Underestimation of house dust mite–specific IgE with extract-based ImmunoCAPs compared with molecular ImmunoCAPs

House dust mites (HDMs) are one of the most important allergen sources causing severe forms of respiratory and skin allergy.1 A major problem associated with the use of natural allergen extracts for diagnostic testing is that they show large variability regarding the contents of the major HDM allergens groups 1 and 2 and might lack clinically important allergens, such as Der p 5, Der p 7, Der p 21, and Der p 23.2 In addition to skin testing, intradermal and provocation testing, measurement of allergen-specific IgE levels in serum is a valid method to detect HDM-specific IgE sensitization.