Oehling A
Allergol Immunopathol (Madr). 1986 Jul-Aug;14(4):329-36.
The better comprehension of the dynamics involved in the etiopathogenesis of asthma in determined circumstances needs the complement of immunologic methods. The improved immunologic methods for the diagnosis of allergic diseases in the last twenty years has in general confirmed the results obtained by the intradermal test. However, it is important to bear in mind that in a reliable "in vivo" diagnostic, the technique has to be considered, and that there is a better correlation in the intracutaneous test than in the Prick one. Of the various immunologic tests carried out, the hemagglutination test offers a better reliability in the diagnosis of food-induced bronchial asthma, together with the histamine release test. In our experience, the RAST was less reliable when it came to the diagnosis of food allergy, though on the other hand it was applicable for inhalant allergens (pollens and dermatophagoides). In clinical practice and in daily routine work ups, all these techniques of course, impose an additional cost for diagnosis. Therefore, the use of sophisticated modern immunologic methods has to be reserved unless needed for clinical research, or as happens in some cases, for suspicious clinical histories with negative skin tests, in order to confirm the possible allergens responsible.
在特定情况下，要更好地理解哮喘发病机制中涉及的动态过程，需要免疫方法的补充。在过去二十年中，用于诊断过敏性疾病的改进免疫方法总体上证实了皮内试验所获得的结果。然而，必须牢记的是，在可靠的“体内”诊断中，必须考虑技术因素，并且皮内试验的相关性比点刺试验更好。在进行的各种免疫试验中，血凝试验与组胺释放试验一起，在食物诱发的支气管哮喘诊断中具有更高的可靠性。根据我们的经验，RAST在食物过敏诊断方面不太可靠，不过另一方面它适用于吸入性变应原（花粉和尘螨）。在临床实践和日常检查中，当然所有这些技术都会增加诊断成本。因此，除非临床研究需要，或者像某些情况下那样，对于皮肤试验阴性但临床病史可疑的情况，为了确定可能的致病变应原，否则应保留使用复杂的现代免疫方法。
