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. 1983 Aug;75(8):831–834.

Controversial Techniques in Allergy Treatment

Marvin Barton, James Oleske, James LaBraico
PMCID: PMC2561513  PMID: 6355491

Abstract

The treatment of allergies is based more on sound scientific principles today than it was 20 years ago; however, allergy control still suffers from controversial diagnostic and treatment methods. Controlled studies have failed to support the skin titration (Rinkel method) used to establish an optimal dose for the relief of hay fever symptoms. Determining the clinical usefulness of cytotoxic testing is fraught with lack of clinical correlations and a high percentage of false positives. The results of double-blind studies demonstrated that cytotoxic testing is not a reliable diagnostic technique. Similarly, controlled studies do not corroborate the clinical usefulness proponents advocate for sublingual and provocative subcutaneous testing for diagnosing and treating allergy. The use of autogenous-urine immunization has no proven efficacy and can predispose the patient to potential harmful effects. These diagnostic modalities have not proved to be helpful and should not be employed in the assessment of the allergic patient.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adkinson N. F., Jr The radioallergosorbent test in 1981--limitations and refinements. J Allergy Clin Immunol. 1981 Feb;67(2):87–89. doi: 10.1016/0091-6749(81)90001-4. [DOI] [PubMed] [Google Scholar]
  2. BLACK A. P. A new diagnostic method in allergic disease. Pediatrics. 1956 May;17(5):716–724. [PubMed] [Google Scholar]
  3. BRYAN W. T., BRYAN M. P. The application of in vitro cytotoxic reactions to clinical diagnosis of food allergy. Laryngoscope. 1960 Jun;70:810–824. doi: 10.1288/00005537-196006000-00006. [DOI] [PubMed] [Google Scholar]
  4. Benson T. E., Arkins J. A. Cytotoxic testing for food allergy: evaluation of reproducibility and correlation. J Allergy Clin Immunol. 1976 Oct;58(4):471–476. doi: 10.1016/0091-6749(76)90190-1. [DOI] [PubMed] [Google Scholar]
  5. Draper W. L. Food testing in allergy. Intradermal provocative vs deliberate feeding. Arch Otolaryngol. 1972 Feb;95(2):169–171. doi: 10.1001/archotol.1972.00770080257015. [DOI] [PubMed] [Google Scholar]
  6. Final report of the Food Allergy Committee of the American College of Allergists on the clinical evaluation of sublingual provocative testing method for diagnosis of food allergy. Ann Allergy. 1974 Sep;33(3):164–166. [PubMed] [Google Scholar]
  7. Hawkins D., Cochrane C. G. Glomerular basement membrane damage in immunological glomerulonephritis. Immunology. 1968 May;14(5):665–681. [PMC free article] [PubMed] [Google Scholar]
  8. Hirsch S. R., Kalbfleisch J. H., Golbert T. M., Josephson B. M., McConnell L. H., Scanlon R., Kniker W. T., Fink J. N., Murphree J. J., Cohen S. H. Rinkel injection therapy: a multicenter controlled study. J Allergy Clin Immunol. 1981 Aug;68(2):133–155. doi: 10.1016/0091-6749(81)90172-x. [DOI] [PubMed] [Google Scholar]
  9. Kailin E. W., Collier R. "Relieving" therapy for antigen exposure. JAMA. 1971 Jul 5;217(1):78–78. doi: 10.1001/jama.217.1.78b. [DOI] [PubMed] [Google Scholar]
  10. Lehman C. W. A double-blind study of sublingual provocative food testing: a study of its efficacy. Ann Allergy. 1980 Sep;45(3):144–149. [PubMed] [Google Scholar]
  11. Lerner R. A., Dixon F. J. The induction of acute glomerulonephritis in rabbits with soluble antigens isolated from normal homologous and autologous urine. J Immunol. 1968 Jun;100(6):1277–1287. [PubMed] [Google Scholar]
  12. Lieberman P., Crawford L., Bjelland J., Connell B., Rice M. Controlled study of the cytotoxic food test. JAMA. 1975 Feb 17;231(7):728–730. [PubMed] [Google Scholar]
  13. McPhaul J. J., Jr, Dixon F. J. Basement membrane antigens in serum and urine. Transplant Proc. 1969 Dec;1(4):964–967. [PubMed] [Google Scholar]
  14. Miller J. B. A double-blind study of food extract injection therapy: a preliminary report. Ann Allergy. 1977 Mar;38(3):185–191. [PubMed] [Google Scholar]
  15. Morris D. L. Use of sublingual antigen in diagnosis and treatment of food allergy. Ann Allergy. 1969 Jun;27(6):289–294. [PubMed] [Google Scholar]
  16. Norman P. S., Winkenwerder W. L., Lichtenstein L. M. Maintenance immunotherapy in ragweed hay fever. Booster injections at six week intervals. J Allergy. 1971 May;47(5):273–282. [PubMed] [Google Scholar]
  17. RINKEL H. J. The management of clinical allergy. III. Inhalant allergy therapy. Arch Otolaryngol. 1963 Feb;77:205–225. doi: 10.1001/archotol.1963.00750010211018. [DOI] [PubMed] [Google Scholar]
  18. Shapiro G., Bierman C. W., Furukawa C. T., Pierson W. E. Allergy skin testing: science or quackery? Pediatrics. 1977 Apr;59(4):495–498. [PubMed] [Google Scholar]
  19. Van Metre T. E., Adkinson N. F., Jr, Amodio F. J., Lichtenstein L. M., Mardiney M. R., Norman P. S., Rosenberg G. L., Sobotka A. K., Valentine M. D. A comparative study of the effectiveness of the Rinkel method and the current standard method of immunotherapy for ragweed pollen hay fever. J Allergy Clin Immunol. 1980 Dec;66(6):500–513. doi: 10.1016/0091-6749(80)90012-3. [DOI] [PubMed] [Google Scholar]
  20. Van Metre T. E., Jr, Adkinson N. F., Jr, Lichtenstein L. M., Mardiney M. R., Jr, Norman P. S., Jr, Rosenberg G. L., Sobotka A. K., Valentine M. D. A controlled study of the effectiveness of the Rinkel method of immunotherapy for ragweed pollen hay fever. J Allergy Clin Immunol. 1980 Apr;65(4):288–297. doi: 10.1016/0091-6749(80)90158-x. [DOI] [PubMed] [Google Scholar]
  21. Willoughby J. W. Serial dilution titration skin tests in inhalant allergy: A clinical quantitative assessment of biologic skin reactivity to allergenic extracts. Otolaryngol Clin North Am. 1974 Oct;7(3):579–615. [PubMed] [Google Scholar]

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