Algorithm for the use of allergy tests
Authors: Гареев Алексей 
Published: October 2020

The article describes the current practice of the relationship between clinicians and laboratory doctors.The dependence in the formation of the list and content of laboratory services on the tasks put forward by the clinician is traced. These may be tests based solely on extractable markers, tests may include extract components, it is possible that in the future the tests will be epitope.The process of protein resorption into the internal environment of a macroorganism is described. The extremely important role of the microbiome of the mucous membranes and the skin in the translational destruction of protein structures is emphasized. The determining factor is that the path of penetration, bypassing the habitat of the microbiome, does not exist. The emphasis is placed on the fact that an allergological reaction is possible only in the case where protein destruction does not lead to complete degradation to amino acids, preserved protein structures, penetrating into the internal environment, are perceived by the immune system as an antigen (allergen) with the subsequent launch of a cascade of humoral and cellular reactions. This suggests that the basis of the pathogenesis of an allergic disease is the insufficiency of protein destruction factors, which are involved both from the macroorganism and from the microbiome.Normalization of the functioning of these factors should lead to the recovery of the allergic patient. ASIT should be considered as a palliative. The main and only resorption mechanism is passive diffusion. The determining role of the degree of dissociation of electrolyte solutions created by protein molecules is estimated. The microbiome is presented as an additional organ, chimeric for a macroorganism, whose role is to form barrier, protective functions, preventing the penetration of antigenic structures into the internal environment. It is concluded that the main task of the allergist doctor at the stage of diagnosis should be the desire to identify sensitization to protein homologs that make up one group. This approach makes it possible to assess the spread of sensitizationamong proteins of homologs of various nature of origin, thereby assessing the most widespread pathological process in a particular patient. Laboratory tests for the production of Simesta take into account the ideas presented, for this reason they are arranged in a system with a thought-out sequence of use, depending on the clinical manifestations and the results of the previous study. In the line of proposals there are tests of the original layout, not offered by other manufacturers. These are linear blots collected exclusively on a group basis, namely the Profilins Polcalcins blot, the PR-10, nsLTP blot, the Storageproteins blot, the Serum albumins, Lipocalins blot, the Tropomyosins blot. The test application algorithm is divided into three levels, flexibly using with reference to a specific clinical situation, the clinician’s doctor has the opportunity to obtain the most possible information at the lowest possible cost. Assessing the prospects for the development of allergology, an assumption is made about the development with subsequent implementation of epitope tests into practice, the results of the study on which will make it possible using mathematical tools to model the structure of the protein structure that has penetrated the internal environment. This will determine the missing factors of the destruction of the allergen in a particular patient, which will lead to pathogenetic treatment.