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Matricardi PM, Potapova E, Panetta V, Lidholm J, Mattsson L, Scala E, Bernardini R, Caffarelli C, Casani A, Cervone R, Chini L, Comberiati P, De Castro G, Miraglia Del Giudice M, Dello Iacono I, Di Rienzo Businco A, Gallucci M, Giannetti A, Moschese V, Varin E, Bianchi A, Calvani M, Frediani T, Macrì F, Maiello N, Paravati F, Pelosi U, Peroni D, Pingitore G, Tosca M, Zicari AM, Ricci G, Asero R, Tripodi S. IgE to cyclophilins in pollen-allergic children: Epidemiologic, clinical, and diagnostic relevance of a neglected panallergen. J Allergy Clin Immunol 2024; 153:1586-1596.e2. [PMID: 38513837 DOI: 10.1016/j.jaci.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/25/2023] [Accepted: 01/26/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Cyclophilins are ubiquitous panallergens whose epidemiologic, diagnostic, and clinical relevance is largely unknown and whose sensitization is rarely examined in routine allergy practice. OBJECTIVE We investigated the epidemiologic, diagnostic, and clinical relevance of cyclophilins in seasonal allergic rhinitis and its comorbidities. METHODS We examined a random sample of 253 (25%) of 1263 Italian children with seasonal allergic rhinitis from the Panallergens in Pediatrics (PAN-PED) cohort with characterized disease phenotypes. Nested studies of sensitization prevalence, correlation, and allergen extract inhibition were performed in patients sensitized to birch pollen extract but lacking IgE to Bet v 1/2/4 (74/1263) or with highest serum level of IgE to Bet v 1 (26/1263); and in patients with sensitization to various extracts (ragweed, mugwort, pellitory, Plantago, and plane tree), but not to their respective major allergenic molecule, profilins, and polcalcins. IgE to cyclophilin was detected with recombinant Bet v 7, and extract inhibition tests were performed with the same rBet v 7. RESULTS IgE to rBet v 7 was detected in 43 (17%) of 253 patients. It was associated with asthma (P < .028) and oral allergy syndrome (P < .017) in univariate but not multivariate analysis adjusted for IgE to profilins (Phl p 12), PR-10s (Bet v 1), and lipid transfer proteins (Pru p 3). IgE to rBet v 7 was also highly prevalent (47/74, 63%) among patients with unexplained sensitization to birch pollen extract. In patients with unexplained sensitization to ragweed, mugwort, pellitory, Plantago and plane tree pollen, the levels of IgE to those extracts correlated with the levels of IgE to rBet v 7, and they were also significantly inhibited by rBet v 7 (inhibition range 45%-74%). CONCLUSIONS IgE sensitization to cyclophilin is frequent in pollen-allergic patients living in temperate areas and can produce "false" positive outcomes in skin prick and IgE tests to pollen extracts. Molecular diagnostic guidelines should include this panallergen family.
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MESH Headings
- Humans
- Immunoglobulin E/immunology
- Immunoglobulin E/blood
- Child
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/blood
- Male
- Female
- Cyclophilins/immunology
- Allergens/immunology
- Pollen/immunology
- Adolescent
- Child, Preschool
- Antigens, Plant/immunology
- Italy/epidemiology
- Prevalence
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Affiliation(s)
- Paolo Maria Matricardi
- Charité-Universitätsmedizin Berlin, a corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, the Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Berlin, Germany; Institute of Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Allergology and Immunology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany.
| | - Ekaterina Potapova
- Charité-Universitätsmedizin Berlin, a corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, the Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Berlin, Germany
| | - Valentina Panetta
- Consultancy & Training, Biostatistics, L'altrastatistica, Rome, Italy
| | | | | | - Enrico Scala
- Clinical and Laboratory Molecular Allergy Unit, IDI-IRCCS, Rome, Italy
| | | | - Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, University of Parma, Parma, Italy
| | | | - Rosa Cervone
- Pediatric Unit, San Giuseppe Hospital, Empoli, Italy
| | - Loredana Chini
- UOSD di Immunopatologia ed Allergologia Pediatrica, Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | | | - Michele Miraglia Del Giudice
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università della Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Marcella Gallucci
- Pediatric Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
| | - Arianna Giannetti
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Viviana Moschese
- UOSD di Immunopatologia ed Allergologia Pediatrica, Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy
| | - Elena Varin
- Allergology Service, San Carlo Clinic, Paderno Dugnano, Milan, Italy
| | | | - Mauro Calvani
- Pediatric Unit, San Camillo Forlanini Hospital, Rome, Italy
| | | | | | - Nunzia Maiello
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università della Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Diego Peroni
- Pediatric Section, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | | | - Mariangela Tosca
- Pulmonary Disease and Allergy Unit, G. Gaslini Hospital, Genoa, Italy
| | | | - Giampaolo Ricci
- Pediatric Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
| | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - Salvatore Tripodi
- Pediatric Department and Pediatric Allergology Unit, Sandro Pertini Hospital, Rome, Italy
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Giusti D, Guemari A, Perotin JM, Fontaine JF, Tonye Libyh M, Gatouillat G, Tabary T, Pham BN, Vitte J. Molecular allergology: a clinical laboratory tool for precision diagnosis, stratification and follow-up of allergic patients. Clin Chem Lab Med 2024; 0:cclm-2024-0305. [PMID: 38815141 DOI: 10.1515/cclm-2024-0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024]
Abstract
Identification of the molecular culprits of allergic reactions leveraged molecular allergology applications in clinical laboratory medicine. Molecular allergology shifted the focus from complex, heterogeneous allergenic extracts, e.g. pollen, food, or insect venom, towards genetically and immunologically defined proteins available for in vitro diagnosis. Molecular allergology is a precision medicine approach for the diagnosis, stratification, therapeutic management, follow-up and prognostic evaluation of patients within a large range of allergic diseases. Exclusively available for in vitro diagnosis, molecular allergology is nonredundant with any of the current clinical tools for allergy investigation. As an example of a major application, discrimination of genuine sensitization from allergen cross-reactivity at the molecular level allows the proper targeting of the culprit allergen and thus dramatically improves patient management. This review aims at introducing clinical laboratory specialists to molecular allergology, from the biochemical and genetic bases, through immunological concepts, to daily use in the diagnosis and management of allergic diseases.
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Affiliation(s)
- Delphine Giusti
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, EA7509 IRMAIC, Reims, France
| | - Amir Guemari
- Univ Montpellier, Desbrest Institute of Epidemiology and Public Health (IDESP), INSERM, Montpellier, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, INSERM UMR 1250, Reims, France
| | | | - Marcelle Tonye Libyh
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
| | - Gregory Gatouillat
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
| | - Thierry Tabary
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
| | - Bach-Nga Pham
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, EA7509 IRMAIC, Reims, France
| | - Joana Vitte
- Immunology Laboratory, Biology and Pathology Department, University Hospital of Reims, Reims, France
- University of Reims Champagne Ardenne, INSERM UMR 1250, Reims, France
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Sharma E, Vitte J. A systematic review of allergen cross-reactivity: Translating basic concepts into clinical relevance. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100230. [PMID: 38524786 PMCID: PMC10959674 DOI: 10.1016/j.jacig.2024.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 10/29/2023] [Accepted: 01/03/2024] [Indexed: 03/26/2024]
Abstract
Access to the molecular culprits of allergic reactions allows for the leveraging of molecular allergology as a new precision medicine approach-one built on interdisciplinary, basic, and clinical knowledge. Molecular allergology relies on the use of allergen molecules as in vitro tools for the diagnosis and management of allergic patients. It complements the conventional approach based on skin and in vitro allergen extract testing. Major applications of molecular allergology comprise accurate identification of the offending allergen thanks to discrimination between genuine sensitization and allergen cross-reactivity, evaluation of potential severity, patient-tailored choice of the adequate allergen immunotherapy, and prediction of its expected efficacy and safety. Allergen cross-reactivity, defined as the recognition of 2 or more allergen molecules by antibodies or T cells of the same specificity, frequently interferes with allergen extract testing. At the mechanistic level, allergen cross-reactivity depends on the allergen, the host's immune response, and the context of their interaction. The multiplicity of allergen molecules and families adds further difficulty. Understanding allergen cross-reactivity at the immunologic level and translating it into a daily tool for the management of allergic patients is further complicated by the ever-increasing number of characterized allergenic molecules, the lack of dedicated resources, and the need for a personalized, patient-centered approach. Conversely, knowledge sharing paves the way for improved clinical use, innovative diagnostic tools, and further interdisciplinary research. Here, we aimed to provide a comprehensive and unbiased state-of-the art systematic review on allergen cross-reactivity. To optimize learning, we enhanced the review with basic, translational, and clinical definitions, clinical vignettes, and an overview of online allergen databases.
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Affiliation(s)
| | - Joana Vitte
- Aix-Marseille University, MEPHI, IHU Méditerranée Infection, Marseille, France
- Desbrest Institute of Epidemiology and Public Health (IDESP), University of Montpellier, INSERM, Montpellier, France
- University of Reims Champagne-Ardenne, INSERM UMR-S 1250 P3CELL and University Hospital of Reims, Immunology Laboratory, Reims, France
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Smith SA, Chruszcz M, Chapman MD, Pomés A. Human Monoclonal IgE Antibodies-a Major Milestone in Allergy. Curr Allergy Asthma Rep 2023; 23:53-65. [PMID: 36459330 PMCID: PMC9831959 DOI: 10.1007/s11882-022-01055-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE OF REVIEW Bound to its high affinity receptor on mast cells and basophils, the IgE antibody molecule plays an integral role in the allergic reaction. Through interactions with the allergen, it provides the sensitivity and specificity parameters for cell activation and mediator release that produce allergic symptoms. Advancements in human hybridoma technologies allow for the generation and molecular definition of naturally occurring allergen-specific human IgE monoclonal antibodies. RECENT FINDINGS A high-resolution structure of dust mite allergen Der p 2 in complex with Fab of the human IgE mAb 2F10 was recently determined using X-ray crystallography. The structure reveals the fine molecular details of IgE 2F10 binding its 750 Å2 conformational epitope on Der p 2. This review provides an overview of this major milestone in allergy, the first atomic resolution structure of an authentic human IgE epitope. The molecular insights that IgE epitopes provide will allow for structure-based design approaches to the development of novel diagnostics, antibody therapeutics, and immunotherapies.
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Affiliation(s)
- Scott A Smith
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
| | - Maksymilian Chruszcz
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, 29208, USA
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Guo W, Zhan X, Jiang F, Xi Y. Analysis of allergen components and identification of bioactivity of HSP70 in pollen of Populus deltoides. Proteome Sci 2021; 19:10. [PMID: 34479544 PMCID: PMC8417992 DOI: 10.1186/s12953-021-00178-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background Allergies caused by pollen from Populus deltoides are common, but the allergic components are still unclear. Methods The total proteins in pollen of P. deltoides were analyzed by proteomics, and the potential allergens were identified via the WHO/IUIS database and the allergenOnline database retrieval. One target protein was screened by bioinformatics and expressed in Escherichia coli. The biological activity of the expressed product was verified by animal experiments. Results The total of 3929 proteins in pollen of P. deltoides were identified, and 46 potential allergens belonging to 10 protein families were recognized by database retrieval. B9N9W6 protein of Hsp70 family was screened by bioinformatics analysis and expressed successfully. ELISA showed that B9N9W6 can stimulate the immune system to produce specific IgE and promote the generation of IL-4. Flow cytometry showed that B9N9W6 can significantly stimulate the proliferation of CD4+ T cells and promote the polarization of Th2 cells. The pathological sections of mice lung tissues indicated that alveolar destruction was more severe in the B9N9W6 group than that of extract group, and there were more inflammatory cells infiltration, mucus exudation and bleeding. Conclusion B9N9W6 is an important antigenic substance in the pollen of P. deltoides. Due to the conserved structure of Hsp70 family, more attention should be paid to the possibility of sensitization when Hsp70 from any pathogenic species is administered. Supplementary Information The online version contains supplementary material available at 10.1186/s12953-021-00178-8.
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Affiliation(s)
- Wei Guo
- School of Ecology and Environment, Anhui Normal University, Wuhu, 241002, China.,Department of Parasitology, School of Basic Medicine, Wannan Medical College, Wuhu, 241002, China
| | - Xiaodong Zhan
- Department of Parasitology, School of Basic Medicine, Wannan Medical College, Wuhu, 241002, China
| | - Feng Jiang
- Department of Parasitology, School of Basic Medicine, Wannan Medical College, Wuhu, 241002, China
| | - Yilong Xi
- School of Ecology and Environment, Anhui Normal University, Wuhu, 241002, China.
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Karmakar B, Saha B, Jana K, Gupta Bhattacharya S. Identification and biochemical characterization of Asp t 36, a new fungal allergen from Aspergillus terreus. J Biol Chem 2021; 295:17852-17864. [PMID: 33454019 DOI: 10.1074/jbc.ra120.015801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/14/2020] [Indexed: 11/06/2022] Open
Abstract
Aspergillus terreus is an allergenic fungus, in addition to causing infections in both humans and plants. However, the allergens in this fungus are still unknown, limiting the development of diagnostic and therapeutic strategies. We used a proteomic approach to search for allergens, identifying 16 allergens based on two-dimensional immunoblotting with A. terreus susceptible patient sera. We further characterized triose-phosphate isomerase (Asp t 36), one of the dominant IgE (IgE)-reactive proteins. The gene was cloned and expressed in Escherichia coli. Phylogenetic analysis showed Asp t 36 to be highly conserved with close similarity to the triose-phosphate isomerase protein sequence from Dermatophagoides farinae, an allergenic dust mite. We identified four immunodominant epitopes using synthetic peptides, and mapped them on a homology-based model of the tertiary structure of Asp t 36. Among these, two were found to create a continuous surface patch on the 3D structure, rendering it an IgE-binding hotspot. Biophysical analysis indicated that Asp t 36 shows similar secondary structure content and temperature sensitivity with other reported triose-phosphate isomerase allergens. In vivo studies using a murine model displayed that the recombinant Asp t 36 was able to stimulate airway inflammation, as demonstrated by an influx of eosinophils, goblet cell hyperplasia, elevated serum Igs, and induction of Th2 cytokines. Collectively, our results reveal the immunogenic property of Asp t 36, a major allergen from A. terreus, and define a new fungal allergen more broadly. This allergen could serve as a potent candidate for investigating component resolved diagnosis and immunotherapy.
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Affiliation(s)
- Bijoya Karmakar
- Division of Plant Biology, Bose Institute (Main Campus), Kolkata, India
| | - Bodhisattwa Saha
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India.
| | - Kuladip Jana
- Division of Molecular Medicines, Bose Institute (Centenary Building), Kolkata, India
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Jia LJ, Krüger T, Blango MG, von Eggeling F, Kniemeyer O, Brakhage AA. Biotinylated Surfome Profiling Identifies Potential Biomarkers for Diagnosis and Therapy of Aspergillus fumigatus Infection. mSphere 2020; 5:e00535-20. [PMID: 32817453 PMCID: PMC7426169 DOI: 10.1128/msphere.00535-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/31/2020] [Indexed: 12/15/2022] Open
Abstract
Aspergillus fumigatus is one of the most common airborne molds capable of causing mycoses and allergies in humans. During infection, fungal surface proteins mediate the first contact with the human immune system to evade immune responses or to induce hypersensitivity. Several methods have been established for surface proteomics (surfomics). Biotinylation coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS) identification of peptides is a particularly efficient method to identify the surface-exposed regions of proteins that potentially mediate interaction with the host. After biotinylation of surface proteins during spore germination, we detected 231 different biotinylated surface proteins (including several well-known proteins such as RodA, CcpA, and DppV; allergens; and heat shock proteins [HSPs]), as well as some previously undescribed surface proteins. The dynamic change of the surface proteome was illustrated by detection of a relatively high number of proteins exclusively at one developmental stage. Using immunofluorescence microscopy, we confirmed the surface localization of several HSPs of the HSP70 family, which may have moonlighting functions. Collectively, by comparing our data with data representative of previously published A. fumigatus surface proteomes, our study generated a comprehensive data set corresponding to the A. fumigatus surfome and uncovered the surface-exposed regions of many proteins on the surface of conidia or hyphae. These surface-exposed regions are candidates for direct interaction with host cells and may represent antigenic epitopes that either induce protective immune responses or mediate immune evasion. Thus, our data sets provided and compiled here represent reasonable immunotherapy and diagnostic targets for future investigations.IMPORTANCEAspergillus fumigatus is the most important airborne human-pathogenic mold, capable of causing both life-threatening invasive pulmonary aspergillosis in immunocompromised patients and allergy-inducing infections in individuals with atopic allergy. Despite its obvious medical relevance, timely diagnosis and efficient antifungal treatment of A. fumigatus infection remain major challenges. Proteins on the surface of conidia (asexually produced spores) and mycelium directly mediate host-pathogen interaction and also may serve as targets for diagnosis and immunotherapy. However, the similarity of protein sequences between A. fumigatus and other organisms, sometimes even including the human host, makes selection of targets for immunological-based studies difficult. Here, using surface protein biotinylation coupled with LC-MS/MS analysis, we identified hundreds of A. fumigatus surface proteins with exposed regions, further defining putative targets for possible diagnostic and immunotherapeutic design.
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Affiliation(s)
- Lei-Jie Jia
- Department of Molecular and Applied Microbiology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
| | - Thomas Krüger
- Department of Molecular and Applied Microbiology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
| | - Matthew G Blango
- Department of Molecular and Applied Microbiology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
| | - Ferdinand von Eggeling
- Jena University Hospital, Department of Otolaryngology, Jena, Germany
- Jena University Hospital, Core Unit Proteome Analysis, Jena, Germany
- Jena University Hospital, DFG Core Unit Jena Biophotonic and Imaging Laboratory (JBIL), Jena, Germany
| | - Olaf Kniemeyer
- Department of Molecular and Applied Microbiology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
- Department of Microbiology and Molecular Biology, Institute of Microbiology, Friedrich Schiller University, Jena, Germany
| | - Axel A Brakhage
- Department of Molecular and Applied Microbiology, Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute, Jena, Germany
- Department of Microbiology and Molecular Biology, Institute of Microbiology, Friedrich Schiller University, Jena, Germany
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The clinical impact of cross-reactions between allergens on allergic skin diseases. Curr Opin Allergy Clin Immunol 2020; 20:374-380. [PMID: 32590506 DOI: 10.1097/aci.0000000000000650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The route of allergen sensing via the skin appears to influence the immune system towards mounting a type 2 response, especially in genetically predisposed individuals. Allergens recognized this way may derive from microbial, animal, food, or other plant sources and trigger atopic dermatitis. Allergens can be grouped into families depending on their structure and function, harboring significant structural and sequence similarities. Cross-reactivity between allergens is believed to arise as a consequence, and to underlie the development of further atopic diseases. RECENT FINDINGS Especially for the plant allergens of the families of PR10-related proteins and profilins, immune cross-reactions have been described. Actual studies support that food and pollen allergens can aggravate skin lesions in patients suffering from atopic dermatitis. Further on, allergens derived from air-borne or skin-borne fungi belong to common allergen families and bear cross-reactivity potential. Cross-reactivity to human homologous proteins, so-called autoallergens, is discussed to contribute to the chronification of atopic dermatitis. SUMMARY Due to high evolutionary conservation, allergic reactions can be triggered by highly homologous members of allergen families on the humoral as well as on the cellular level.
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