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September 25, 1987, Vol 258, No. 12 >
ARTICLE | September 25, 1987

In Vitro Testing for Allergy: Title and subTitle BreakReport II of the Allergy Panel FREE

[+] Author Affiliations

This report was submitted to the AMA House of Delegates in December 1986 as an informational report.

This report is not intended to be construed or to serve as a standard of medical care. Standards of medical care are determined on the basis of all of the facts and circumstances involved in an individual case and are subject to change as scientific knowledge and technology advance and patterns of practice evolve. This report reflects the views of the scientific literature as of December 1986.

Reprint requests to Council on Scientific Affairs, American Medical Association, 535 N Dearborn St, Chicago, IL 60610 (William R. Hendee, PhD).


JAMA. 1987;258(12):1639-1643. doi:10.1001/jama.1987.03400120089031
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Article
References

This report is the third of a series of reports prepared by a multidisciplinary panel appointed by the Council on Scientific Affairs of the American Medical Association. This report reviews the current status of in vitro tests available in the evaluation of immunologic and/or allergic diseases. A discussion of the large number of tests available to measure IgE is followed by an overview of the status of complement assays and tests being developed for evaluation of immune complexes. Cellular assays involving polymorphonuclear cells (basophils, eosinophils) and lymphocytes have increased in use; their appropriate indication and current worth are evaluated, as well as the therapeutic monitoring of theophylline serum concentrations. In the view of the panel, the rapidly proliferating number of in vitro diagnostic tests has great potential for the enhancement of the practice of allergy, but also a potential for misuse. Appropriate use of these tests is the focus of this report.

(JAMA 1987;258:1639-1643)

REFERENCES

1 +
Johansson SGO, Berglund A, Kjellman NI:  Comparison of IgE values as determined by different solid phase radioimmunoassay methods . Clin Allergy 1976;;6:91-98.
2 +
Ceska M, Lundkvist U:  A new and simple radioimmunoassay method for determination of IgE . Immunochemistry 1972;;9:1021-1030.
3 +
Bazaral M, Orgel HA, Hamburger RN:  IgE levels in normal infants and mothers and an inheritance hypothesis . J Immunol 1971;;107:794-801.
4 +
Berg T, Johansson SG:  Immunoglobulin levels during childhood, with special regard to IgE . Acta Paediatr Scand 1969;;58:513-524.
5 +
Gerrard JW, Horne S, Vickers P, et al:  Serum IgE levels in parents and children . J Pediatr 1974;; 85:660-663.
6 +
Wide L, Bennich H, Johansson SG:  Diagnosis of allergy by an in-vitro test for allergen antibodies . Lancet 1967;;2:1105-1107.
7 +
Evans R, Reisman RE, Wypych JI, et al:  An immunologic evaluation of ragweed sensitive patients by newer techniques . J Allergy Clin Immunol 1972;;49:285-291.
8 +
Norman PS:  Correlations of RAST with in vivo and in vitro assays , in Evans R (ed): Advances in Diagnosis of Allergy: RAST . Miami, Symposia Specialists, 1975;, pp 45-56.
9 +
Nalebuff DJ, Fadal RG:  RAST-based immunotherapy . Rhinology 1984;;22:11-19.
10 +
Norman PS, Lichtenstein LM, Ishizaka K:  Diagnostic tests in ragweed hay fever: A comparison of direct skin tests: IgE antibody measurements, and basophil histamine release . J Allergy Clin Immunol 1973;;52:210-224.
11 +
Davies RJ, Blainey AD, Pepys J:  Occupational asthma , in Middleton E, Reed CE, Ellis EF (eds): Allergy: Principles and Practice . St Louis, CV Mosby Co, 1983;, pp 1037-1065.
12 +
Position statement of the American Academy of Allergy and Immunology:  Skin testing and radioallergosorbent testing (RAST) for diagnosis of specific allergens responsible for IgE mediated diseases . J Allergy Clin Immunol 1983;;72:515-517.
13 +
Bernstein DI, Gallagher JS, Ulmer A, et al:  Prospective evaluation of chymopapain in patients undergoing chemonucleolysis . J Allergy Clin Immunol 1985;;76:458-465.
14 +
Miller SP, Marinkovich VA, Riege DH, et al:  Application of the MAST immunodiagnostic system to the determination of allergen-specific IgE . Clin Chem 1984;;30:1467-1472.
15 +
Ali M, Ramanarayanan MP:  A computerized micro-ELISA assay for allergen-specific IgE antibodies . Am J Clin Pathol 1984;;81:591-601.
16 +
Seltzer JM, Halpern GN, Tsay YG:  Correlation of allergy test results obtained by IgE FAST, RAST, and prick-puncture methods . Ann Allergy 1985;;54:25-30.
17 +
Hamilton RG, Sobotka AK, Adkinson NF:  Solid phase radioimmunoassay for quantitation of antigen-specific IgG in human sera with I125 protein A from Staphylococcus aureus . J Immunol 1979;; 122:1073-1079.
18 +
Patterson R, Grammer LC, Shaughnessy MA:  Immunotherapy: Parameters of assessment . J Allergy Clin Immunol 1985;;76:394-397.
19 +
Mannik M, Gilliand BC:  Relevance of immune complexes in diseases . Univ Washington Med 1984;; 8:9-15.
20 +
Gilliand B:  Serum sickness and immune complexes . N Engl J Med 1984;;311:1435-1436.
21 +
Ruddy S:  Complement , in Cohen AS (ed): Laboratory Diagnostic Procedures in the Rheumatic Diseases , ed 3. New York, Grune & Stratton, 1985;, pp 137-162.
22 +
Schur PH:  Complement studies of sera and other biologic fluids . Hum Pathol 1983;;14:338-342.
23 +
Van EL, Smith SJ, Schur PH, et al:  International collaborative study of four candidate reference preparations for the antigenic and hemolytic measurement of human serum complement components . J Biol Stand 1981;;9:91-104.
24 +
Gigli I:  The human complement system , in Stone J (ed): Dermatologic Immunology and Allergy . St Louis, CV Mosby Co, 1985;, pp 27-37.
25 +
Wasserman SI:  Mediators of intermediate hypersensitivity . J Allergy Clin Immunol 1983;;72: 101-119.
26 +
Stahl S, Mosbech H, Norn S, et al:  Sensitive glass microfibre-based histamine analysis for allergy testing in washed blood cells: Results compared with conventional leukocyte histamine release assay . Allergy 1985;;40:213-218.
27 +
Oppenheim JJ, Rosenstreich DL:  Lymphocyte transformation: Utilization of automatic harvesters , in Bloom BR, David JR (eds): In Vitro Methods in Cell-Mediated and Tumor Immunity . Orlando, Fla, Academic Press Inc, 1976;, pp 573-585.
28 +
Oppenheim JJ, Schechta S:  Lymphocyte transformation , in Rose NR, Friedmann H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1980;, pp 233-245.
29 +
Moller G, Coutinho A:  Role of C3 and Fc receptors in B lymphocyte activation . J Exp Med 1975;;141:647-663.
30 +
Pehamberger H, Knapp W:  Effect of BCG on concanavalin A induced suppressor cell activity and lymphocyte stimulation in stage 1 melanoma . J Invest Dermatol 1981;;76:502-505.
31 +
Battisto JR, Ponzio NM:  Autologous and syngeneic mixed lymphocyte reactions and their immunological significance . Prog Allergy 1981;;28: 160-192.
32 +
Finch SC:  Granulocytosis , in Williams WJ, Beuter E, Erslev AJ, et al (eds): Hematology . New York, McGraw-Hill International Book Co, 1972;, p 657.
33 +
Kay AM, Turner-Warwick M:  Eosinophils and eosinophilia: Biology and clinical significance , in Lockey RF (ed): Allergy and Clinical Immunology . Garden City, NY, Medical Examination Publishing Company, 1979;, p 945.
34 +
Beutner EH, Chorzelski TP, Bean SF: Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979;.
35 +
 Collaborative study: Uses for immunofluorescence tests of skin in sera: Utilization of immunofluorescence in the diagnosis of bullous diseases, lupus erythematosus, and certain other dermatoses . Arch Dermatol 1975;;111:371-381.
36 +
Hendeles L, Weinberger M:  Theophylline: A 'state of the art' review . Pharmacotherapy 1983;;3: 2-44.
37 +
 Drugs used in bronchial disorders , in Lampe KF (ed): Drug Evaluations , ed 6. Chicago, American Medical Association, 1986;, pp 393-418.
38 +
Jenne JW, Wyze E, Rood FS, et al:  Pharmacokinetics of theophylline: Application to adjustment of the clinical dose of aminophylline . Clin Pharmacol Ther 1972;;13:349-360.
39 +
Simons FER, Luciuk GH, Simons KS:  Sustained-release theophylline for treatment of asthma in preschool children . AJDC 1982;;136:790-793.
40 +
Hendeles L, Weinberger M, Bighley L:  Disposition of theophylline after a single intravenous infusion of aminophylline . Am Rev Respir Dis 1978;;118:97-103.
41 +
Weinberger M, Hudgel D, Spector S, et al:  Troleandomycin (TAO): An inhibitor of theophylline metabolism , abstracted. J Allergy Clin Immunol 1976;;57:262.
42 +
Caldwell J, Lancaster R, Monks TJ, et al:  The influence of dietary methylxanthines on the pharmacokinetics of intravenously administered theophylline . Br J Clin Pharmacol 1977;;4:637P-638P.
43 +
Ellis EF, Koysooko R, Levy G:  Pharmacokinetics of theophylline in children with asthma . Pediatrics 1976;;58:542-547.
44 +
Fairshter RD, Busse WW:  Theophylline: How much is enough? J Allergy Clin Immunol 1986;; 77:646-648.
45 +
Furukawa CT, Shapiro GG, DuHamel T, et al:  Learning and behavior problems associated with theophylline therapy . Lancet 1984;;1:621.
46 +
Foon KA, Schroff RW, Bunn PA Jr:  Clinical applications of monoclonal antibodies for patients with leukemia and lymphoma . Prog Clin Biol Res 1986;;211:265-284.
47 +
DePinho RA, Feldman LB, Scharff MD:  Tailormade monoclonal antibodies . Ann Intern Med 1986;; 104:225-233.
48 +
Raff HV:  Monoclonal antibodies: Conversence of technology and application . Prog Clin Biol Res 1986;;211:247-263.
49 +
Black AP:  A new diagnostic method in allergic disease . Pediatrics 1956;;17:716-724.
50 +
Squier TL, Lee HJ:  Lysis in vitro of sensitized leukocytes by ragweed antigen . J Allergy 1947;;18: 156-162.
51 +
Bryan WTK, Bryan MP:  The application of in vitro cytotoxic reactions to clinical diagnosis of food allergy . Laryngoscope 1960;;70:810-824.
52 +
Bryan WTK, Bryan MP:  Diagnosis of food allergy by cytotoxic reactions . Trans Am Soc Ophthalmol Otolaryngol Allergy 1967;;8:14-32.
53 +
Bryan WTK, Bryan MP:  Cytotoxic reactions in the diagnosis of food allergy . Otolaryngol Clin North Am 1971;;4:523-533.
54 +
Bryan WTK, Bryan MP:  Allergy in otolaryngology , in Pararella MM, Schumrick DA (eds): Otolaryngology . Philadelphia, WB Saunders Co, 1973;, vol 3, pp 69-94.
55 +
Golbert TM:  A review of controversial diagnostic and therapeutic techniques employed in allergy . J Allergy Clin Immunol 1975;;56:170-190.
56 +
Lowell FC:  Some untested diagnostic and therapeutic procedures in clinical allergy . J Allergy Clin Immunol 1975;;56:168-169.
57 +
Van Metre TE:  The advancement of the knowledge and practice of allergy . J Allergy Clin Immunol 1979;;64:235-241.
58 +
Lowell FC, Heiner DC:  Food allergy cytotoxic diagnostic technique not proven . JAMA 1972;;220: 1624.
59 +
American Academy of Allergy:  Position statements: Controversial techniques . J Allergy Clin Immunol 1981;;67:333-334.
60 +
Report from National Center for Health Care Technology:  Summary of assessments, 1981 . JAMA 1981;;246:1499.
61 +
Thompson RC:  The flaw in cytotoxic testing: There's no proof it works . FDA Consumer 1984;; 18:34-36.
62 +
Franklin W, Lowell FC:  Failure of ragweed pollen extract to destroy white cells from ragweedsensitive patients . J Allergy 1949;;20:375-377.
63 +
Chambers VV, Hudson BH, Glaser J:  A study of the reactions of human polymorphonuclear leukocytes to various antigens . J Allergy 1958;;29:93-102.
64 +
Lieberman P, Crawford L, Bjelland J, et al:  Controlled study of the cytotoxic food test . JAMA 1974;;231:728-730.
65 +
Benson TE, Arkins JA:  Cytotoxic testing for food allergy: Evaluations of reproducibility and correlation . J Allergy Clin Immunol 1976;;58:471-476.
66 +
Lehman CW:  The leukocytic food allergy test: A study of its reliability and reproducibility: Effect of diet and sublingual food drops on this test . Ann Allergy 1980;;45:150-158.
67 +
Cytotoxic Testing for Allergic Diseases: Compliance Policy Guide 7124.27 . Food and Drug Administration, 1985;.
68 +
 Availability of compliance policy guide for cytotoxic testing for allergic diseases . Federal Register 1985;;50( (April 9) ):14025-14026.
69 +
Shakib F, Brown Morrow H, Phelps A, et al:  Study of IgG sub-class antibodies in patients with milk intolerance . Clin Allergy 1986;;16:451-458.
70 +
Galant SP, Bullock J, Frick OL:  An immunological approach to the diagnosis of food sensitivity . Clin Allergy 1973;;3:363-372.
71 +
Dannaeus A, Johansson SGO, Foucard T, et al:  Clinical and immunological aspects of food allergy in childhood: I. Estimation of IgG, IgA, and IgE antibodies to food antigens in children with food allergy and atopic dermatitis . Acta Paediatr Scand 1977;;66:31-37.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Johansson SGO, Berglund A, Kjellman NI:  Comparison of IgE values as determined by different solid phase radioimmunoassay methods . Clin Allergy 1976;;6:91-98.
2 +
Ceska M, Lundkvist U:  A new and simple radioimmunoassay method for determination of IgE . Immunochemistry 1972;;9:1021-1030.
3 +
Bazaral M, Orgel HA, Hamburger RN:  IgE levels in normal infants and mothers and an inheritance hypothesis . J Immunol 1971;;107:794-801.
4 +
Berg T, Johansson SG:  Immunoglobulin levels during childhood, with special regard to IgE . Acta Paediatr Scand 1969;;58:513-524.
5 +
Gerrard JW, Horne S, Vickers P, et al:  Serum IgE levels in parents and children . J Pediatr 1974;; 85:660-663.
6 +
Wide L, Bennich H, Johansson SG:  Diagnosis of allergy by an in-vitro test for allergen antibodies . Lancet 1967;;2:1105-1107.
7 +
Evans R, Reisman RE, Wypych JI, et al:  An immunologic evaluation of ragweed sensitive patients by newer techniques . J Allergy Clin Immunol 1972;;49:285-291.
8 +
Norman PS:  Correlations of RAST with in vivo and in vitro assays , in Evans R (ed): Advances in Diagnosis of Allergy: RAST . Miami, Symposia Specialists, 1975;, pp 45-56.
9 +
Nalebuff DJ, Fadal RG:  RAST-based immunotherapy . Rhinology 1984;;22:11-19.
10 +
Norman PS, Lichtenstein LM, Ishizaka K:  Diagnostic tests in ragweed hay fever: A comparison of direct skin tests: IgE antibody measurements, and basophil histamine release . J Allergy Clin Immunol 1973;;52:210-224.
11 +
Davies RJ, Blainey AD, Pepys J:  Occupational asthma , in Middleton E, Reed CE, Ellis EF (eds): Allergy: Principles and Practice . St Louis, CV Mosby Co, 1983;, pp 1037-1065.
12 +
Position statement of the American Academy of Allergy and Immunology:  Skin testing and radioallergosorbent testing (RAST) for diagnosis of specific allergens responsible for IgE mediated diseases . J Allergy Clin Immunol 1983;;72:515-517.
13 +
Bernstein DI, Gallagher JS, Ulmer A, et al:  Prospective evaluation of chymopapain in patients undergoing chemonucleolysis . J Allergy Clin Immunol 1985;;76:458-465.
14 +
Miller SP, Marinkovich VA, Riege DH, et al:  Application of the MAST immunodiagnostic system to the determination of allergen-specific IgE . Clin Chem 1984;;30:1467-1472.
15 +
Ali M, Ramanarayanan MP:  A computerized micro-ELISA assay for allergen-specific IgE antibodies . Am J Clin Pathol 1984;;81:591-601.
16 +
Seltzer JM, Halpern GN, Tsay YG:  Correlation of allergy test results obtained by IgE FAST, RAST, and prick-puncture methods . Ann Allergy 1985;;54:25-30.
17 +
Hamilton RG, Sobotka AK, Adkinson NF:  Solid phase radioimmunoassay for quantitation of antigen-specific IgG in human sera with I125 protein A from Staphylococcus aureus . J Immunol 1979;; 122:1073-1079.
18 +
Patterson R, Grammer LC, Shaughnessy MA:  Immunotherapy: Parameters of assessment . J Allergy Clin Immunol 1985;;76:394-397.
19 +
Mannik M, Gilliand BC:  Relevance of immune complexes in diseases . Univ Washington Med 1984;; 8:9-15.
20 +
Gilliand B:  Serum sickness and immune complexes . N Engl J Med 1984;;311:1435-1436.
21 +
Ruddy S:  Complement , in Cohen AS (ed): Laboratory Diagnostic Procedures in the Rheumatic Diseases , ed 3. New York, Grune & Stratton, 1985;, pp 137-162.
22 +
Schur PH:  Complement studies of sera and other biologic fluids . Hum Pathol 1983;;14:338-342.
23 +
Van EL, Smith SJ, Schur PH, et al:  International collaborative study of four candidate reference preparations for the antigenic and hemolytic measurement of human serum complement components . J Biol Stand 1981;;9:91-104.
24 +
Gigli I:  The human complement system , in Stone J (ed): Dermatologic Immunology and Allergy . St Louis, CV Mosby Co, 1985;, pp 27-37.
25 +
Wasserman SI:  Mediators of intermediate hypersensitivity . J Allergy Clin Immunol 1983;;72: 101-119.
26 +
Stahl S, Mosbech H, Norn S, et al:  Sensitive glass microfibre-based histamine analysis for allergy testing in washed blood cells: Results compared with conventional leukocyte histamine release assay . Allergy 1985;;40:213-218.
27 +
Oppenheim JJ, Rosenstreich DL:  Lymphocyte transformation: Utilization of automatic harvesters , in Bloom BR, David JR (eds): In Vitro Methods in Cell-Mediated and Tumor Immunity . Orlando, Fla, Academic Press Inc, 1976;, pp 573-585.
28 +
Oppenheim JJ, Schechta S:  Lymphocyte transformation , in Rose NR, Friedmann H (eds): Manual of Clinical Immunology . Washington, DC, American Society for Microbiology, 1980;, pp 233-245.
29 +
Moller G, Coutinho A:  Role of C3 and Fc receptors in B lymphocyte activation . J Exp Med 1975;;141:647-663.
30 +
Pehamberger H, Knapp W:  Effect of BCG on concanavalin A induced suppressor cell activity and lymphocyte stimulation in stage 1 melanoma . J Invest Dermatol 1981;;76:502-505.
31 +
Battisto JR, Ponzio NM:  Autologous and syngeneic mixed lymphocyte reactions and their immunological significance . Prog Allergy 1981;;28: 160-192.
32 +
Finch SC:  Granulocytosis , in Williams WJ, Beuter E, Erslev AJ, et al (eds): Hematology . New York, McGraw-Hill International Book Co, 1972;, p 657.
33 +
Kay AM, Turner-Warwick M:  Eosinophils and eosinophilia: Biology and clinical significance , in Lockey RF (ed): Allergy and Clinical Immunology . Garden City, NY, Medical Examination Publishing Company, 1979;, p 945.
34 +
Beutner EH, Chorzelski TP, Bean SF: Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979;.
35 +
 Collaborative study: Uses for immunofluorescence tests of skin in sera: Utilization of immunofluorescence in the diagnosis of bullous diseases, lupus erythematosus, and certain other dermatoses . Arch Dermatol 1975;;111:371-381.
36 +
Hendeles L, Weinberger M:  Theophylline: A 'state of the art' review . Pharmacotherapy 1983;;3: 2-44.
37 +
 Drugs used in bronchial disorders , in Lampe KF (ed): Drug Evaluations , ed 6. Chicago, American Medical Association, 1986;, pp 393-418.
38 +
Jenne JW, Wyze E, Rood FS, et al:  Pharmacokinetics of theophylline: Application to adjustment of the clinical dose of aminophylline . Clin Pharmacol Ther 1972;;13:349-360.
39 +
Simons FER, Luciuk GH, Simons KS:  Sustained-release theophylline for treatment of asthma in preschool children . AJDC 1982;;136:790-793.
40 +
Hendeles L, Weinberger M, Bighley L:  Disposition of theophylline after a single intravenous infusion of aminophylline . Am Rev Respir Dis 1978;;118:97-103.
41 +
Weinberger M, Hudgel D, Spector S, et al:  Troleandomycin (TAO): An inhibitor of theophylline metabolism , abstracted. J Allergy Clin Immunol 1976;;57:262.
42 +
Caldwell J, Lancaster R, Monks TJ, et al:  The influence of dietary methylxanthines on the pharmacokinetics of intravenously administered theophylline . Br J Clin Pharmacol 1977;;4:637P-638P.
43 +
Ellis EF, Koysooko R, Levy G:  Pharmacokinetics of theophylline in children with asthma . Pediatrics 1976;;58:542-547.
44 +
Fairshter RD, Busse WW:  Theophylline: How much is enough? J Allergy Clin Immunol 1986;; 77:646-648.
45 +
Furukawa CT, Shapiro GG, DuHamel T, et al:  Learning and behavior problems associated with theophylline therapy . Lancet 1984;;1:621.
46 +
Foon KA, Schroff RW, Bunn PA Jr:  Clinical applications of monoclonal antibodies for patients with leukemia and lymphoma . Prog Clin Biol Res 1986;;211:265-284.
47 +
DePinho RA, Feldman LB, Scharff MD:  Tailormade monoclonal antibodies . Ann Intern Med 1986;; 104:225-233.
48 +
Raff HV:  Monoclonal antibodies: Conversence of technology and application . Prog Clin Biol Res 1986;;211:247-263.
49 +
Black AP:  A new diagnostic method in allergic disease . Pediatrics 1956;;17:716-724.
50 +
Squier TL, Lee HJ:  Lysis in vitro of sensitized leukocytes by ragweed antigen . J Allergy 1947;;18: 156-162.
51 +
Bryan WTK, Bryan MP:  The application of in vitro cytotoxic reactions to clinical diagnosis of food allergy . Laryngoscope 1960;;70:810-824.
52 +
Bryan WTK, Bryan MP:  Diagnosis of food allergy by cytotoxic reactions . Trans Am Soc Ophthalmol Otolaryngol Allergy 1967;;8:14-32.
53 +
Bryan WTK, Bryan MP:  Cytotoxic reactions in the diagnosis of food allergy . Otolaryngol Clin North Am 1971;;4:523-533.
54 +
Bryan WTK, Bryan MP:  Allergy in otolaryngology , in Pararella MM, Schumrick DA (eds): Otolaryngology . Philadelphia, WB Saunders Co, 1973;, vol 3, pp 69-94.
55 +
Golbert TM:  A review of controversial diagnostic and therapeutic techniques employed in allergy . J Allergy Clin Immunol 1975;;56:170-190.
56 +
Lowell FC:  Some untested diagnostic and therapeutic procedures in clinical allergy . J Allergy Clin Immunol 1975;;56:168-169.
57 +
Van Metre TE:  The advancement of the knowledge and practice of allergy . J Allergy Clin Immunol 1979;;64:235-241.
58 +
Lowell FC, Heiner DC:  Food allergy cytotoxic diagnostic technique not proven . JAMA 1972;;220: 1624.
59 +
American Academy of Allergy:  Position statements: Controversial techniques . J Allergy Clin Immunol 1981;;67:333-334.
60 +
Report from National Center for Health Care Technology:  Summary of assessments, 1981 . JAMA 1981;;246:1499.
61 +
Thompson RC:  The flaw in cytotoxic testing: There's no proof it works . FDA Consumer 1984;; 18:34-36.
62 +
Franklin W, Lowell FC:  Failure of ragweed pollen extract to destroy white cells from ragweedsensitive patients . J Allergy 1949;;20:375-377.
63 +
Chambers VV, Hudson BH, Glaser J:  A study of the reactions of human polymorphonuclear leukocytes to various antigens . J Allergy 1958;;29:93-102.
64 +
Lieberman P, Crawford L, Bjelland J, et al:  Controlled study of the cytotoxic food test . JAMA 1974;;231:728-730.
65 +
Benson TE, Arkins JA:  Cytotoxic testing for food allergy: Evaluations of reproducibility and correlation . J Allergy Clin Immunol 1976;;58:471-476.
66 +
Lehman CW:  The leukocytic food allergy test: A study of its reliability and reproducibility: Effect of diet and sublingual food drops on this test . Ann Allergy 1980;;45:150-158.
67 +
Cytotoxic Testing for Allergic Diseases: Compliance Policy Guide 7124.27 . Food and Drug Administration, 1985;.
68 +
 Availability of compliance policy guide for cytotoxic testing for allergic diseases . Federal Register 1985;;50( (April 9) ):14025-14026.
69 +
Shakib F, Brown Morrow H, Phelps A, et al:  Study of IgG sub-class antibodies in patients with milk intolerance . Clin Allergy 1986;;16:451-458.
70 +
Galant SP, Bullock J, Frick OL:  An immunological approach to the diagnosis of food sensitivity . Clin Allergy 1973;;3:363-372.
71 +
Dannaeus A, Johansson SGO, Foucard T, et al:  Clinical and immunological aspects of food allergy in childhood: I. Estimation of IgG, IgA, and IgE antibodies to food antigens in children with food allergy and atopic dermatitis . Acta Paediatr Scand 1977;;66:31-37.

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