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Factors that Add to Security in Immunotherapy Treatment

There are some factors that can add to the security of the treatment with immunotherapy. These are the type of test being used and the type of dilutions used in the test and treatment vials.

Type of Test Being Used

There are tests that are qualitative: The result is “patient is” or “patient is not” allergic to the allergen being tested.

There are tests that are quantitative. Not only will this type of test inform if the individual is reactive to the allergen being tested, but also will give information to the degree of reactivity. This has obvious implications for safety as the more reactive the individual to a given allergen, less amount of the allergen is needed to elicit the reaction and therefore less amount of antigen is needed to over load  the  system and produce a reaction

Tests are also divided in tests performed on the patient’s blood (called in vitro) and tests performed on the patient’s skin (called in vivo). Because the allergic condition is a very complex one involving multiple antibodies and different cells (Gell and Coombs described 4 types of allergic reactions) and because the in vitro tests only determine for the most part the presence of the antibody IgE, the in vivo test being really a biological assay of reactivity to the allergen being tested will give a much more complete picture of the involved allergens.

This explains why some patients with obvious allergic symptoms having been tested in blood are told they are not allergic as the test (usually called RAST test) came negative

Obviously for the patient that reacts to multiple allergens (the overwhelming majority of allergic patients). The more allergens that can be diagnosed, the more allergens can be incorporated in the vaccine and the better this patient will do with the treatment

The only test that offers a quantitative result (therefore separating the high reactors from the low reactors) and at the same time is an in-vivo biological assay is the intradermal test done with several dilutions of each allergen, known as intradermal test with progressive dilutions (IDTPD, or IDT).

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