIC IgE
3	3.50 – 17.49	HIGH LEVEL OF ALLERGEN SPECIFIC IgE
4	17.50 – 49.99	VERY HIGH LEVEL OF ALLERGEN SPECIFIC IgE
5	50.00 – 100.00	ULTRA HIGH LEVEL OF ALLERGEN SPECIFIC IgE
6	> 100.00	EXTREMELY HIGH LEVEL OF ALLERGEN SPECIFIC IgE

History

The market-leading RAST methodology was invented and marketed in 1974 by Pharmacia Diagnostics AB, Uppsala, Sweden, and the acronym RAST is actually a brand name. In 1989, Pharmacia Diagnostics AB replaced it with a superior test named the ImmunoCAP Specific IgE blood test, which literature may also describe as: CAP RAST, CAP FEIA (fluorenzymeimmunoassay), and Pharmacia CAP. A review of applicable quality assessment programs shows that this new test has replaced the original RAST in approximately 80% of the world's commercial clinical laboratories, where specific IgE testing is performed. The newest version, the ImmunoCAP Specific IgE 0-100, is the only specific IgE assay to receive FDA approval to quantitatively report to its detection limit of 0.1kU/l. This clearance is based on the CLSI/NCCLS-17A Limits of Detection and Limits of Quantitation, October 2004 guideline.

The guidelines for diagnosis and management of food allergy issues by the National Institute of Health state that:

In 2010 the United States National Institute of Allergy and Infectious Diseases recommended that the RAST measurements of specific immunoglobulin E for the diagnosis of allergy be abandoned in favor of testing with more sensitive fluorescence enzyme-labeled assays.^[13]

References

^ NIH Guidelines for the Diagnosis and Management of Food Allergy in the United States. Report of the NIAID- Sponsored Expert Panel, 2010, NIH Publication no. 11-7700.
^ Cox, L. Overview of Serological-Specific IgE Antibody Testing in Children. Pediatric Allergy and Immunology. 2011.
^ Hamilton R et al. Proficiency Survey-Based Evaluation of Clinical Total and Allergen-Specific IgE Assay Performance. Arch Pathol Lab Med. 2010; 134: 975–982
^ UpToDate (http://www.uptodate.com/contents/overview-of-skin-testing-for-allergic-disease?source=search_result&search=skin+testing&selectedTitle=1~150)
^ Chinoy B, Yee E, Bahna SL. Skin testing versus radioallergosorbent testing for indoor allergens. Clin Mol Allergy. 2005 Apr 15;3(1):4.
^ Holzweber, F. (2013). "Inhibition of IgE binding to cross-reactive carbohydrate determinants enhances diagnostic selectivity". Allergy 68: 1269–1277. doi:10.1111/all.12229.
^ Boyce J et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of
^ Wood R et al. Accuracy of IgE antibody laboratory results. Ann Allergy Asthma Immunol. 2007; 99: 34–41.
^ Wang J, et al. J Allergy Clin Immunol. 2008;121(5):1219-1224
^ American Academy of Allergy, Asthma, and Immunology, "Five Things Physicians and Patients Should Question" (PDF), Choosing Wisely: an initiative of the ABIM Foundation (American Academy of Allergy, Asthma, and Immunology), retrieved August 14, 2012
^ Cox, L.; Williams, B.; Sicherer, S.; Oppenheimer, J.; Sher, L.; Hamilton, R.; Golden, D. (2008). "Pearls and pitfalls of allergy diagnostic testing: Report from the American College of Allergy, Asthma and Immunology/American Academy of Allergy, Asthma and Immunology Specific IgE Test Task Force". Annals of allergy, asthma & immunology 101 (6): 580–592. doi:10.1016/S1081-1206(10)60220-7. PMID 19119701.
^ WebMD > Medical Dictionary > radioallergosorbent test (RAST) Citing: Stedman’s Medical Dictionary 28th Edition. Copyright 2006
^ NIAID-Sponsored Expert Panel (December 2010). "Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel". The Journal of Allergy and Clinical Immunology 126 (6): S1–S58. doi:10.1016/j.jaci.2010.10.007. PMID 21134576. Retrieved 30 August 2012.

External links

Allergies - Americal Academy of Allergy Asthma and Immunology
Allergy Blood Testing - Lab Tests Online
Radioallergosorbent Test at the US National Library of Medicine Medical Subject Headings (MeSH)

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. アレルギーのin vitro検査の概要 overview of in vitro allergy tests
2. 食物アレルギーの診断的評価 diagnostic evaluation of food allergy
3. IgEとアレルギー疾患の関係 the relationship between ige and allergic disease
4. アレルギー疾患のための皮膚試験の概要 overview of skin testing for allergic disease
5. 高齢者における喘息の診断およびマネージメント diagnosis and management of asthma in older adults

English Journal

Der p 11 is a major allergen for house dust mite-allergic patients suffering from atopic dermatitis.

Banerjee S1, Resch Y1, Chen KW1, Swoboda I2, Focke-Tejkl M3, Blatt K4, Novak N5, Wickman M6, van Hage M7, Ferrara R8, Mari A8, Purohit A9, Pauli G9, Sibanda EN10, Ndlovu P10, Thomas WR11, Krzyzanek V12, Tacke S13, Malkus U13, Valent P4, Valenta R2, Vrtala S14.
The Journal of investigative dermatology.J Invest Dermatol.2015 Jan;135(1):102-9. doi: 10.1038/jid.2014.271. Epub 2014 Aug 7.
House dust mites (HDMs) belong to the most potent indoor allergen sources worldwide and are associated with allergic manifestations in the respiratory tract and the skin. Here we studied the importance of the high-molecular-weight group 11 allergen from Dermatophagoides pteronyssinus (Der p 11) in H
PMID 24999597

Screening for hen's egg and chicken meat specific IgE antibodies in Saudi patients with allergic disorders.

Shakoor Z1, Almogren A1, Mohammed R1, Hasanato W1, Zahid B1.
African health sciences.Afr Health Sci.2014 Sep;14(3):634-40. doi: 10.4314/ahs.v14i3.19.
BACKGROUND: Allergy to hen's egg and meat contributes significantly to the manifestations of food allergy all over the world.OBJECTIVES: This study was performed to assess the presence of hen's egg and meat specific IgE antibodies among patients investigated for various allergic disorders.METHODS: T
PMID 25352882

Common methodologies in the evaluation of food allergy: pitfalls and prospects of food allergy prevalence studies.

Shu SA1, Chang C, Leung PS.
Clinical reviews in allergy & immunology.Clin Rev Allergy Immunol.2014 Jun;46(3):198-210. doi: 10.1007/s12016-012-8337-8.
Global and regional studies on the prevalence of food allergies are plagued by inconsistent methodologies, variations in interpretation of results, and non-standardized study design. Hence, it becomes difficult to compare the prevalence of food allergies in different communities. This information wo
PMID 23179516

Japanese Journal

川崎医科大学耳鼻咽喉科におけるアレルギー性鼻炎の現況(第7報)カモガヤ抗原について

藤崎倫也,兵行義,濵本真一 [他]
耳鼻咽喉科臨床 107(12), 965-971, 2014-12
NAID 40020285054

川崎医科大学耳鼻咽喉科におけるアレルギー性鼻炎の現況（第7報）:―カモガヤ抗原について―

藤崎倫也,兵行義,濵本真一,増田勝巳,原田保
耳鼻咽喉科臨床 107(12), 965-971, 2014
… glomerata allergen in 1927 patients treated at the Department of Otolaryngology of Kawasaki Medical School between 2000 and 2012, who were tested for serum specific IgE antibodies using the CAP-radioallergosorbent test. …
NAID 130004707196

Cedar Pollen Aggravates Atopic Dermatitis in Childhood Monozygotic Twin Patients with Allergic Rhino Conjunctivitis

, , , , ,
Allergology International 60(3), 397-400, 2011
… Both serum IgE levels and cedar pollen radioallergosorbent test (RAST) scores were high in the twins (elder/younger sister: IgE: 5170/3980IU/ml and Japansese cedar pollen: >100/64.0) in contrast to low mite and food RAST scores (Dermatophagoides Pterygonium; … The patients showed positive immediate (20 min in both sisters) and delayed (24 hours in elder sister, 24, 48, 72 hours in younger sister) reactions to a scratch test with Japanese cedar pollen. …
NAID 130004723054