EAACIMolecular Allergology User's Guide 2.0

Pediatric Allergy and Immunology, Journal Year: 2023, Volume and Issue: 34(S28)

Published: March 1, 2023

Abstract Since the discovery of immunoglobulin E (IgE) as a mediator allergic diseases in 1967, our knowledge about immunological mechanisms IgE‐mediated allergies has remarkably increased. In addition to understanding immune response and clinical symptoms, allergy diagnosis management depend strongly on precise identification elicitors reaction. past four decades, innovations bioscience technology have facilitated production well‐defined, highly pure molecules for component‐resolved (CRD), allowing personalized disease individual patients. The first edition “EAACI Molecular Allergology User's Guide” (MAUG) 2016 rapidly became key reference clinicians, scientists, interested readers with background allergology, immunology, biology, medicine. Nevertheless, field molecular allergology is moving fast, after 6 years, new EAACI Taskforce was established provide an updated document. Guide 2.0 summarizes state‐of‐the‐art information allergen molecules, their relevance, application diagnostic algorithms practice. It designed both, clinicians guiding health care professionals through overwhelming list different available testing. Further, it provides relevance allergenic gives overview basic test formats, tests measure exposure.

Language: Английский

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Protease allergens as initiators–regulators of allergic inflammation

Allergy, Journal Year: 2023, Volume and Issue: 78(5), P. 1148 - 1168

Published: Feb. 16, 2023

Abstract Tremendous progress in the last few years has been made to explain how seemingly harmless environmental proteins from different origins can induce potent Th2‐biased inflammatory responses. Convergent findings have shown key roles of allergens displaying proteolytic activity initiation and progression allergic response. Through their propensity activate IgE‐independent pathways, certain allergenic proteases are now considered as initiators for sensitization themselves non‐protease allergens. The protease degrade junctional keratinocytes or airway epithelium facilitate allergen delivery across epithelial barrier subsequent uptake by antigen‐presenting cells. Epithelial injuries mediated these together with sensing protease‐activated receptors (PARs) elicit responses resulting release pro‐Th2 cytokines (IL‐6, IL‐25, IL‐1β, TSLP) danger‐associated molecular patterns (DAMPs; IL‐33, ATP, uric acid). Recently, were cleave sensor domain IL‐33 produce a super‐active form alarmin. At same time, cleavage fibrinogen trigger TLR4 signaling, various cell surface further shape Th2 polarization. Remarkably, nociceptive neurons represent primary step development goal this review is highlight multiple innate immune mechanisms triggered that converge initiate

Language: Английский

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A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

World Allergy Organization Journal, Journal Year: 2020, Volume and Issue: 13(2), P. 100091 - 100091

Published: Feb. 1, 2020

Abstract

Precision allergy molecular diagnostic applications (PAMD@) is increasingly entering routine care. Currently, more than 130 allergenic molecules from 50 sources are commercially available for in vitro specific immunoglobulin E (sIgE) testing. Since the last publication of this consensus document, a great deal new information has become regarding topic, with over 100 publications in year alone. It thus seems quite reasonable to publish an update. imperative that clinicians and immunologists specifically trained allergology keep abreast rapidly evolving evidence PAMD@. PAMD@ may initially appear complex interpret; however, increasing experience, gained provides relevant allergist. This especially true food allergy, Hymenoptera selection allergen immunotherapy. Nevertheless, all sIgE tests, including PAMD@, should be evaluated within framework patient's clinical history, because sensitization does not necessarily imply allergies.

Language: Английский

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Past, present, and future of allergen immunotherapy vaccines

Allergy, Journal Year: 2020, Volume and Issue: 76(1), P. 131 - 149

Published: April 6, 2020

Allergen-specific immunotherapy (AIT) is an allergen-specific form of treatment for patients suffering from immunoglobulin E (IgE)-associated allergy; the most common and important immunologically mediated hypersensitivity disease. AIT based on administration disease-causing allergen with goal to induce a protective immunity consisting blocking IgG antibodies alterations cellular immune response so that patient can tolerate contact. Major advantages over all other existing treatments allergy are induces long-lasting protection prevents progression disease severe manifestations. cost effective because it uses patient´s own system potentially be used as preventive treatment. However, broad application limited by mainly technical issues such quality preparations risk inducing side effects which results in extremely cumbersome schedules reducing compliance. In this article we review progress made its beginning provide overview state art, needs further development, possible solutions available through molecular allergology. Finally, consider visions development towards prophylactic application.

Language: Английский

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Egg Allergy: Diagnosis and Immunotherapy

International Journal of Molecular Sciences, Journal Year: 2020, Volume and Issue: 21(14), P. 5010 - 5010

Published: July 16, 2020

Hypersensitivity or an allergy to chicken egg proteins is a predominant symptomatic condition affecting 1 in 20 children Australia; however, effective form of therapy has not yet been found. This occurs as the immune system allergic individual overreacts when contact with allergens (egg proteins), triggering complex response. The subsequent instantaneous inflammatory response characterized by excessive production immunoglobulin E (IgE) antibody against allergen, T-cell mediators and inflammation. Current allergen-specific approaches diagnosis treatment lack consistency therefore pose safety concerns among anaphylactic patients. Immunotherapy thus far found be most efficient way treat relieve symptoms, this includes oral immunotherapy (OIT) sublingual (SLIT). A major limitation immunotherapy, difficulty preparing safe extracts from natural allergen sources. Advances molecular techniques allow for standardized recombinant hypoallergenic variants targeting IgE-binding epitopes responsible clinical symptoms. Site-directed mutagenesis can performed create such hypoallergens their potential use future methods providing feasible therapeutic approach target allergies safely.

Language: Английский

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Molecular profiling of allergen-specific antibody responses may enhance success of specific immunotherapy

Journal of Allergy and Clinical Immunology, Journal Year: 2020, Volume and Issue: 146(5), P. 1097 - 1108

Published: April 13, 2020

House dust mites (HDMs) are among the most important allergen sources containing many different allergenic molecules. Analysis of patients from a double-blind, placebo-controlled allergen-specific immunotherapy (AIT) study indicated that may benefit AIT to extents depending on their molecular sensitization profiles.Our aim was investigate in real-life setting whether stratification with HDM allergy according analysis enhance success.Serum and nasal secretion samples (n = 24) (at baseline, 7, 15, 33, 52 weeks) who had received 1 year treatment well-defined subcutaneous form (Alutard SQ 510) were tested for IgE IgG reactivity 15 microarrayed molecules ImmunoCAP Immuno-solid-phase Allergen Chip technology. subclass levels allergens peptides determined by ELISA, blocking assessed basophil activation. In vitro parameters related reduction symptoms combined symptom medication score visual analog scale score.Alutard 510 induced protective mainly against Dermatophagoides pteronyssinus (Der p) Der p 2 lesser extent 23, but not other such as 5, 21, showing better clinical efficacy sensitized only and/or compared having additional specificities.Stratification profiles monitoring AIT-induced responses success AIT.

Language: Английский

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Recombinant allergens for immunotherapy: state of the art

Current Opinion in Allergy and Clinical Immunology, Journal Year: 2019, Volume and Issue: 19(4), P. 402 - 414

Published: May 13, 2019

More than 30 years ago, the first molecular structures of allergens were elucidated and defined recombinant became available. We review state art regarding AIT with goal to understand why progress in this field has been slow, although there is huge potential for treatment allergen-specific prevention.On basis allergen structures, several strategies have developed advanced into clinical evaluation. In trials, promising results obtained synthetic derivatives inducing IgG antibodies, which interfered recognition by IgE whereas efficacy could not yet be demonstrated approaches targeting only T-cell responses. Available data suggest that many advantages over extract-based AIT.Clinical studies indicate allergen-based vaccines, are superior existing can respiratory, food venom allergy. Allergen-specific preventive based on vaccine induction tolerance horizon hold promise allergy prevented. However, limited lack resources needed studies, necessary development these innovative strategies.

Language: Английский

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Selection of house dust mite–allergic patients by molecular diagnosis may enhance success of specific immunotherapy

Journal of Allergy and Clinical Immunology, Journal Year: 2018, Volume and Issue: 143(3), P. 1248 - 1252.e12

Published: Nov. 13, 2018

House dust mites (HDMs) are one of the most potent and frequent allergen sources worldwide.1 More than 40% patients with allergy sensitized to HDM allergens suffer from allergic symptoms such as rhinoconjunctivitis, atopic dermatitis, asthma, severe form respiratory allergy.2 The Dermatophagoides pteronyssinus contains several different which Der p 1, 2, 5, 7, 21, 23 clinically relevant according frequency IgE sensitization ability induce reactions.

Language: Английский

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30 years of sublingual immunotherapy

Allergy, Journal Year: 2019, Volume and Issue: 75(5), P. 1107 - 1120

Published: Nov. 12, 2019

Allergen Immunotherapy (AIT) was introduced in clinical practice on an empirical basis more than 100 years ago. Since the first attempts, AIT administered subcutaneously. Indeed, other routes of administration were proposed and studied, particular to improve safety, but only sublingual route (SLIT) achieved a credibility based evidence then accepted as viable "alternative" option subcutaneous route. SLIT largely used trials this last 30 years. Thus, large amount data is available, coming from either controlled postmarketing surveillance studies. It clear that overall effective, it also efficacy not "class-related," derived meta-analyses, restricted each specific product. The 30-year lasting use allowed clarify many aspects, such efficacy, asthma, regimens administration, optimal doses. In parallel, mechanisms action elucidated, new indications (eg food allergy, atopic dermatitis). addition, introduction molecular-based diagnosis, better refine prescription SLIT, sensitization profiles. present article will describe origin evolution for respiratory taking into account context suggested form treatment, recently developed future perspectives unmet needs, This not, therefore, systematic review, rather narrative historical description past history, look forward opportunities.

Language: Английский

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The allergenic activity and clinical impact of individual IgE-antibody binding molecules from indoor allergen sources

World Allergy Organization Journal, Journal Year: 2020, Volume and Issue: 13(5), P. 100118 - 100118

Published: April 29, 2020

A large number of allergens have been discovered but we know little about their potential to induce inflammation (allergenic activity) and symptoms. Nowadays, the clinical importance is determined by frequency intensity IgE antibody binding (allergenicity). This a rather limited parameter considering development experimental allergology in last 20 years criteria that support personalized medicine. Now it known some allergens, addition properties, can through non mediated pathways, which increase allergenic activity. There are several ways evaluate activity, among them provocation tests, demonstration non-IgE pathways inflammation, case control studies IgE-binding frequencies, animal models respiratory allergy. In this review explored current status basic research on activity indoor confirm that, for most them, important property has not investigated. However, during recent advances made field, conclude at least following, demonstrated: Der p 1, 2, 5 Blo t from HDMs; Per 10 P. americana; Asp f 3, 4 6 A. fumigatus; Mala s 8 13 M. sympodialis; Alt 1 alternata; Pen c chrysogenum; Fel d cats; Can dogs; Mus m mice Bos 2 cows. Defining other molecules necessary precision-medicine-oriented management allergic diseases.

Language: Английский

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