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Cacheiro-Llaguno C, Mösges R, Calzada D, González-de la Fuente S, Quintero E, Carnés J. Polysensitisation is associated with more severe symptoms: The reality of patients with allergy. Clin Exp Allergy 2024. [PMID: 38676405 DOI: 10.1111/cea.14486] [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: 02/05/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Studying the sensitisation profiles of patients with allergies allows for a deeper understanding of the disease which may facilitate the selection of the best-personalised allergen immunotherapy. This observational, cross-sectional, multicentre study aimed to demonstrate the heterogeneity of the German population with allergies by analysing specific immunoglobulin E (sIgE) patterns towards aeroallergens and exploring the relationship between sensitisation and clinical symptoms. METHODS In total, 500 patients with allergies from different regions of Germany were recruited based on their case histories, clinical allergic symptoms and skin prick test data for aeroallergens. Serum samples were analysed using ImmunoCAP assays to determine sIgE levels for 33 allergenic sources and 43 molecular allergens. RESULTS Most patients (81%) were polysensitised. Betula verrucosa pollen was the most common cause of sensitisation (59%), followed by Phleum pratense (58%) and Dermatophagoides pteronyssinus (44%). The highest prevalence rates of molecular allergens were observed for Bet v 1 (84%) from birch pollen, Phl p 1 from grass pollen (82%), Der p 2 (69%) from mites and Fel d 1 (69%) from cat. Polysensitisation was significantly associated with the presence of asthma and the severity of rhinitis symptoms. CONCLUSIONS Our findings show a high rate of polysensitisation and emphasise the importance of molecular diagnosis for more precise and comprehensive insights into sensitisation patterns and their association with clinical symptoms. These data may help improve personalised diagnosis and immunotherapy adapted to the needs of individual patients in the region.
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Affiliation(s)
| | - Ralph Mösges
- IMSB, Faculty of Medicine, University of Cologne, Cologne, Germany
- ClinCompetence Cologne GmbH, Cologne, Germany
| | - David Calzada
- R&D Allergy and Immunology Unit, LETI Pharma, Madrid, Spain
| | | | - Eliana Quintero
- IMSB, Faculty of Medicine, University of Cologne, Cologne, Germany
- Praxis Dr. Kasche und Kollegen, Hamburg, Germany
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Nieto-García A, Abel-Fernández E, Nieto-Cid M, Pineda de la Losa F. 360° approach to the patient with mite allergy: from scientific evidence to clinical practice. FRONTIERS IN ALLERGY 2024; 5:1298816. [PMID: 38379594 PMCID: PMC10876833 DOI: 10.3389/falgy.2024.1298816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/23/2024] [Indexed: 02/22/2024] Open
Abstract
In the recent years, several important advances have been made in the diagnosis of allergy using molecular techniques. The aetiological diagnosis of allergy using molecular components of allergens allows a more precise definition of the patient's IgE repertoire. Precision medicine is a structural model aimed at personalising healthcare and places the patient at the centre of the specialist's decision-making process. To this end, an accurate characterisation of the external exposome at a molecular level and their putative role as clinically relevant allergens is essential to elucidate the phenotypic diversity of atopic disease, with a view to personalising diagnosis and therapy. It has been proposed a decision algorithm, the Top-Down approach, where the clinical history is set first and is followed by the use of skin tests or specific IgE techniques, which facilitates the clinicians to make decisions. The therapeutic intervention driven by the standard diagnostic approach, but supported by these innovative tools, can lead to a better phenotyping of highly complex patients, and a more appropriate prescription of AIT. To this end, the allergen extracts used for diagnosis require to be of proven quality and contain the most relevant allergens. Likewise, allergen vaccines must gather efficacy, safety, duration, and patient compliance, hence the demand for new vaccines to overcome these drawbacks.
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Affiliation(s)
- Antonio Nieto-García
- Pediatric Allergy and Pneumology Unit, La Fe Hospital, Valencia, Spain
- La Fe Health Research Institute, Valencia, Spain
| | | | - María Nieto-Cid
- Allergy Service, University Hospital of La Plana, Vila-real, Spain
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Tuten Dal S, Sahiner UM, Soyer O, Sekerel BE. Mite allergen sensitization patterns in Turkish children: Age-related changes and molecular correlations. Pediatr Allergy Immunol 2024; 35:e14093. [PMID: 38376849 DOI: 10.1111/pai.14093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Mites are ubiquitous aeroallergens found worldwide. Elucidating individual mite allergen sensitization patterns provides critical insights for managing allergic diseases. This study aimed to investigate molecular allergen (MA) sensitization patterns across different age groups and explore cluster relationships among mite-sensitized children. METHODS We analyzed 76 children who exhibited sensitization to at least one of the 17 distinct mite MAs through microarray testing. RESULTS Dermatophagoides farinae exhibited a slightly higher prevalence of sensitization compared with Dermatophagoides pteronyssinus. Der p 1/2 and Der f 1/2 demonstrated an almost 40% sensitization rate, while Der p 10/Blo t 10, Der p 20, Der p 23, and Gly d 2/Lep d 2 displayed an approximately 20% sensitization rate. Sensitization levels and ratios increased significantly with age for Der p 23 but showed numerical rises for other MAs, except for Der p 10/Blo t 10. The presence of various types of atopic diseases had only a minimal impact on sensitization profiles. Strong correlations emerged between Der f 2 and Der p 2, Der p 10 and Blo t 10, Der p 21 and Blo t 5, as well as Gly d 2 and Lep d 2. Hierarchical cluster analysis substantiated these relationships. Der p 10 and its homolog Blo t 10-sensitive patients (15/76) were mostly seen as mono sensitization(12/15). Ten patients exhibited monosensitization to Der p 20, suggesting a possible association with scabies infection. CONCLUSION In children, mite sensitization diversity and levels increased with age. The presence of significant correlations/cluster relationships among these sensitizations underscores homologies among specific MAs.
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Affiliation(s)
- Sevda Tuten Dal
- Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Umit Murat Sahiner
- Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ozge Soyer
- Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Bulent Enis Sekerel
- Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
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Lee YZ, Kow ASF, Jacquet A, Lee MT, Tham CL. House dust mite allergy in Malaysia: review of research gaps in the current scenario and the way forward. EXPERIMENTAL & APPLIED ACAROLOGY 2023; 91:509-539. [PMID: 37995026 DOI: 10.1007/s10493-023-00857-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/20/2023] [Indexed: 11/24/2023]
Abstract
The prevalence of house dust mite (HDM) allergy, especially in Asian countries with rapid urbanization, has been increasing. House dust mites thrive in places with relatively high humidity. With the combination of climate change, naturally high humidity, and urbanization, tropical countries like Malaysia are becoming a hotspot for HDM allergy fast. With a previously reported sensitization rate of between 60 and 80%, it is a worrying trend for Malaysia. However, due to incomplete and out-of-date data, as seen by the limited study coverage in the past, these numbers do not paint a complete picture of the true HDM allergy scene in Malaysia. This review briefly discusses the HDM fauna, the HDM sensitization rate, the common diagnosis and therapeutic tools for HDM allergy in Malaysia, and makes suggestions for possible improvements in the future. This review also highlights the need of more comprehensive population-based prevalence studies to be done in Malaysia, encompassing the three main HDMs-Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis-as the lack of up-to-date studies failed to give a clearer picture on the current scenario of HDM allergy in Malaysia. Future studies will be beneficial to the nation in preparing a better blueprint for the management and treatment of HDM allergy.
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Affiliation(s)
- Yu Zhao Lee
- Office of Postgraduate Studies, UCSI University, 56000, Kuala Lumpur, Malaysia
| | | | - Alain Jacquet
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Ming Tatt Lee
- Faculty of Pharmaceutical Sciences, UCSI University, 56000, Kuala Lumpur, Malaysia
- Graduate Institute of Pharmacology, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan
- Centre of Research for Mental Health and Wellbeing, UCSI University, 56000, Kuala Lumpur, Malaysia
| | - Chau Ling Tham
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia.
- Natural Medicines and Products Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
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Huang J, Xiang R, Tan L, Deng Y, Tao Z, Zhang W, Xu Y. Dust mite component Analysis: Identifying key allergens components for effective immunotherapy in allergic rhinitis. Int Immunopharmacol 2023; 125:111111. [PMID: 37925948 DOI: 10.1016/j.intimp.2023.111111] [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: 05/30/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND The aim of this study was to examine the frequency of sensitization to house dust mite (HDM) components among allergic rhinitis patients receiving subcutaneous immunotherapy (SCIT), and to assess the correlation between SCIT efficacy and specific IgE (sIgE) levels for allergenic HDM components. METHODS Serum samples and clinical data were collected from 38 allergic rhinitis patients receiving HDM-SCIT at baseline and after 1 year of treatment. Effective treatment was defined as a therapeutic index (TI) of at least 50% after 1 year. Cytokine levels were analyzed using commercial ELISA kits, while serum total and specific IgE levels were determined by the fluoroenzymeimmunoassay technique. The ALLEOS 2000 magnetic particle chemiluminescence system was used to measure sIgE levels for Der f, Der p 1, Der p 2, Der p 10, and Der p 23. RESULTS Allergic rhinitis patients undergoing HDM-SCIT had a high rate of allergic sensitization to the HDM major allergens Der p (100%), Der f (100%), Der p 1 (94.74%), Der p 2 (94.74%), and Der p 23 (36.84%). Patients who responded to SCIT had higher levels of IgE for HDM components at baseline, while those with ineffective treatment showed an opposite performance, particularly for Der p 1 (P<0.05). After 1 year of treatment, effective and ineffective patients showed opposite trends in sIgE for dust mite components (decreased in effective patients, increased in ineffective patients). HDM-SCIT led to a significant reduction in IL-2, IL-4, IL-6, and EOS% (P<0.05). IgE for Der p, Der f, Der p 1, Der p 2, and HDM sIgE were significantly positively correlated (P < 0.001). The correlation heatmap analysis based on changes in values reveals a negative correlation between CSMS score changes and sIgE for Der f and Der p 1, and a positive correlation with IL-2, IL-10, and TNF (P < 0.05). CONCLUSIONS The molecular sensitization profiles during HDM-SCIT are variable and relate to treatment efficacy. Molecular diagnosis can assist allergists in identifying patients eligible for HDM-SCIT, thereby enhancing the treatment's clinical efficacy. Serum cytokine levels of IL-2, IL-4, IL-6,and EOS% may serve as useful biomarkers for monitoring HDM-SCIT efficacy.
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Affiliation(s)
- Jingyu Huang
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Rong Xiang
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Lu Tan
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Yuqin Deng
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Zezhang Tao
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China; Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Wei Zhang
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Yu Xu
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China; Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, China; Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
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González-Pérez R, Poza-Guedes P, Pineda F, Galán T, Mederos-Luis E, Abel-Fernández E, Martínez MJ, Sánchez-Machín I. Molecular Mapping of Allergen Exposome among Different Atopic Phenotypes. Int J Mol Sci 2023; 24:10467. [PMID: 37445644 DOI: 10.3390/ijms241310467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Climate change and exposure to environmental pollutants play a key role in the onset and aggravation of allergic diseases. As different climate-dependent patterns of molecular immunoglobulin E (IgE) reactivity have been regionally described, we sought to investigate the evolving allergen exposome in distinctive allergic phenotypes and subtropical weather conditions through a Precision Allergy Molecular Diagnosis (PAMD@) model. Concurrent sensitization to several house dust mites (HDM) and storage mite molecules were broadly dominant in the investigated cohort, followed by the major cat allergen Fel d 1, and regardless of the basal allergic disease. Although a complex repertoire of allergens was recognized, a steadily increasing number of IgE binding molecules was associated with the complexity of the underlying atopic disease. Besides the highly prevalent IgE responses to major HDM allergens, Der p 21, Der p 5, and Der p 7 also showed up as serodominant molecules, especially in subjects bothered by asthma and atopic dermatitis. The accurate characterization of the external exposome at the molecular level and their putative role as clinically relevant allergens is essential to elucidate the phenotypic diversity of atopic disease in terms of personalized diagnosis and therapy.
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Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | | | - Tania Galán
- Inmunotek SL Laboratories, 28805 Madrid, Spain
| | - Elena Mederos-Luis
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | | | | | - Inmaculada Sánchez-Machín
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Allergen Immunotherapy Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
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7
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Vrtala S. Allergene von Hausstaub- und Vorratsmilben. ALLERGO JOURNAL 2022. [DOI: 10.1007/s15007-022-5640-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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8
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González-Pérez R, Poza-Guedes P, Mederos-Luis E, Sánchez-Machín I. Dupilumab modulates specific IgE mite responses at the molecular level in severe T2-high atopic dermatitis: A real-world experience. Front Med (Lausanne) 2022; 9:939598. [PMID: 36035412 PMCID: PMC9411935 DOI: 10.3389/fmed.2022.939598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Atopic dermatitis (AD) is regarded as a chronic systemic disease which is characterized by a robust overexpression of type 2 related cytokines, with increased total IgE levels and a concomitant sensitization to common allergens. Dupilumab, a fully human monoclonal antibody (mAb) to IL-4Rα that inhibits both IL-4 and IL-13 signaling, has previously shown a marked and rapid improvement when treating the moderate-to-severe forms of AD. We sought to evaluate the real-world evidence (RWE) of dupilumab in the modulation of total and specific IgE (sIgE) serum levels to a panel of molecular house dust mites (HDM) and storage mites (SM) allergens in patients with severe AD. Methods Demographic and clinical data for severe AD adult patients receiving dupilumab treatment (300 mg every 2 weeks) were reviewed. Mean (standard deviations SD) values and percent changes from baseline in total and sIgE to the complete HDM and SM extracts, and 14 individual molecular allergens were measured over 52 weeks. Results Significant (p < 0.05) changes in mean total IgE levels were observed from baseline to week-52 after treatment with dupilumab. Despite no changes were found in sIgE against the extract of HDM during the 52-week treatment with dupilumab, baseline mean levels from 7 out of 14 individual molecular mite allergens -Der p 1, Der p 2, Der p 5, Der p 7, Der p 21, Der p 23, and Lep d 2- were significantly (p < 0.05) decreased—after 52 weeks of treatment with dupilumab. Conclusions Dupilumab therapy for 52 weeks resulted in a profound reduction in blood levels of total IgE and allergen-specific IgE to both HDM and SM at the molecular level in adults with severe AD under RWE conditions. The potential benefits of these concomitant immunomodulatory effects after treatment with dupilumab should be explored to a greater extent.
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Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
- Severe Asthma Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
- *Correspondence: Ruperto González-Pérez
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
- Severe Asthma Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Elena Mederos-Luis
- Allergy Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
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Luengo O, Galvan-Blasco P, Cardona V. Molecular diagnosis contribution for personalized medicine. Curr Opin Allergy Clin Immunol 2022; 22:175-180. [PMID: 35174793 DOI: 10.1097/aci.0000000000000822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW The purpose of the current review is to highlight the most recent findings in molecular allergy and its applicability in precision medicine for allergic patients. RECENT FINDINGS Molecular allergy provides useful information in areas of respiratory allergy (house dust mites, pet dander and pollen allergy), food allergy (tree nuts, peanuts, fruits and vegetables), hymenoptera venom allergy and others, in order to improve management of patients. Regional differences in sensitization profiles, assay characteristics and interpretation of molecular sensitization in relation to whole extracts and total immunoglobulin E need to be taken into account. Studies of the impact of such strategies are needed. SUMMARY Molecular allergy diagnosis represents a major contribution for personalized medicine. It aids in the assesment of risk prediction, disease severity, genuine/cross-reactive sensitization, and finally to apply precise management strategies.
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Affiliation(s)
- Olga Luengo
- Allergy Section, Internal Medicine Department, Hospital Universitari Vall d'Hebron
- Vall d'Hebron Institut de Recerca (VHIR), Immunomediated Diseases and Innovative Therapies, Barcelona
- ARADyAL Research Network, Instituto de Salud Carlos III (ISCIII), Madrid
- Universitat Autonomade Barcelona (UAB), Medicine Department, Barcelona, Spain
| | - Paula Galvan-Blasco
- Allergy Section, Internal Medicine Department, Hospital Universitari Vall d'Hebron
- Vall d'Hebron Institut de Recerca (VHIR), Immunomediated Diseases and Innovative Therapies, Barcelona
- ARADyAL Research Network, Instituto de Salud Carlos III (ISCIII), Madrid
- Universitat Autonomade Barcelona (UAB), Medicine Department, Barcelona, Spain
| | - Victoria Cardona
- Allergy Section, Internal Medicine Department, Hospital Universitari Vall d'Hebron
- Vall d'Hebron Institut de Recerca (VHIR), Immunomediated Diseases and Innovative Therapies, Barcelona
- ARADyAL Research Network, Instituto de Salud Carlos III (ISCIII), Madrid
- Universitat Autonomade Barcelona (UAB), Medicine Department, Barcelona, Spain
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González-Pérez R, Poza-Guedes P, Pineda F, Castillo M, Sánchez-Machín I. Storage Mite Precision Allergy Molecular Diagnosis in the Moderate-to-Severe T2-High Asthma Phenotype. Int J Mol Sci 2022; 23:ijms23084297. [PMID: 35457116 PMCID: PMC9030016 DOI: 10.3390/ijms23084297] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 12/30/2022] Open
Abstract
Storage mites (SM) may induce allergic respiratory symptoms in sensitized individuals, in both rural and urban settings. The relationship among specific IgE reactions to determined groups of SM allergens in the coincident asthma pheno-endotypes has not yet been investigated. We aimed to study a Precision Allergy Molecular Diagnosis (PAMD@) model to depict the SM molecular profile in individuals presenting with Type-2 inflammation, in two different (moderate and severe) asthma phenotypes. A customized PAMD@ panel, including SM allergens and their concurrent protein allergenic characterization was investigated. Mite group 2 allergens were most frequently recognized, including Lep d 2 (83.45%), followed by Gly d 2 (69.17%) and Tyr p 2 (47,37%), in 133/164 asthmatic subjects. Blo t 5 and Blo t 21 exhibited significant higher titres in both asthma groups. Although relevant mite group 2 allergens cross-reactivity is suggested, individualized sensitization patterns were relevantly identified. The present PAMD@ panel confirmed the dominance of mite group 2 allergens in moderate-to-severe T2 asthmatics. A broadly heterogeneous molecular repertoire of SM allergens was found in all subjects, regardless of their asthma severity. Blomia tropicalis deserves special attention in certain territories, as diagnostic and/or therapeutic approaches merely based on Pyroglyphidae mites may be insufficient.
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Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (P.P.-G.); (I.S.-M.)
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Correspondence: ; Tel.: +34-922-677237
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (P.P.-G.); (I.S.-M.)
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
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González-Pérez R, Poza-Guedes P, Pineda F, Castillo M, Sánchez-Machín I. House Dust Mite Precision Allergy Molecular Diagnosis (PAMD@) in the Th2-prone Atopic Dermatitis Endotype. Life (Basel) 2021; 11:1418. [PMID: 34947948 PMCID: PMC8705438 DOI: 10.3390/life11121418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 01/13/2023] Open
Abstract
Atopic dermatitis (AD) endotyping might be important for developing personalized diagnostic and therapeutic strategies to the different phenotypes. The current study investigated the IgE molecular profile to Dermatophagoides pteronyssinus (D. pteronyssinus) in a subset of patients afflicted with varying severity stages of atopic dermatitis in a subtropical region subjected to a high perennial house dust mite (HDM) exposure. We selected patients showing a clinically relevant sensitization to HDM with mild-to-moderate and severe AD according to their basal Severity Scoring Atopic Dermatitis (SCORAD) index. Skin prick test (SPT) with standardized mite extracts, as well as a Precision Allergy Molecular Diagnosis (PAMD@) panel including nine different D. pteronyssinus allergens and the related protein allergenic characterization, were assessed in all serum samples. A total of 80 European American AD patients with the marked T2 endotype confirmed their eligibility for the study. Major allergens (Der p 23, Der p 2, and Der p 1) were present in more than 86% of all subjects, with mid-tier allergens (Der p 5, Der p 7, and Der p 21) reaching up to 65%. A serodominant role for Der p 11 could not be quantitatively confirmed in the present cohort. The proposed component resolved diagnosis (CRD) panel appeared to be sufficient to obtain a precise D. pteronyssinus molecular diagnosis in AD patients subjected to a climate-dependent high-mite allergen exposure. The raised seroprevalence of IgE response to Der p 23 confirmed this constituent as a major D. pteronyssinus allergen in severe stages of atopic dermatitis. A clinically driven molecular approach appears to be essential to frame a more precise diagnosis and therapy of this heterogeneous allergic condition.
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Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (P.P.-G.); (I.S.-M.)
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (P.P.-G.); (I.S.-M.)
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
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12
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Zheng P, Liu X, Lin L, Wu H, Zhao X, Sun B. Efficacy of mite allergen immunotherapy in allergic rhinitis and the immune synergistic effect on cross-allergens. Immunotherapy 2021; 14:217-233. [PMID: 34845913 DOI: 10.2217/imt-2020-0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To compare the efficacy of single- and double-species mite allergen immunotherapy. Materials and methods: An open, pseudo-randomized, controlled study was conducted (n = 125 allergic rhinitis patients). The primary end point involved the visual analogue scale. Secondary end points included a basophil activation test and serum specific IgE and IgG4 assays. Results: Visual analogue scale analysis indicated considerable reductions in both groups. Both treatments improved quality of life and induced sIgG4 antibody production. Basophil activation and serum IgE inhibition were not evident in either treatment. Neither treatment displayed an early stage immune synergistic effect on cross-allergens. Conclusions: Both treatments were effective against allergic rhinitis, and statistical differences were not observed. Future studies may require long-term, large-scale research.
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Affiliation(s)
- Peiyan Zheng
- Department of Allergy & Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
| | - Xiaoqing Liu
- Department of Clinical Laboratory, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Lili Lin
- Department of Otolaryngology Head & Neck Surgery, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Huiqin Wu
- Department of Otolaryngology Head & Neck Surgery, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Xiaoming Zhao
- Department of Otolaryngology Head & Neck Surgery, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519070, China
| | - Baoqing Sun
- Department of Allergy & Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China
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Changes in the Sensitization Pattern to Alternaria alternata Allergens in Patients Treated with Alt a 1 Immunotherapy. J Fungi (Basel) 2021; 7:jof7110974. [PMID: 34829261 PMCID: PMC8618185 DOI: 10.3390/jof7110974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Alternaria alternata is the most important allergenic fungus, with up to 20% of allergic patients affected. The sensitization profile of patients sensitized to A. alternata and how it changes when treated with immunotherapy is not known. Our objective is to determine the allergen recognition pattern of allergic patients to A. alternata and to study its association to the parameters studied in a clinical trial recently published. Sera of 64 patients from the clinical trial of immunotherapy with native major allergen Alt a 1 were analyzed by immunoblotting; 98. 4% of the patients recognized Alt a 1. The percentage of recognition for Alt a 3, Alt a 4, and/or Alt a 6, Alt a 7, Alt a 8, Alt a 10 and/or Alt a 15 was 1.6%, 21.9%, 12.5%, 12.5%, and 12.5% respectively. Of the 64 patients, 45 (70.3%) only recognized Alt a 1 among the allergens present in the A. alternata extract. Immunotherapy with Alt a 1 desensitizes treated patients, reducing their symptoms and medication consumption through the elimination of Alt a 1 sensitization, which is no longer present in the immunoblotting of some patients. There may be gender differences in the pattern of sensitization to A. alternata allergens, among others.
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González-Pérez R, El-Qutob D, Letrán A, Matheu V. Precision Medicine in Mite Allergic Rhinitis. FRONTIERS IN ALLERGY 2021; 2:724727. [PMID: 35387006 PMCID: PMC8974769 DOI: 10.3389/falgy.2021.724727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
It is well-known that a correct diagnosis is necessary for effective treatment. In the case of allergic rhinitis due to mites, imprecise diagnosis with effective but improvable methods means that in many cases an optimal result is not reached in patients. The diagnosis of allergic rhinitis due to mite sensitization have to require more homogeneously reproducible diagnostic tests that try to encompass many more of the protein antigens contained in them. With the few proteins that the problem has usually focused on, there is no they would cover many of the clinically relevant allergens in a large proportion of patients. In this mini-review we try to highlight the importance of having good allergenic sources and briefly gather information on various allergenic proteins included in mites that could be clinically relevant. All this to try to get closer to a more accurate diagnosis. We are also talking about two diagnostic tools that are clearly out of use and that should be promoted in the consultations to obtain an even greater and better outcome in patients.
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Affiliation(s)
- Ruperto González-Pérez
- Allergy Department, Complejo Hospital Universitario de Canarias, San Cristóbal de La Laguna, Spain
| | - David El-Qutob
- Allergy Unit, University Hospital of La Plana, Villarreal, Spain
| | - Antonio Letrán
- Allergy Unit, Hospital HLA Jerez Puerta del Sur, Jerez de la Frontera, Spain
| | - Víctor Matheu
- Allergy Department, Complejo Hospital Universitario de Canarias, San Cristóbal de La Laguna, Spain
- *Correspondence: Víctor Matheu
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15
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González-Pérez R, Poza-Guedes P, Pineda F, Castillo M. Depiction of Major Mite Allergens in Severe Allergic Rhinitis with High Mite Perennial Exposure. Turk Arch Otorhinolaryngol 2020; 58:155-162. [PMID: 33145499 DOI: 10.5152/tao.2020.5365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/25/2020] [Indexed: 11/22/2022] Open
Abstract
Objective Airway diseases, including allergic rhinitis, are prompted by specific IgE antibodies against airborne allergens and notably those derived from mites. The presented study focused on the specific IgE immediate response to Dermatophagoides pteronyssinus (D. pteronyssinus) mite major allergens and the corresponding pertinence of molecular diagnosis in patients bothered with severe persistent rhinitis. Methods Individuals exhibiting confirmed sensitization to D. pteronyssinus along with a clinical diagnosis of coexisting severe allergic rhinitis were included in the study. In vivo investigations encompassed intradermal testing with a battery of standardized allergenic extracts, concurrent with in vitro specific IgE to the crude extract of D. pteronyssinus, and associated individual molecular allergens were assessed. Results Fifty-five out of 59 subjects showed serodominant IgE responses to the major allergens Der p 1, Der p 2 and Der p 23. Both Der p 2 and Der p 23 reached a prevalence above 80%, while group 10 allergen tropomyosin was scarcely depicted (<10%) and exclusively present in younger individuals. Conclusion The proposed component-resolved diagnosis panel accurately recognized 93.22% of D. pteronyssinus allergic patients. The raised seroprevalence of IgE response to Der p 23 also confirmed this constituent as a major D. pteronyssinus allergen in severe allergic rhinitis. A molecular approach appears to be essential to frame a more precise diagnosis and eventually a personalized immunotherapy regarding this allergic condition.
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Affiliation(s)
- Ruperto González-Pérez
- Department of Allergy & Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
| | - Paloma Poza-Guedes
- Department of Allergy & Severe Asthma Unit, Hospital Universitario de Canarias, Tenerife, Spain
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Mao S, Wu L, Shi W. Prevalence and distribution patterns of allergens among children with asthma and asthma-like symptoms in Shanghai, China. Respir Res 2020; 21:57. [PMID: 32070330 PMCID: PMC7029476 DOI: 10.1186/s12931-020-1318-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/10/2020] [Indexed: 02/08/2023] Open
Abstract
Objective We aimed to identify the prevalence and distribution patterns of allergens among Chinese children with asthma/asthma-like symptoms (ALS). Methods A total of 3479 children with asthma/ALS were enrolled. Skin prick test (SPT) was used to test the allergen-specific IgE. We analysed allergens prevalence and distribution, and its relationship with demographic characteristics. Results Aeroallergens prevalence was higher than that of food allergens (p < 10− 4). Boys had higher aeroallergens prevalence than that in girls (p < 10− 4). Significant difference of aeroallergens prevalence among cases with different parental allergy history was observed (p < 10− 4). Age was positively associated with aeroallergens prevalence before the age of 11.5 (P < 10− 4), particularly before the age of 2.42 (P < 10− 4). Age was negatively associated with aeroallergens prevalence after the age of 11.5 (P = 0.021). Age was negatively associated with food allergens prevalence before the age of 3.42 (P < 10− 4). Age was associated with the intensity of dermatophagoides farinae (DF)/house dust mite (HDM) allergens (P < 10− 4). Age was negatively associated with the intensity of shrimp, and crab allergens before the age of 3.3 and 3.3, respectively (P = 0.012, < 10− 4). Boys had higher intensity of DF and HDM allergens than that in girls (P < 10− 4, P < 10− 4). Significant differences of the intensity of DF and HDM allergens among groups with different parental allergy history were noted (P < 10− 4, P < 10− 4). Conclusions Boys and parental allergy history were associated with higher prevalence and intenstity of aeroallergens. Age was positively and negatively associated with aeroallergens prevalence before and after the age of 11.5, respectively. Age was negatively associated with food allergens prevalence before the age of 3.42.
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Affiliation(s)
- Song Mao
- Department of Pediatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan road, Shanghai, China. .,China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
| | - Liangxia Wu
- Department of Pediatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan road, Shanghai, China.,China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjing Shi
- Department of Pediatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan road, Shanghai, China.,China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
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