We are now in the epoch of "molecular allergology" and numerous clinically relevant allergenic molecules are available improving the performance of in vitro
allergen tests and
allergen detection methods. This review is focusing on characterized occupational
allergens and their implementation into the in vitro diagnosis for occupational
allergy and in
allergen detection methods. More than 400 occupational agents are identified and documented as being 'respiratory sensitizers', but currently only a limited number of them are characterized on the molecular level and available for routine diagnosis as native or recombinant
allergens. One exception, however, is
natural rubber latex (NRL) from Hevea brasiliensis still remaining an important occupational
allergen source. Characterization of 15 NRL
allergens led to the development of assays for the determination of
allergen content of NRL materials and the implementation of component-resolved diagnosis (CRD) for specific
IgE antibody measurement. Microarray or singleplex using recombinant or native
allergens are reliable tools for NRL
allergy diagnosis. In addition, NRL
allergy is an excellent model for improving extract-based specific
IgE measurement by amplification of NRL extract preparation with stable recombinant major
allergen rHev b 5. Despite the many efforts to characterize the occupationally relevant wheat
allergens for baker's
asthma, the most frequently occurring forms of
occupational asthma, the results are highly diverse. Wheat sensitization profiles of bakers showed great interindividual variability and no wheat
allergen could be classified as the major
allergen. For diagnosis of baker's
asthma, a whole wheat extract is still the best option for specific
IgE determination. But single wheat
allergens might help to discriminate between wheat-induced
food allergy, grass
pollen allergy and baker's
asthma. For workplace-related
allergens like
coffee, wood, soybean, seafood and moulds
allergens are characterized and few of them are available, but their relevance for occupational sensitization routes should be verified in the further studies.