In order to answer the question if an IgE-mediated allergy (A-IgE) may occur in subjects with celiac disease (CD), a systematic review was performed of available publications collected in the United States National Institute for Biotechnology Information/National Institutes of Health/National Library of Medicine/PubMed database up to 28 December 2022, with the use of the following keywords “allergy&celiac/coeliac”, “sensitization&celiac/coeliac”, and “anaphylaxis&celiac/coeliac” compared in the form of a conjunction. In total, the search returned 2013 publications from these keywords in any section of the article. As numerous review articles included the above-mentioned entries in the abstract, we decided to focus on the publications with the entries only in the title (n = 63). After rejecting studies unrelated to the topic, narrative reviews, book chapters, conference abstracts, symposium reports, letters to the editor, or non-English articles, 18 publications (6 observational original studies and 12 case reports describing a total of 15 cases of A-IgE developed after a diagnosis of CD) were included to this review. Our study is the first systematic review on allergy occurrence in CD patients. The analysis indicated that the possibility of a coexistence of A-IgE with any food and inhalant allergens in subjects diagnosed with CD should be considered. A sensitization to wheat was the most frequently described in subjects with CD. The clinical manifestation of A-IgE in CD was similar to that in subjects without CD; e.g., with possible atopic dermatitis, vomiting, urticaria, angioedema, or anaphylactic shock. Screening for allergies in subjects with CD should be considered, especially in those cases where symptoms persist after introducing a gluten-free diet. The elimination of wheat from the diet of patients with CD may lead to a loss of immune tolerance and to the development of sensitization, which may even manifest as anaphylaxis. In conclusion, although there are few studies assessing the occurrence of A-IgE in subjects with CD, they show the possibility of a coexistence of both diseases and the high clinical significance of this phenomenon, which indicates the need for further studies.

The diagnosis of celiac disease (CD) at the first diagnostic step requires the detection of specific class A antibodies to tissue transglutaminase type-2 (TG2 IgA) and the measurement of total immunoglobulin A (tIgA) to exclude IgA deficiency. The aim of the study was to evaluate the new quantitative immunoassay panel allowing for the detection of celiac-specific antibodies with the simultaneous determination of tIgA from the same sample of blood at one time. This retrospective study included 104 pediatric patients divided into groups with recognized CD and IgA deficiency (n = 20; 19%), immunocompetent children with CD (n = 28; 27%), children with IgA deficiency and without CD (n = 28; 27%), and the control group of immunocompetent children without CD (n = 28; 27%). Intestinal biopsy with histopathological evaluation (except five patients with CD who were diagnosed without biopsy) and measurement of reference celiac specific antibodies were performed in all children. Multiparametric quantitative immunoassay Polycheck^® Celiac IgA plus total IgA test was used to evaluate its usefulness in CD screening and IgA deficiency diagnosis. The statistical analysis showed the high sensitivity and specificity of both TG2 IgA and tIgA on the multiparametric panel (sensitivity 96% and 100%; specificity 100% and 79%, respectively). The accuracy and area under the ROC curve for tIgA were 0.904 and 0.955, while for TG2 IgA they were 0.982 and 1.000, respectively. Although the sensitivity of IgA antibodies against deaminated gliadin peptides was low (20%), the specificity reached 100%. The study showed that Polycheck^® Celiac IgA plus total IgA test is a specific and sensitive tool for simultaneous serological CD screening and recognition of IgA deficiency.

A high quality of knowledge and how it is communicated by healthcare professionals (HCPs) let the patient understand coeliac disease (CD) and result in better adherence to therapeutic recommendations. Therefore, the aim of the current study was to assess the opinion of Polish respondents with CD on the comprehension of CD among Polish HCPs. The analysis was based on 796 responses from patients (the members of the Polish Coeliac Society) with confirmed CD diagnosis (224; 28.1% children and 572; 71.9% adults). The most frequently consulted HCPs regarding CD symptoms in the analysed group were gastroenterologists, and various support groups and associations for CD patients. Furthermore, their comprehension of CD was rated best, as 89.3% (n = 552) of the patients who had contact with support groups and associations classified their knowledge on CD as good. More than a half of the respondents (n = 310, 56.6%) who had contact with general practitioners (GPs) due to their symptoms, rated the doctor’s knowledge on CD as bad. Nurses’ comprehension on CD was classified as bad by 45 (52.3%) respondents who had contact with a nurse. Out of 294 Polish patients with CD who had contact with a dietician, 247 (84.0%) assessed that the dietician communicated their knowledge on CD well. The respondents rated that GPs and nurses communicated their knowledge on CD in the worst manner (60.4% and 58.1%, respectively). Out of 796 respondents, 792 (99.5%) provided information about the number of appointments with GPs due to symptoms that occurred prior to CD diagnosis. The respondents had contact with GPs 13 863 times before obtaining a CD diagnosis due to their symptoms. After the establishment of a CD diagnosis, the number of appointments with GPs decreased to 3850, and the average number of appointments decreased from 17.8 to 5.1. The respondents assessed that the knowledge on CD of HCPs is not satisfactory. The work of support groups and associations on CD, who promote reliable CD diagnosis and treatment methods, should be promoted. The cooperation between various HCPs needs to be encouraged, which may lead to better compliance.

In order to establish the reliability of new multiplex tests for determining allergen-specific immunoglobulin E (asIgE) levels in serum, the results of asIgE determinations obtained via ALEX tests were compared to those obtained via ImmunoCAP ISAC in a group of 40 Polish children hospitalized due to food allergy and/or anaphylaxis. The analysis was based on 6320 determinations of asIgEs relative to 79 common allergen molecules included in both tests (80 tests conducted—40 ALEX and 40 ISAC). The study showed a high correlation of results between the compared diagnostic tests, with the concordance of asIgE determinations at the level of 92.5% (n = 2922). The results of this study showed the sensitivity of the ALEX test to be comparable with that of the ImmunoCAP ISAC test. One indisputable advantage of the ALEX test is its high number of determinations per procedure, which provides more information about the patient’s molecular profile; moreover, the use of an inhibitor of the asIgEs that bind to cross-reactive carbohydrate determinants (CCDs) reduces their impact on the results for allergens naturally containing carbohydrate determinants. Comparative analyses of asIgE test results obtained with ALEX and ImmunoCAP ISAC tests demonstrate that the ALEX test is a reliable diagnostic tool for asIgE assessments. However, significant differences in the absolute values of asIgEs relative to individual molecules suggest the need for caution when directly comparing asIgE levels from both tests.

Introduction: House dust mite (HDM) allergens are considered among the most essential elicitors of allergic rhinitis and asthma worldwide [1]. How can we determine the individual sensitization profile of a patient? Is there a way to monitor the development of allergic symptoms? Is it possible to tailor different forms of therapy based on the individual sensitization profile of a patient? Purpose: The study aims to show the benefits of molecular diagnostics of allergies based on the example of HDM allergy. Description of the state of knowledge: Clinical manifestation is the most important aspect of diagnosing HDM allergy. The determination of allergen specific immunoglobulins E (asIgE) against HDM extracts may be helpful in the identification of the cause of allergy symptoms. However, the diagnosis using allergen extracts cannot be established in all cases. What revolutionised the diagnosing process of HDM allergy is the molecular diagnostics of allergy. Based on the presence of asIgE against allergen molecules it is possible to identify the allergen responsible for the sensitisation as well as personalise the therapeutic recommendations. Summary: The molecular diagnostics of allergy significantly improved the specificity and sensitivity of HDM allergy diagnostics. Molecular diagnostics in individuals with HDM allergy make it possible to establish the individual patient’s allergy profile, and consequently personalise therapeutic recommendations. It is especially important regarding the selection of patients who may benefit from immunotherapy. The component-resolved diagnostics in allergology is a step toward personalised medicine.

The profiles of house dust mite (HDM) sensitization may differ in various geographical regions, which could affect the course of allergic diseases. The identification of these discrepancies could help to introduce improved methods of HDM allergy management, more suited to the local needs. The study aimed to analyze the pattern of sensitization to Dermatophagoides pteronyssinus (DP) allergen components and allergens that may cross-react with the allergen components among Polish children and adults with suspicion of allergy. The sensitization to DP allergens and homologous proteins was assessed in 17,821 Polish individuals suspected of allergy. The specific immunoglobulins E (sIgE) were detected with the ALEX2® test between 2019 and 2023 in various laboratories across the country. Almost 25% of the study participants had sIgE to any DP molecule (DP_m), and in this group, sIgE to Der p 2 was detected most frequently. The most common profile of sensitization was monosensitization to Der p 2. Polysensitization occurred in 61.3% of patients with sIgE to any DP_m. Among patients sensitized to Der p 23, 91.2% were co-sensitized to Der p 1 and/or Der p 2. The most common pattern of sensitization to tropomyosins included sIgE to all five proteins from the family. Major DP_ms, in various combinations, most frequently cause sensitization in the study group. Tropomyosin is a panallergen with high cross-reactivity potential, which was proved by the sensitization profile to tropomyosins in our study group.