Is specific antibody determination diagnostic for asthma attributable to low-molecular-weight agents?

It is important to understand a medical testís performance characteristics, so that it can be used appropriately. Performance characteristics of tests for antibodies specific to low-molecular-weight (LMW) agents in predicting asthma caused by these agents differ in the study population. In general, currently published data supporting the use of tests to detect specific IgE and IgG to LMW agents in the diagnosis of occupational asthma is limited and inconclusive. However, a few general statements can be made. The most promising results have been achieved for agents such as acid anhydrides and platinum salts, where specific IgE responses appear to play a significant pathogenic role in causing occupational asthma. Results have been less promising for agents such as isocyanates and plicatic acid, for which antibody responses do not appear to underlie the development of asthma in most individuals. In the case of isocyanates, determination of antigen-specific IgG might have some utility as a biomarker of exposure.