Do we have suitable in-vitro diagnostic tests for the diagnosis of food allergy?

Purpose of review Positive standardized food challenges represent the gold standard of diagnostic procedures in food-related reactions suspected to be of allergic nature. Skin prick testing and in-vitro diagnosis is helpful in most cases and can help to avoid cumbersome food challenges. This review considers recent progress in the use of in-vitro tests in the diagnosis of food allergy. Recent findings Recent studies have addressed the characterization of 'new' food allergens which might now be used more accurately in the in-vitro diagnosis of food allergy. Additionally, while in-vitro tests must always be interpreted in line with the allergen tested and the clinical history, levels of food-specific immunoglobulin E can be correlated with the outcome of challenges to foods such as tree nuts as well as egg, according to two recent studies. Finally, epitope binding patterns of specific food allergens might help to predict which patients will most likely outgrow their food allergy, or which patients are clinically tolerant. This might help to avoid food challenges, which carry a risk for a potentially severe outcome. Summary Recent studies of in-vitro diagnosis of food allergy have helped to provide safer and more accurate tests in the diagnosis and prognosis of food allergy.