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Background  Allergy diagnosis by determination of allergen‐specific  I g E  is complicated by clinically irrelevant  I g E , of which the most prominent example is  I g E  against cross‐reactive carbohydrate determinants ( CCD s) that occur on allergens from plants and insects. Therefore,  CCD s cause numerous false‐positive results. Inhibition of  CCD s has been proposed as a remedy, but has not yet found its way into the routine diagnostic laboratory. We sought to provide a simple and affordable procedure to overcome the  CCD  problem.    Methods  Serum samples from allergic patients were analysed for allergen‐specific  I g E s by different commercial tests (from  M ediwiss,  P hadia and  S iemens) with and without a semisynthetic  CCD  blocker with minimized potential for nonspecific interactions that was prepared from purified bromelain glycopeptides and human serum albumin.    Results  Twenty two per cent of about 6000 serum samples reacted with  CCD  reporter proteins. The incidence of anti‐ CCD I g E  reached 35% in the teenage group. In patients with anti‐ CCD I g E , application of the  CCD  blocker led to a clear reduction in read‐out values, often below the threshold level. A much better correlation between laboratory results and anamnesis and skin tests was achieved in many cases. The  CCD  blocker did not affect test results where  CCD s were not involved.    Conclusion  Eliminating the effect of  I g E s directed against  CCD s by inhibition leads to a significant reduction in false‐positive  in vitro  test results without lowering sensitivity towards relevant sensitizations. Application of the  CCD  blocker may be worthwhile wherever natural allergen extracts or components are used.

Inhibition of I g E binding to cross‐reactive carbohydrate determinants enhances diagnostic selectivity