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Successful management of allergic diseases necessitates identifying their specific causes (ie, identify the causative agent(s) and the route of contact to allergen: airborne, or skin contact) to avoid further exposure. Identification of sensitization by a sensitive and validated measurement of specific IgE is an important step in the diagnosis. However, only a limited number of environmental and occupational allergens are available on the market for use in sIgE testing. Accordingly, specific in\u2010house testing by individual diagnostic and laboratory centers is often required. Currently, different immunological tests are in use at various diagnostic centers that often produce considerably divergent results, mostly due to lack of standardized allergen preparation and standardized procedures as well as inadequate quality control. Our review and meta\u2010analysis exhibited satisfactory performance of sIgE detection test for most high molecular weight (HMW) allergens with a pooled sensitivity of 0.74 and specificity of 0.71. However, for low molecular weight (LMW) allergens, pooled sensitivity is generally lower (0.28) and specificity higher (0.89) than for HMW tests. Major recommendations based on the presented data include diagnostic use of sIgE to HMW allergens. A negative sIgE result for LMW agents does not exclude sensitization. In addition, the requirements for full transparency of the content of allergen preparations with details on standardization and quality control are underlined. Development of standard operating procedures for in\u2010house sIgE assays, and clinical validation, centralized quality control and audits are emphasized. There is also a need for specialized laboratories to provide a custom service for the development of tests for the measurement of putative novel occupational allergens that are not commercially available.<\/jats:p>","DOI":"10.1111\/all.13809","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T16:59:30Z","timestamp":1554569970000},"page":"1885-1897","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Immunological methods for diagnosis and monitoring of IgE\u2010mediated allergy caused by industrial sensitizing agents (IMExAllergy)"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1880-1220","authenticated-orcid":false,"given":"Xaver","family":"Baur","sequence":"first","affiliation":[{"name":"European Society for Environmental and Occupational Medicine Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cezmi A.","family":"Akdis","sequence":"additional","affiliation":[{"name":"Swiss Institute of Allergy and Asthma Research, UZH Christine K\u00fchne\u2010Center for Allergy Research and Education Davos Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lygia Therese","family":"Budnik","sequence":"additional","affiliation":[{"name":"Translational Toxicology and Immunology Unit, Institute for Occupational and Maritime Medicine University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9759-5466","authenticated-orcid":false,"given":"Maria Jesus","family":"Cruz","sequence":"additional","affiliation":[{"name":"Pneumology Department Vall d'Hebron Hospital Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Fischer","sequence":"additional","affiliation":[{"name":"Clinical Research Unit of Allergy Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"F\u00f6rster\u2010Ruhrmann","sequence":"additional","affiliation":[{"name":"ENT Clinic Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8226-9227","authenticated-orcid":false,"given":"Thomas","family":"G\u00f6en","sequence":"additional","affiliation":[{"name":"Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine Friedrich\u2010Alexander\u2010University Erlangen\u2010Nurnberg Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlem","family":"Goksel","sequence":"additional","affiliation":[{"name":"Pulmonary, Immunology and Allergy, Laboratory of Occupational &amp; 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