Foreword 1	5
	Foreword 2	7
	Preface	9
	Molecular Allergology: From Research Topic to Innovative Allergy Diagnosis	9
	Acknowledgments	11
	Contributors	16
	Contents	13
	Part I: Protein Families and Relationships	20
	1: Introduction to Molecular Allergology: Protein Families, Databases, and Potential Benefits	21
	1.1 The Era of Molecular Allergology	22
	1.2 Immediate-Type Allergens and Their Names	23
	1.3 Sequence and Structure: From T Cell to Antibody (B Cell) Epitopes	24
	1.4 Protein Families and Relatedness of Type I Allergens	24
	1.5 Databases for Clinical Practice and Research	27
	1.6 Potential Use of Single Allergens	30
	1.6.1 Quantification of Allergens in Extracts	30
	1.6.2 Molecular Epidemiology	31
	1.6.3 Diagnostics with Single Allergens	31
	1.7 Scope and Limits of Interpretation	33
	1.8 Immunotherapy and Single Allergens	33
	1.9 Molecular Allergology Drives Innovation	34
	Conclusions	35
	References	35
	2: Bet v 1 and its Homologs: Triggers of Tree-Pollen Allergy and Birch Pollen-­Associated Cross-Reactions	38
	2.1 Introduction	38
	2.2 Biological Facts and Characteristics	39
	2.2.1 Allergen Identification	39
	2.2.2 Family	39
	2.2.3 Bet v 1 and the Bet v 1 Superfamily	39
	2.2.4 Physiological Function of Bet v 1	40
	2.2.5 Characteristics	41
	2.3 Importance of Bet v 1 and Related Allergens	41
	2.3.1 Sources of Bet v 1 and its Biological and Allergological Role	41
	2.3.2 Prevalence and Distribution of Sensitization	42
	2.3.3 Bet v 1: A Marker Allergen for Tree (Fagales Order) Pollen Sensitization and IgE Cross-Reactivity to Plant-Derived Foods	42
	2.3.3.1 Bet v 1 Cross-Reactive Inhalant Allergens	42
	2.3.3.2 Bet v 1 Cross-Reactive Food Allergens	43
	2.4 Diagnosis	45
	2.4.1 Airway Symptoms Caused by Tree Pollen Allergy	45
	2.4.2 Bet v 1-Associated Cross-Allergies to Plant-Derived Foods	47
	2.4.3 Added Benefits of Molecular Diagnostics	54
	2.4.3.1 Advantages of Bet v 1 in Molecular Diagnostics	55
	2.4.3.2 Possibilities of Diagnostics Using Bet v 1-Homologous Allergens	55
	2.5 Therapy and Recommendations	57
	2.6 Perspectives	57
	2.7 Conclusions for Clinical Practice	57
	References	57
	3: The Concept of Pollen Panallergens: Profilins and Polcalcins	60
	3.1 Introduction	60
	3.2 Allergen Nomenclature	61
	3.3 Structure and Function of Profilins	61
	3.4 Relevance of Profilins	63
	3.5 Sensitization to Profilins	64
	3.6 Structure and Function of Polcalcins	65
	3.7 Relevance of Polcalcins	65
	3.8 Diagnosis of Relevant Multi-Sensitizations to Pollen	66
	3.9 Component-Resolved Diagnosis of Panallergen Sensitizations	68
	3.10 Clinical Relevance of Panallergens	68
	3.11 Extract Selection for Allergen Immunotherapy (AIT)	70
	3.12 Conclusions from a Clinical Perspective	71
	References	71
	4: Stable Plant Food Allergens I: Lipid-Transfer Proteins	74
	4.1 Introduction	74
	4.2 Structure of Allergens	75
	4.3 Biological Function of Allergens	77
	4.4 Frequency of Sensitization and Geographic Distribution	77
	4.5 Clinical Relevance	80
	4.6 IgE Cross-Reactivity Between LTPs	81
	4.7 Diagnosis by Sensitization Tests with LTPs and LTP-­Containing Extracts	84
	4.8 Clinical Relevance of LTP Sensitization	85
	4.9 Therapeutic Recommendations	87
	4.10 Other Perspectives	87
	4.11 Implications for Routine Clinical Practice	87
	References	88
	5: Stable Plant Food Allergens II: Storage Proteins	93
	5.1 Introduction	93
	5.2 Allergen Nomenclature	94
	5.3 Protein Structures	94
	5.4 Functions	97
	5.5 Relevance	98
	5.6 Complex Cross-Reactivity Among Storage Proteins	98
	5.7 Diagnostic Challenges	101
	5.8 Additional Possible Benefits from Molecular Diagnostics	102
	5.9 Outlook	104
	5.10 Conclusion: Potential for Routine Clinical Practice	104
	References	104
	6: Cross-Reactive Carbohydrate Determinants: Diagnostic and Clinical Relevance	107
	6.1 Introduction	108
	6.1.1 Cross-Reactive Carbohydrate Determinants	109
	6.2 Allergen Sources	110
	6.2.1 “Classical” CCDs	110
	6.2.2 Galactose-?-1,3-Galactose	110
	6.3 Structural Considerations	110
	6.3.1 “Classical” CCDs	110
	6.3.2 Galactose-?-1,3-Galactose	111
	6.4 Frequency of Sensitization and Allergenicity	111
	6.4.1 “Classical” CCDs	111
	6.4.2 Galactose-?-1,3-Galactose	112
	6.5 Clinical Assessment of Allergenicity	113
	6.5.1 “Classical” CCDs	113
	6.5.2 Galactose-?-1,3-Galactose	114
	6.6 Unresolved Issues	115
	6.7 Relevance for Allergy Diagnostic Tests and Availability of Reagents for In Vitro or In Vivo Testing	115
	6.7.1 “Classical” CCDs	115
	6.7.2 Galactose-?-1,3-Galactose	118
	6.8 Evaluating the Clinical Relevance of CCDs	118
	6.8.1 “Classical” CCDs	118
	6.8.2 Galactose-?-1,3-Galactose	120
	6.9 Conclusion: Implications for Everyday Clinical Practice	121
	References	121
	Part II: Test Systems, Singleplex Analysis and Multiplex Analysis	125
	7: Molecular Allergy Diagnostics Using IgE Singleplex Assays: Methodological and Practical Considerations	126
	7.1 Introduction	126
	7.1.1 Atopy and Allergen-Specific IgE	126
	7.1.2 IgE, IgE Receptors, and the Effector Phase of Allergic Reactions: Background Information and Relevance in IgE Antibody Diagnostics	127
	7.1.3 The IgE Repertoire: A Phenomenon with Complex Variables	129
	7.1.4 Techniques to Detect Sensitization in Routine Diagnostics	130
	7.2 Technological Basis of IgE Determination	131
	7.2.1 Test Design and Test Components	131
	7.2.2 Detection Thresholds in sIgE Determination	140
	7.2.3 Specific IgE–Total IgE Ratio	141
	7.2.4 Isoforms: Natural Variants of Allergen Molecules	141
	7.3 Possible Applications for Allergen Molecules in IgE Diagnostics	142
	7.3.1 Distinction Between Purified and Recombinantly Produced Components	144
	7.3.2 Laboratory-Scale Evaluation: Assay Sensitivity and Analytical Specificity (Selectivity)	148
	7.3.3 Universal Arguments for the Use of Molecular Allergens in IgE Diagnostics	151
	7.4 Clinical Evaluation: Diagnostic Sensitivity and Specificity	152
	7.5 Interpretation to Establish Clinical Relevance	164
	7.6 Potential and Quantitative Concepts of Molecular Allergology	165
	7.6.1 The Use of Singleplex IgE Assays in Bet v 1-Related Cross-Reactivity	166
	7.6.2 The Use of Singleplex IgE Assays in Profilin Sensitization	166
	7.6.3 The Use of Singleplex IgE Assays Against Storage Proteins	167
	References	169
	8: Spiking with Recombinant Individual Allergens for Improvement of Allergen Extracts	172
	8.1 Introduction	172
	8.2 Improvement of Diagnostics Through Allergen Addition in Latex Allergy	174
	8.3 Benefits and Disadvantages of Allergen Addition in Hazelnut Allergy	176
	8.4 Improvement of Test Sensitivity by Allergen Addition in Yellow Jacket Venom Allergy	177
	8.5 Additional Value of Molecular Diagnostics and Conclusion for Routine Clinical Practice	180
	8.6 Conclusion for Clinical Routine	181
	Bibliography	181
	9: Molecular Allergy Diagnostics Using Multiplex Assays	183
	9.1 Introduction	184
	9.2 Molecular Allergy Diagnostics Using Multiplex Assays	185
	9.3 Immuno Solid-Phase Allergen Chip (ISAC)	190
	9.3.1 Test Procedure	190
	9.3.2 Test Performance	192
	9.3.2.1 Intra- and Inter-Assay Variance	192
	9.3.2.2 Linearity and Limit of Detection (LoD)	193
	9.3.2.3 Sample Material and Interference	195
	9.3.3 Comparison of sIgE to Single Allergens Determined in Multiplex (ISAC sIgE 112) and Singleplex Assays (ImmunoCAP)	195
	9.4 Molecular Allergy Diagnostics Using Multiplex Assays in Clinical Routine	197
	9.4.1 Allergen Spectrum Available and Potential Advantages in Diagnostics	197
	9.4.2 Added Benefits Conferred by Molecular Allergy Diagnostics in Clinical Routine	200
	9.4.2.1 Differentiation Between Genuine Sensitization and Cross-­Reactivity with Inhalant Allergens	200
	9.4.2.2 Identification of Sensitizations to Food Allergens Associated with a High Risk for Severe Allergic Reactions	202
	9.4.3 Paralysis Through Analysis? Interpretation Supported by Intelligent Software and Results Evaluated by the Physician	204
	9.4.4 Special Features in Routine Use	207
	9.5 Molecular Allergy Diagnostics Using Multiplex Assays in Research	208
	9.5.1 New Insights Gained Using ISAC Technology	208
	9.5.1.1 Diversity of Sensitization Profiles	209
	9.5.1.2 Developing Sensitization Profiles	209
	9.5.1.3 Prescribing Behavior in Allergen-Specific Immunotherapy (SIT)	210
	9.5.2 The Use of Individually Tailored Allergen Chips in Research	210
	9.6 Summary and Perspectives	211
	References	213
	Part III: Marker Allergens	215
	10: Marker Allergens and Panallergens in Tree and Grass Pollen Allergy	216
	10.1 Introduction	217
	10.2 Allergen Sources in Trees and Grasses	217
	10.2.1 Grasses	217
	10.2.2 Trees	219
	10.3 Important Grass Pollen Allergens	220
	10.3.1 Allergens Found in all Poaceae Grasses	220
	10.3.1.1 Marker Allergen for all Poaceae Grasses: Group 1 (Phl p 1)	220
	10.3.1.2 Group 13	222
	10.3.2 Allergens Found Only in Pooideae Grasses	222
	10.3.2.1 Marker Allergen for Pooideae: Group 5 (Phl p 5)	222
	10.3.2.2 Other Pooideae-Specific Allergens	223
	10.3.3 Allergens from Tropical and Subtropical Grasses	223
	10.3.4 Marker Allergens for Grass Pollen Allergy: Summary	224
	10.3.5 Carbohydrate Sensitivity in Grass Pollen Allergic Patients	224
	10.4 Important Tree Pollen Allergens	225
	10.4.1 Allergens of Trees of the Order Fagales	225
	10.4.1.1 Marker Allergen for Fagales: Bet v 1	225
	10.4.1.2 Other Fagales-Specific Minor Allergens	227
	10.4.2 Allergens of Trees of the Order Lamiales	227
	10.4.2.1 Marker Allergen for Lamiales: Ole e 1	227
	10.4.2.2 Other Lamiales-Specific Allergens	228
	10.4.3 Allergens of Trees of the Order Proteales	228
	10.4.4 Allergens of Trees of the Order Cupressales	229
	10.5 Panallergens: Markers for Cross-Reactivity	229
	10.5.1 Polcalcins	230
	10.5.2 Profilins	230
	10.5.3 Panallergens: Summary	230
	10.6 Conclusions for Clinical Routine Work	231
	References	233
	11: Marker Allergens of Weed Pollen: Basic Considerations and Diagnostic Benefits in Routine Clinical Practice	240
	11.1 Introduction	240
	11.2 Allergen Nomenclature	242
	11.3 Structure and Biological Function of Relevant Protein Families	242
	11.3.1 Pectate Lyases	242
	11.3.2 Defensin-Like Proteins	243
	11.3.3 Nonspecific Lipid Transfer Proteins	244
	11.3.4 Ole e 1-Like Proteins	244
	11.4 Clinical Relevance of Allergens	244
	11.4.1 Pectate Lyases	244
	11.4.2 Defensin-Like Proteins	245
	11.4.3 Nonspecific Lipid Transfer Proteins (nsLTP)	245
	11.4.4 Ole e 1-Like Proteins	245
	11.5 Sensitization Frequencies	245
	11.6 Cross-Reactive Versus Marker Allergens	246
	11.7 Allergy Diagnosis	248
	11.8 Added Value of Molecular Allergy Diagnostics	248
	11.9 Therapeutic Recommendations	250
	11.10 Perspectives	250
	11.11 Conclusions for Routine Clinical Practice	251
	References	251
	12: Molecular Diagnostics for Peanut Allergy	254
	12.1 The Peanut’s Role as an Allergen	254
	12.2 Individual Peanut Allergens	255
	12.2.1 Primary Major Allergens: Storage Proteins	257
	12.2.2 Primary Minor Allergens: Oleosins	257
	12.2.3 Secondary Allergens: nsLTPs and Cross-Reactive Aeroallergens	258
	12.3 Clinical Data Concerning Molecular Diagnostics	258
	12.4 Diagnostics with Peanut Allergens	262
	12.4.1 Available Single Allergens	262
	12.4.2 Potential Benefits of Molecular Diagnostics with Peanut Allergens	262
	12.4.3 Procedure for Diagnosing Peanut Allergy in Childhood (<14 Years)	263
	12.4.4 Common Peanut Cross-Reactions Regarding Birch Pollen Sensitization	265
	12.4.5 Less Common Sensitization Patterns in Peanut Allergy	266
	12.5 Cross-Reactive Allergens	266
	12.6 Conclusions: Relevance in Daily Clinical Practice	266
	References	267
	13: Molecular Diagnostics for Tree Nut Allergy	270
	13.1 Allergen Determination	270
	13.2 Structure, Function, and Role of Allergens	272
	13.3 Sensitization Frequencies	273
	13.4 Serological Cross-Reactions	273
	13.5 Diagnostics: Available Single Allergens	274
	13.5.1 Hazelnut	274
	13.5.2 Walnut	276
	13.5.3 Other Nuts	278
	13.6 Clinical Value of Molecular Diagnostics	278
	13.7 Perspectives	279
	13.8 Conclusions: Relevance in Daily Clinical Practice	279
	References	281
	14: Molecular Diagnostics of Allergy to Fruits and Vegetables	283
	14.1 Introduction	283
	14.2 Epidemiology of Fruit and Vegetable Allergy	284
	14.3 Potential Benefits of Molecular Diagnostics in  Food Allergy	284
	14.4 Allergies to Fruits and Vegetables: The Most Important Allergen Families	285
	14.5 Molecular Diagnostics in Vegetable Allergy	286
	14.5.1 Celery Root Allergy	286
	14.5.2 Carrot Allergy	287
	14.5.3 Tomato Allergy	288
	14.6 Molecular Diagnostics in Fruit Allergy	289
	14.6.1 Kiwi Fruit Allergy	290
	14.6.2 Peach Allergy	294
	14.6.3 Latex-Fruit Syndrome and the Relevance of the Hevein-­Like Domain	295
	14.7 Summary and Outlook	295
	14.8 Conclusion: Potential for Routine Clinical Practice	296
	References	296
	15: Cow’s Milk and Hen’s Egg Allergy: What Do Molecular-Based Allergy Diagnostics Have to Offer?	302
	15.1 Introduction	302
	15.2 Allergen Nomenclature	303
	15.3 Properties of the Most Relevant Allergens	304
	15.3.1 Cow’s Milk	304
	15.3.2 Hen’s Egg	306
	15.3.3 Special Case: Cow’s Milk and Hen’s Egg in Baked Foods	307
	15.4 Prevalence, Distribution, and Prognosis of Sensitization	307
	15.4.1 Prognosis	308
	15.5 Diagnostic Methods	309
	15.5.1 Assessing Clinical Relevance	309
	15.5.2 Assessing Tolerance in Baked Goods	310
	15.6 Additional Benefits Conferred by Molecular-Based Allergy Diagnostics	311
	15.7 Treatment and Recommendations	311
	15.8 Conclusions for Clinical Practice	312
	References	312
	16: Molecular and Extract-Based Diagnostics in Meat Allergy	315
	16.1 Introduction to Molecular and Extract-Based Diagnostics in Meat Allergy	315
	16.2 Pork-Cat Syndrome, a Link Between Pet Dander and Meat	316
	16.2.1 Allergen Structure and Function	316
	16.2.2 Allergen Prevalence and Sensitization	317
	16.2.3 Diagnosis and Recommendations	318
	16.3 Type I Hypersensitivity Reactions to Galactose-?-1,3-Galactose in Red Meat Allergy	319
	16.3.1 Carbohydrate Side Chain Galactose-?-1,3-Galactose (?-Gal)	319
	16.3.2 Type I Allergy to ?-Gal and the Role of Tick Bites	322
	16.3.3 Diagnostic Measures in Delayed Type I Hypersensitivity Reactions to Red Meat and Innards	324
	16.3.4 Clinical Relevance and Particular Features of Delayed Type I Hypersensitivity Reactions to Red Meat and Innards	324
	16.4 Bird-Egg Syndrome and Genuine Poultry Meat Allergy	326
	16.4.1 Types of Poultry Meat Allergy	326
	16.4.2 Allergen Structure and Function	326
	16.4.3 Allergen Prevalence and Sensitization in Bird-Egg Syndrome-Related Poultry Meat Allergy	327
	16.4.4 Allergen Prevalence and Sensitization in Primary Poultry Meat Allergy	328
	16.4.5 Immunologic Relationships Between Poultry Meat, Red Meat, and Other Foods	329
	16.4.6 Diagnosis and Recommendations	330
	16.5 Advantage of Molecular Diagnostics	331
	16.6 Recommendations for Clinical Practice	331
	References	332
	17: Molecular Diagnostics in Food-­Dependent Exercise-Induced Anaphylaxis	337
	17.1 Introduction	337
	17.2 Allergen Identification	339
	17.3 Structure, Function, and Importance of the Allergens	341
	17.4 Sensitization Prevalences/Distribution	342
	17.5 Cross-Reactive Versus Marker Allergens	343
	17.6 Diagnostic Workup	344
	17.7 Added Benefits Conferred by Molecular Allergy Diagnostics	346
	17.8 Therapy and Recommendations	347
	17.9 Perspectives	347
	References	348
	18: Benefits and Limitations of Recombinant Allergens in Diagnostics of Insect Venom Allergy	351
	18.1 Introduction	351
	18.2 Structure, Function, and Relevance of Hymenoptera Venom Allergens	354
	18.3 Methodological Aspects for the Production of Recombinant Hymenoptera Venom Allergens	359
	18.3.1 Recombinant Allergens from Eukaryotic Cells	359
	18.4 Benefits of Molecular Diagnostics	360
	18.4.1 Molecular Diagnostics for Differentiation of Double Sensitizations	360
	18.4.2 Use of Recombinant Insect Venom Allergens in Clinical Routine Diagnostics	362
	18.4.3 Improvement of Test Sensitivity by Recombinant Allergens	364
	18.4.4 Potential Relevance for Specific Immunotherapy	366
	18.5 Open Questions and Future Perspectives	367
	18.6 Conclusion for Daily Practice	368
	References	369
	19: Molecular Diagnostics in Allergy to Mammals	373
	19.1 Introduction	373
	19.2 Protein Structure and Function	374
	19.3 Current Status of Identified Allergenic Molecules from Different Mammalian Allergen Sources	375
	19.3.1 Cat Allergenic Molecules	375
	19.3.2 Dog Allergenic Molecules	376
	19.3.3 Horse Allergenic Molecules	377
	19.3.4 Cattle Allergenic Molecules	377
	19.3.5 Rabbit Allergenic Molecules	378
	19.3.6 Mouse and Rat Allergenic Molecules	378
	19.3.7 Guinea Pig Allergenic Molecules	379
	19.3.8 Hamster Allergenic Molecules	379
	19.4 Prevalence of Sensitization/Distribution	379
	19.5 Cross-Reactive Versus Marker Allergens in Mammals	380
	19.6 Problems in Diagnosing Sensitization to Animals	381
	19.7 Current Additional Benefits from Molecular Diagnostics	383
	19.8 Therapy and Recommendations	383
	19.9 Outlook	384
	19.10 Conclusion: Potential for Routine Clinical Practice	384
	References	386
	20: Extract-Based and Molecular Diagnostics in Fish Allergy	390
	20.1 Introduction	390
	20.2 Allergens: Nomenclature	391
	20.3 Allergens: Structure	391
	20.4 Allergens: Function	394
	20.5 Allergens: Relevance	395
	20.6 Sensitization Prevalence	396
	20.7 Cross-Reactive Versus Marker Allergens	397
	20.8 Diagnostics	398
	20.9 Additional Benefit from Molecular Diagnostics	399
	20.10 Therapy and Recommendation	402
	20.11 Outlook	402
	20.12 Conclusions: Potential for Everyday Clinical Practice	403
	References	403
	21: Allergens and Molecular Diagnostics of Shellfish Allergy	407
	21.1 Background	407
	21.2 Classification of Shellfish Groups	408
	21.3 Prevalence of Shellfish Allergy	409
	21.4 Structure and Biological Functions of Shellfish Allergens	411
	21.5 Clinical and Immunological Cross-Reactivity	415
	21.5.1 Potential Advantages of Component-Resolved Diagnosis (CRD) in Shellfish Allergy	416
	21.6 Diagnostics Separating IgE-Mediated Allergy from Other Reactions	417
	21.7 Outlook for Future Diagnostic Options	418
	21.8 Suggestions for Present Clinical Practice	418
	References	420
	22: Allergens, Diagnostics, and Therapeutic Aspects in House Dust Mite Allergy	423
	22.1 Introduction	423
	22.2 Designation of Allergens	424
	22.3 Structure and Function of Allergens	424
	22.4 Importance of the Allergens	428
	22.5 Frequency of Sensitization/Distribution	429
	22.6 Cross-Reactive Allergens/Marker Allergens	429
	22.7 Diagnosis	430
	22.8 Added Value of Molecular Diagnosis	431
	22.9 Therapy and Recommendations	431
	22.10 Perspectives	433
	Conclusion	433
	References	434
	23: Cockroach, Tick, Storage Mite, and Other Arthropod Allergies: Molecular Aspects	437
	23.1 Introduction	437
	23.2 Cockroach Allergy	438
	23.2.1 Exposure and Distribution	438
	23.2.2 Allergen Identification	439
	23.2.3 Function and Structure	440
	23.2.4 Relevance and Sensitization Frequency	441
	23.2.5 Cross-Reactive Allergens	441
	23.3 Storage Mite Allergy	442
	23.3.1 Exposure and Distribution	442
	23.3.2 Allergen Identification	442
	23.3.3 Relevance	442
	23.3.4 Cross-Reactive Allergens	442
	23.4 Tick Allergy	443
	23.4.1 Exposure and Distribution	443
	23.4.2 Allergen Identification	444
	23.5 Allergies to Other Arthropods	444
	23.6 Diagnostics and the Added Benefit of Molecular-Based Diagnosis	448
	23.7 Treatment and Diagnostic Outlook	449
	References	449
	24: Mold Allergens and Their Importance in Molecular Allergy Diagnosis	453
	24.1 Background	453
	24.2 Classification of Fungal Allergens	454
	24.3 Mold Exposure and Health Risks	454
	24.4 Mold Allergens Belong to Various Protein Families, Most Often with Enzymatic Function in the Organism	458
	24.4.1 Proteases	459
	24.4.2 Ribosomal Proteins	459
	24.4.3 Enolases	459
	24.4.4 Dehydrogenases	459
	24.4.5 Thioredoxins	460
	24.4.6 Heat Shock Proteins	460
	24.4.7 Peroxisomal Membrane Proteins	460
	24.4.8 MnSODs	460
	24.4.9 Flavodoxins	460
	24.4.10 Cyclophilins	461
	24.5 Commercially Available Single Allergens Originating from Mold	461
	24.5.1 Specific IgG Tests	463
	24.6 Outlook	463
	24.7 Conclusions for Routine Clinical Practice	464
	References	464
	25: Latex Allergens: Source of Sensitization and Single Allergens	467
	25.1 Introduction	467
	25.2 Source of Proteins and Denomination of Allergens	468
	25.3 Function of NRL Allergens	468
	25.4 Importance of the Major Allergens	470
	25.5 Dissemination of Latex Allergy	471
	25.6 Cross-Reactive Carbohydrate Determinants (CCDs)	472
	25.7 Latex-Food Syndrome	472
	25.8 Diagnosis with Single Latex Allergens	474
	25.9 Perspectives (Conclusions)	474
	References	476
	Part IV: Designer Allergens, Hypoallergens and Fusion Allergens	479
	26: Recombinant Allergens in Specific Immunotherapy	480
	26.1 Introduction	480
	26.2 Advantages and Opportunities Posed by Recombinant Allergens for Allergen-Specific Immunotherapy	481
	26.2.1 Recombinant Allergens for Specific Immunotherapy: Why?	481
	26.2.2 The Challenge: Selecting the Relevant Allergens	482
	26.2.3 Various Treatment Strategies Using Recombinant Allergens	484
	26.3 Clinical Experience with Recombinant Allergens	485
	26.3.1 Regulatory Requirements	485
	26.3.2 Studies with Unmodified Recombinant Allergens	486
	26.3.3 Studies with Hypoallergenic Recombinant Allergenoids	488
	26.3.4 Studies Involving Alternative Concepts	490
	26.4 Molecular Diagnosis for Molecular Treatment?	491
	References	492
	27: Definition and Design of Hypoallergenic Foods	494
	27.1 Introduction	495
	27.2 Definition of Hypoallergenic Foods	496
	27.3 Design and Evaluation of Hypoallergenic Foods	497
	27.4 Methods of Gene Silencing to Produce Hypoallergenic Foods	498
	27.5 Allergen Reduction Achieved in Allergen Source Models of Plant-Based Foods	500
	27.5.1 Rice (Oryza sativa)	500
	27.5.2 Soybean (Glycine max)	502
	27.5.3 Apple (Malus domestica)	503
	27.5.4 Tomato (Solanum lycopersicum, Formerly: Lycopersicon esculentum)	504
	27.5.5 Carrot (Daucus carota)	507
	27.5.6 Peanut (Arachis hypogaea)	508
	27.6 Acceptance of Hypoallergenic GM Foods Among Consumers	509
	27.7 Additional Benefits of Molecular Diagnostics	510
	27.8 Treatment and Recommendations	510
	27.9 Perspectives	511
	Conclusions	512
	References	513
	Index	519