Multiparametric or “multiplex” systems allow many and different biological molecules to be tested simultaneously “in vitro”: there are basically two types, one is based on an ISACE112i microarray technology (ISAC) and the other one on an ALEX2 macroarray technology (ALEX). As for any immunodiagnostic assay, the two systems, ISAC and ALEX, are based on specific “designs” concerning the quality of the antigen, substrate, conjugated antibody and isotopic reference system used to calibrate the results. The use of multiplex systems in allergy diagnostics may be appropriate, unnecessary, or even harmful. An unnecessary and harmful use of multiplex systems can determine both risks for the patient such as the prescription of “absurd” extended exclusion diets, a self-diagnosis without a specialist visit, and social-economic risks with unjustified increase of costs by labelling patients as allergic when they actually are not. We have analyzed both these systems, highlighting their virtues, strengths and pitfalls, considering the currently available data in literature and the specific characteristics of each multiplex system. In order to avoid incorrect diagnosis and damage to patients, the choice between the two diagnostic tests has to be tailored to the patient and a prerogative of the specialist with specific knowledge in the field of molecular allergology and able to interpret the results.



SIAIP Allergy Diagnostic Commission - SIAIP

Roberto Bernardini - Pediatric and Neonatology Unit, Maternal and Child Department, San Giuseppe Hospital, Azienda USL Toscana Centro, Empoli, Italy

Stefania Arasi - Allergy Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy

Simona Barni - Allergy Unit, Department of Pediatric, Meyer Children’s Hospital, IRCCS, Florence, Italy

Davide Caimmi - Allergy Unit, Montpellier University Hospital, IDESP, UMR 1318, Univ Montpellier - INSERM, France

Fernanda Chiera - Pediatric Unit, “Giovanni Paolo II” Hospital, Lamezia Terme, Azienda Ospedaliera Provinciale of Catanzaro, Italy

Giulio Dinardo - Department of Woman, Child and of General and Specialized Surgery, University of Campania “L. Vanvitelli”, Naples, Italy

Arianna Giannetti - Pediatric Unit, IRCCS University Hospital of Bologna, Italy

Serena Gracci - Pediatric and Neonatology Unit, Maternal and Child Department, San Giuseppe Hospital, Azienda USL Toscana Centro, Empoli, Italy

Carla Mastrorilli - Pediatric and Pediatric Emergency Complex Unit, Pediatric Hospital “Giovanni XXIII”, Bari Italy

Luca Pecoraro - Pediatric Unit, Women and Children’s Hospital, Verona Italy

How to Cite
Allergy Diagnostic Commission, S., Bernardini, R., Arasi, S., Barni, S., Caimmi, D., Chiera, F., Dinardo, G., Giannetti, A., Gracci, S., Mastrorilli, C., & Pecoraro, L. (2024). Multiparametric or multiplex systems in allergy diagnostics. Italian Journal of Pediatric Allergy and Immunology, 38(2). https://doi.org/10.53151/2531-3916/2024-463
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