***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The diagnosis of shellfish allergy remains a challenge for clinicians . Several shellfish allergens have been characterized and their IgE epitopes identified . However , the clinical relevance of this sensitization is still not clear . OBJECTIVE The objective of this study was to identify allergens and epitopes associated with clinical reactivity to shrimp . METHODS Shrimp-sensitized subjects were recruited and grouped based on the history of shrimp-allergic reactions and challenge outcome . IgE reactivity to recombinant crustacean allergens , and IgE and IgG4 reactivity to peptides were determined . Subjects sensitized to dust mites and /or cockroach without shrimp sensitization or reported allergic reactions , as well as nonatopic individuals , were used as controls . RESULTS A total of 86 subjects were recruited with a skin prick test to shrimp ; 74 reported shrimp-allergic reactions , 58 were allergic ( 38 positive double-blind placebo-controlled food challenge and 20 recent anaphylaxis ) , and 16 were tolerant . All subjects without a history of reactions had negative challenges . The individuals with a positive challenge more frequently recognized tropomyosin and sarcoplasmic calcium-binding proteins than those found tolerant by the challenge . Especially a sarcoplasmic-calcium-binding-protein positive test is very likely to result in a positive challenge , though the frequency of recognition is low . Subjects with dust mite and /or cockroach allergy not sensitized to shrimp recognized arginine kinase and hemocyanin . Several epitopes of these allergens may be important in predicting clinical reactivity . CONCLUSION Tropomyosin and sarcoplasmic-calcium-binding-protein sensitization is associated with clinical reactivity to shrimp . Myosin light chain testing may help in the diagnosis of clinical reactivity . Arginine kinase and hemocyanin appear to be cross-reacting allergens between shrimp and arthropods . Detection of IgE to these allergens and some of their epitopes may be better diagnostic tools in the routine workup of shrimp allergy Component resolved diagnosis is a new concept in the investigation of pediatric allergic disease . The aim of the present paper is to review the available data on component resolved diagnosis with respect to implication s for investigation of children with allergic disease . In most conditions head-to-head comparisons of component resolved diagnosis with traditional IgE testing have not been performed . Rather than alternatives the molecular methods should be seen as adjuncts to the cheaper traditional specific IgE tests . It may be appropriate to determine IgE antibodies to components as part of the diagnostic work-up in selected cases of peanut and birch pollen allergy and in hymenoptera allergy . However , cost benefit analyses of component resolved diagnosis compared with traditional work-up of allergy are needed . Prospect ively planned protocol s for assessment of the extent to which component resolved diagnosis may be able to improve the selection of children to immunotherapy and , thus , the efficacy of immunotherapy , are needed . Finally , studies of component resolved diagnosis with microarray technology in screening panels with hundreds of components should be undertaken before it can be determined to which extent such panel screening , if at all , may be helpful in children BACKGROUND Increasing data suggest that analysis of IgE to peanut components can be clinical ly helpful and possibly more accurate than IgE to whole peanut . Not all studies examining this topic , however , have used prospect i ve sample s , multiple components , and peanut challenges . OBJECTIVE We sought to determine the utility of peanut component testing , using a st and ardized , commercially available test done before oral peanut challenge in various population s of patients with suspected peanut allergy from 2 different countries . METHODS IgE to whole peanut and the recombinant allergen components Ara h 1 , 2 , 3 , and 8 were analyzed from serum sample s drawn before double-blind peanut challenge from 4 distinct cohorts of patients with suspected peanut allergy from 2 nations ( United States and Sweden ) . RESULTS Patients ( n = 167 ; median age , 11.7 years ; interquartile range , 7.0 - 15.0 years ) had serum analyzed for peanut components and completed an oral food challenge to peanut . Although IgE to peanut was the most sensitive test ( 0.93 ) , Ara h 2 was the most specific ( 0.92 ) and provided the best positive predictive value ( 0.94 ) of all the tests . Ara h 2 was also the best overall diagnostic test by receiver operating characteristic analysis ( area under the curve , 0.84 ; P < .05 ) . CONCLUSIONS In patients with suspected peanut allergy , IgE to peanut is a sensitive test but is not specific . IgE to Ara h 2 is a more specific and more accurate diagnostic test in this sampling of patients with suspected peanut allergy . Given each tests attributes , a stepwise approach to testing may provide clinicians with a way to minimize the need for peanut challenges Component‐resolved diagnostics offers a modern tool in peanut allergy , but studies applying consistently double‐blind placebo‐controlled challenges are lacking . We aim ed to optimize diagnostics for moderate‐to‐severe peanut allergy in a birch‐endemic region and to create an oral‐peanut challenge with its allergen activity characterized IgE sensitization to hazelnut is common , especially in birch endemic areas . However , its clinical significance often needs to be confirmed by a food challenge 
    Output:
    
Selected components of cow 's milk , hen 's egg , peanut , hazelnut , and shrimp allergen showed high specificity , but lower sensitivity .