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Huber P, Becker S, Gröger M. [Pitfalls in the diagnosis of house dust mite allergy]. HNO 2024:10.1007/s00106-024-01425-y. [PMID: 38358481 DOI: 10.1007/s00106-024-01425-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/16/2024]
Abstract
House dust mite (HDM) is the most significant indoor allergen, responsible for not only many cases of rhinoconjunctivitis but also for many cases of bronchial asthma, rendering it of considerable socioeconomic relevance. Besides symptomatic treatment and avoidance measures, allergen immunotherapy (AIT) is crucial, as the only causal, disease-modifying therapeutic approach. However, high diagnostic certainty is essential for initiating AIT. The challenge in making a correct diagnosis lies in interpreting the demonstrated HDM sensitization regarding its clinical relevance (clinically silent sensitization vs. allergy). While the risk of allergy increases with the level of IgE titers against HDM extract, Der p 1, or Der p 2, as well as with the breadth of the molecular sensitization profile against HDM components (Der p 1, Der p 2, Der p 23), no threshold can be defined for the presence of allergy, nor can sensitization to a specific component be confidently considered allergy inducing. It should be noted that at least in Southern Bavaria, the prevalence of Der p 23 sensitization is too low to be considered a major allergen, and Der p 23 is not able to molecularly differentiate all HDM sensitizations when added to the two major allergens Der p 1 and Der p 2. Evidently, HDM possesses a diverse profile of allergens, with some relevant ones possibly yet to be described. Unfortunately, patient history does not provide a sufficient assessment of the clinical relevance of a demonstrated HDM sensitization, necessitating allergen provocation testing before initiating AIT with HDM, despite the relatively large effort involved.
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Affiliation(s)
- P Huber
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland
| | - S Becker
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik Tübingen, Tübingen, Deutschland
| | - M Gröger
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
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Gao Y, Li J, Xu X, Wang C, Zhang Y, Zhang L. Sensitisation to House Dust Mite Component Der p 23 Is Associated with Severe Symptoms and Asthma in Allergic Rhinitis Patients. Int Arch Allergy Immunol 2023; 184:906-913. [PMID: 37437556 DOI: 10.1159/000531244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/12/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION House dust mite (HDM) is an important source of airborne allergens in China as it contains several allergenic components that can cause allergic rhinitis (AR) and other allergic diseases. This study aimed to determine the clinical characteristics and disease severity in AR patients sensitised to different allergenic HDM components. METHODS This was a retrospective study, which examined 129 patients who were first diagnosed with only HDM-induced AR at the Department of Allergy of Beijing Tongren Hospital from December 2019 to April 2021. Clinical characteristics and disease severity of the patients were assessed based on the sensitisation to specific Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) allergenic components, including Der p 1, Der p 2, Der p 23, Der f 1, and Der f 2, employing multiple correspondence analysis (MCA) with correspondence analysis chart of MCA. RESULTS Among HDM-induced AR cases, the positive rate of Der p 1 was the highest (87.6%), followed by Der p 2 (78.3%), Der f 2 (76.64%), Der f 1 (68.2%), and Der p 23 (37.2%). Multiple correspondence analyses showed that sensitisation to Der p 23 was associated with severe AR symptoms and asthma; sensitisation to Der p 2, Der f 1, and Der f 2 was associated with moderate AR; and no sensitisation to Der p 23 was associated with mild AR. CONCLUSION Der p 23 sensitisation is prevalent in northern China and may be associated with severe symptoms and asthma in AR patients.
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Affiliation(s)
- Yunbo Gao
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jingyun Li
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Xu Xu
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Chengshuo Wang
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuan Zhang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Luo Zhang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory of Allergic Diseases and Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
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Vidal-Quist JC, Declercq J, Vanhee S, Lambrecht BN, Gómez-Rial J, Vidal C, Aydogdu E, Rombauts S, Hernández-Crespo P. RNA viruses alter house dust mite physiology and allergen production with no detected consequences for allergenicity. Insect Mol Biol 2023; 32:173-186. [PMID: 36511188 DOI: 10.1111/imb.12822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
RNA viruses have recently been detected in association with house dust mites, including laboratory cultures, dust samples, and mite-derived pharmaceuticals used for allergy diagnosis. This study aimed to assess the incidence of viral infection on Dermatophagoides pteronyssinus physiology and on the allergenic performance of extracts derived from its culture. Transcriptional changes between genetically identical control and virus-infected mite colonies were analysed by RNAseq with the support of a new D. pteronyssinus high-quality annotated genome (56.8 Mb, 108 scaffolds, N50 = 2.73 Mb, 96.7% BUSCO-completeness). Extracts of cultures and bodies from both colonies were compared by inspecting major allergen accumulation by enzyme-linked immunosorbent assay (ELISA), allergen-related enzymatic activities by specific assays, airway inflammation in a mouse model of allergic asthma, and binding to allergic patient's sera IgE by ImmunoCAP. Viral infection induced a significant transcriptional response, including several immunity and stress-response genes, and affected the expression of seven allergens, putative isoallergens and allergen orthologs. Major allergens were unaffected except for Der p 23 that was upregulated, increasing ELISA titers up to 29% in infected-mite extracts. By contrast, serine protease allergens Der p 3, 6 and 9 were downregulated, being trypsin and chymotrypsin enzymatic activities reduced up to 21% in extracts. None of the parameters analysed in our mouse model, nor binding to human IgE were significantly different when comparing control and infected-mite extracts. Despite the described physiological impact of viral infection on the mites, no significant consequences for the allergenicity of derived extracts or their practical use in allergy diagnosis have been detected.
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Affiliation(s)
- José Cristian Vidal-Quist
- Entomología Aplicada a la Agricultura y la Salud, Departamento de Biotecnología Microbiana y de Plantas, Centro de Investigaciones Biológicas Margarita Salas (CIB), CSIC, Madrid, Spain
| | - Jozefien Declercq
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Stijn Vanhee
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Bart N Lambrecht
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Ghent, Belgium
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - José Gómez-Rial
- Laboratorio de Inmunogenética, Unidad de Inmunología, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain
| | - Carmen Vidal
- Servicio de Alergología, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain
| | - Eylem Aydogdu
- Center for Plant Systems Biology, VIB, Ghent, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, Ghent, Belgium
| | - Stephane Rombauts
- Center for Plant Systems Biology, VIB, Ghent, Belgium
- Department of Plant Biotechnology and Bioinformatics, Ghent University, Ghent, Belgium
| | - Pedro Hernández-Crespo
- Entomología Aplicada a la Agricultura y la Salud, Departamento de Biotecnología Microbiana y de Plantas, Centro de Investigaciones Biológicas Margarita Salas (CIB), CSIC, Madrid, Spain
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Forchert L, Potapova E, Panetta V, Dramburg S, Perna S, Posa D, Resch-Marat Y, Lupinek C, Rohrbach A, Grabenhenrich L, Icke K, Bauer CP, Hoffman U, Forster J, Zepp F, Schuster A, Wahn U, Keil T, Lau S, Vrtala S, Valenta R, Matricardi PM. Der p 23-specific IgE response throughout childhood and its association with allergic disease: A birth cohort study. Pediatr Allergy Immunol 2022; 33:e13829. [PMID: 35871456 DOI: 10.1111/pai.13829] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 06/02/2022] [Accepted: 06/18/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND The Dermatophagoides pteronyssinus molecule Der p 23 is a major allergen whose clinical relevance has been shown in cross-sectional studies. We longitudinally analysed the trajectory of Der p 23-specific IgE antibody (sIgE) levels throughout childhood and youth, their early-life determinants and their clinical relevance for allergic rhinitis and asthma. METHODS We obtained sera and clinical data of 191 participants of the German Multicentre Allergy Study, a prospective birth cohort. Serum samples from birth to 20 years of age with sIgE reactivity to Der p 23 in a customised semiquantitative microarray were newly analysed with a singleplex quantitative assay. Early mite exposure was assessed by measuring the average content of Der p 1 in house dust at 6 and 18 months. RESULTS Der p 23-sIgE levels were detected at least once in 97/191 participants (51%). Prevalence of Der p 23 sensitisation and mean sIgE levels increased until age 10 years, plateaued until age 13 years and were lowest at age 20 years. Asthma, allergic rhinitis (AR) and atopic dermatitis (AD) were more prevalent in Der p 23-sensitised children, including those with monomolecular but persistent sensitisation (11/97, 11%). A higher exposure to mites in infancy and occurrence of AD before 5 years of age preceded the onset of Der p 23 sensitisation, which in turn preceded a higher incidence of asthma. CONCLUSIONS Der p 23 sensitisation peaks in late childhood and then decreases. It is preceded by early mite exposure and AD. Asthma and AR can occur in patients persistently sensitised to Der p 23 as the only mite allergen, suggesting the inclusion of molecular testing of Der p 23-sIgE for subjects with clinical suspicion of HDM allergy but without sIgE to other major D.pt. allergens.
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Affiliation(s)
- Leandra Forchert
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ekaterina Potapova
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Valentina Panetta
- L'altrastatistica srl, Consultancy & Training, Biostatistics office, Rome, Italy
| | - Stephanie Dramburg
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Serena Perna
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Daniela Posa
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Yvonne Resch-Marat
- The Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Wien, Austria
| | - Christian Lupinek
- The Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Wien, Austria
| | - Alexander Rohrbach
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Linus Grabenhenrich
- The Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Katja Icke
- The Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Carl-Peter Bauer
- The Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Ute Hoffman
- The Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Johannes Forster
- The Department of Pediatrics, Allergy Working Group, University Clinic Freiburg, Freiburg, Germany
| | - Fred Zepp
- The Department of Pediatrics and Adolescent Medicine, University Medicine Mainz, Mainz, Germany
| | - Antje Schuster
- The Department of Pediatrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Ulrich Wahn
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Keil
- The Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.,The Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.,The State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Susanne Lau
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Susanne Vrtala
- The Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Wien, Austria
| | - Rudolf Valenta
- The Division of Immunopathology, Department of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Wien, Austria
| | - Paolo Maria Matricardi
- The Department of Pediatrics, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Bożek A, Zalejska Fiolka J, Czuba Z, Miodońska M, Kozłowska R. Allergy to Der p 23 influences the cytokine profile in patients with allergic asthma - a preliminary study. J Asthma 2022; 59:2491-2494. [PMID: 35645174 DOI: 10.1080/02770903.2022.2083635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Der p 23 is a major allergen of Dermatophagoides pteronyssinus, which could contribute to allergic asthma. The study compared the cytokine profile (Il-1beta, Il-4, Il-5, Il-6, Il-13, Il-17, TNF-alpha) in patients with allergic asthma, with confirmed allergy to D. pteronyssinus and with the presence or absence of allergy to Der p 23. METHODS Among 173 included patients, the following combinations were analyzed: profile A - Der p 1 (+), Der p 2 (+), and Der p 23 (-) observed in 38 (22%) patients; profile B - Der p 1 (+), Der p 2 (+), and Der p 23 (+) in 87 (50.3%) patients; and profile C - Der p 1 (-), Der p 2 (-), and Der p 23 (+) in 15 (8.7%) patients. RESULTS The mean concentration of Il-1beta was significantly lower in profile A than in profiles B and C: 10.51 ± 5.22 (pg/ml) vs. 21.92 ± 11.34 vs. 23.1 ± 8.56 (A vs. B for p = 0.03 and A vs. C for p = 0.019). Similar trends were observed for Il-5: 38.5 ± 10.45 (pg/ml) vs. 94.8 ± 54.11 vs. 103.61 ± 34.9 (A vs. B for p = 0.008 and A vs. C for p = 0.001). CONCLUSION The higher Il-1 and Il-5 activities observed in profiles B and C with Der p 23 (+) could be responsible for the more effective acceleration of allergic inflammation than in profile A with Der p 23.
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Affiliation(s)
- Andrzej Bożek
- Clinical Department of Internal Diseases and Geriatrics, Department of Internal Diseases, Dermatology and Allergology, Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jolanta Zalejska Fiolka
- Department of Biochemistry, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Zenon Czuba
- Department of Microbiology and Immunology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Martyna Miodońska
- Clinical Department of Internal Diseases and Geriatrics, Department of Internal Diseases, Dermatology and Allergology, Zabrze, Medical University of Silesia, Katowice, Poland
| | - Renata Kozłowska
- Clinical Department of Internal Diseases and Geriatrics, Department of Internal Diseases, Dermatology and Allergology, Zabrze, Medical University of Silesia, Katowice, Poland
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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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