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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; 54:607-620. [PMID: 38676405 DOI: 10.1111/cea.14486] [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: 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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Santaolalla M, Arias-Irigoyen J, Soler JM, Duque JM, Escudero R, Pérez-Formoso JL, Lobera T, Rueda M, Alias C, Hermida H, Vela C, Begoña L, Vazquez A, Madariaga B. Efficacy and safety of subcutaneous immunotherapy with polymerized allergen mixtures in polyallergic patients - ARES observational study. Expert Rev Clin Immunol 2024:1-12. [PMID: 38934292 DOI: 10.1080/1744666x.2024.2373886] [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: 02/22/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Administration of allergen mixtures of many components comprises the most common approach for American allergists regarding the management of polyallergic patients. European allergists, however, are more reluctant to this type of treatment due to the potential drawbacks of mixing extracts. RESEARCH DESIGN AND METHODS To assess the efficacy and safety of subcutaneous immunotherapy (SCIT) with polymerized allergen mixtures without dilutional effect in polyallergic patients.This observational, prospective, multicenter study included patients (between 5 and 60 years) with respiratory allergic diseases that had been prescribed with SCIT with mixtures of two pollen or mite extracts. Changes in Symptoms and Medication Score (SMS) and in rhinitis quality of life questionnaire (RQLQ), subjective clinical improvement, treatment satisfaction and tolerability were assessed after the 1-year treatment. RESULTS A total of 115 patients were included in the assessment. Mean global SMS decreased from 3.5 (SD = 1.1) to 1.6 (SD = 1.2) points, with a mean absolute reduction of 1.6 (SD = 1.3) points in the RQLQ score (p < 0.001, Wilcoxon test). General subjective clinical improvements and a good treatment satisfaction and tolerability were observed. CONCLUSION SCIT with polymerized allergen mixtures from either pollen or mite extracts proved to be an effective and safe treatment option for polyallergic patients suffering from allergic respiratory diseases.
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Affiliation(s)
| | | | - Jose Miguel Soler
- Allergy and Clinical Immunology Unit, ALLERCEN, Barcelona, Catalonia, Spain
| | | | - Rosario Escudero
- Allergy department, Fundación Hospital Calahorra, Calahorra, La Rioja, Spain
| | | | - Teófilo Lobera
- Allergy department, CAR San Millán, Logroño, La Rioja, Spain
| | - María Rueda
- Allergy department, Hospital Quirónsalud Barcelona, Barcelona, Catalonia, Spain
| | - César Alias
- Allergy unit, Centre Assitencial Baix Llobregat, Cornellà de Llobregat, Catalonia, Spain
| | - Helena Hermida
- Allergy unit, Policlínica Augusta, Badalona, Catalonia, Spain
| | - Catalina Vela
- Allergy unit, Logroño Promosalud, Logroño, La Rioja, Spain
| | - Leire Begoña
- Medical Department, ROXALL Medicina España S.A, Zamudio, Basque Country, Spain
| | - Alexander Vazquez
- Medical Department, ROXALL Medicina España S.A, Zamudio, Basque Country, Spain
| | - Begoña Madariaga
- Medical Department, ROXALL Medicina España S.A, Zamudio, Basque Country, Spain
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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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Mahmood F, Nissen-Meyer LSH, Hetland G, Nentwich I. Assessing IgE sensitization profiles to birch and timothy grass pollen allergens in birch pollen allergic blood donors using an oligoplex specific IgE assay. Scand J Clin Lab Invest 2023; 83:444-447. [PMID: 37737679 DOI: 10.1080/00365513.2023.2255972] [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: 10/10/2022] [Accepted: 09/03/2023] [Indexed: 09/23/2023]
Abstract
IgE sensitization profiles to single birch allergens in birch-sensitized patients differ among European countries. The aim of this study was to determine the distribution of specific IgE antibodies to major and minor birch pollen allergens in a population of allergic Norwegian individuals by using a birch allergic blood donor population as a surrogate sample. Sixty blood donors were recruited and sampled based on birch allergy symptoms such as rhinitis, rhinoconjunctivitis and/or mild asthma in previous seasons. All sera were collected before start of the pollen season and tested using a line blot assay (Euroimmun AG, Lübeck, Germany) for IgE to birch and timothy pollen. Both extracts, single allergens, and cross-reacting carbohydrate determinants (CCD) were analysed. Only donors with specific IgE to birch and/or timothy grass were further evaluated. Specific IgE to birch pollen extract was found in 52 sera, and sensitization to timothy grass in 40 sera. Specific IgE to Bet v 1 was predominant in contrast to Bet v 4 which was absent. However, sensitization to the minor allergens Bet v 2 and 6 was always found together with high levels of IgE to Bet v 1. Subjects sensitized to the profilin Bet v 2 from birch were also sensitized to Phl p 12 from timothy grass. In conclusion, there was predominantly Bet v 1 sensitization in this cohort and low sensitization to minor allergens and cross-reactive allergens (Bet v 2, Bet v 4, Phl p 7 and Phl p 12).
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Affiliation(s)
- Faiza Mahmood
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
- Department of Immunology and Transfusion Medicine, Akershus University Hospital, Lørenskog, Norway
| | | | - Geir Hetland
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Norway
| | - Ivo Nentwich
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway
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Xu L, Luo W, Lu Y, Huang Z, Yu X, Liao C, Dai Y, Huang H, Gu W, Zheng P, Zhang X, Chen H, Huang L, Zheng J, Hao C, Sun B. A comprehensive analysis of the components of common weed pollen and related allergens in patients with allergic diseases in southern China. Mol Immunol 2022; 147:180-186. [PMID: 35633613 DOI: 10.1016/j.molimm.2022.05.005] [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: 09/22/2021] [Revised: 05/04/2022] [Accepted: 05/16/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pollen allergens are vital contributors to allergic diseases. The frequency and coreactivity pattern of allergens are closely related to geographical distribution. OBJECTIVE In this study, we aimed to characterize the prevalence of the molecular components of the common weed pollen allergens, birch pollen, walnut, and cross-reactive carbohydrate determinant (CCD), as well as investigate the relationship between the allergens and CCD in Chinese pollen-sensitized patients with allergic diseases. METHODS Based on previous vegetation surveys, serum samples from 165 pollen-sensitized patients with allergic diseases in Guangdong Province in southern China were used to test 19 crude allergen extracts, their components, and CCD using component-resolved diagnosis (CRD). Moreover, the potential associations among CCD, allergens, and their components were described. RESULTS In the 165 samples, the most common sensitized allergens were goosefoot (43.0%), ragweed (40.6%), walnut (37.6%), walnut tree (37.6%), and mugwort (37.0%), followed by platane (35.2%), cocklebur (27.9%), and birch (24.2%). The positivity rate of CCD was 39.4%. Among the samples positive for mugwort, 11 (18.0%), 15 (24.6%), and 15 (24.6%) were positive for Art v 1, Art v 2, and Art v 3, respectively. Among the 67 patients sensitized to ragweed, only five (7.5%) were positive for Amb a 1. In the 40 patients sensitized to birch, Bet v 2 had the highest positivity rate (40.0%). There were 62 patients who were sensitized to walnut. Their components had a lower positivity rate (less than 15%). The hierarchical clustering and optimal scale analysis showed that Art v 4 and Bet v 2 were closely related, and 91.9% of CCD-positive samples were polysensitized. Meanwhile, Spearman's rank correlation method showed that CCD was closely correlated with the sensitization of crude allergen extracts, and there was a low correlation between CCD and allergen components. CCD was highly correlated with goosefoot, ragweed, and walnut trees (r>0.8). Moreover, there was a strong relationship between the levels of Jug r 3 and Art v 3 (r = 0.78; P < 0.001). CONCLUSIONS In southern China, the weed pollens (ragweed, cocklebur, and goosefoot) exhibited higher positivity rates in adults and had a stronger relationship with CCD but not with mugwort. The positivity rate of allergen components was not high. CCD-positive samples were always polysensitized.
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Affiliation(s)
- Lina Xu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Wenting Luo
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Yanhong Lu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Zhifeng Huang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Xingmei Yu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Chenxi Liao
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Yinfang Dai
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Huimin Huang
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Wenjing Gu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Peiyan Zheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Xinxing Zhang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Hongling Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Li Huang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China
| | - Jinping Zheng
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510120, China.
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, China.
| | - Baoqing Sun
- Department of Allergy and Clinical Immunology, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510120, China.
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Shokouhi Shoormasti R, Rafaiani C, Fazlollahi MR, Kazemnejad A, Mahloojirad M, Moslemi M, Abbasi JM, Moin M, Pourpak Z, Mari A. Molecular Profile of Specific IgE to Allergenic Components in Allergic Adults Using Allergen Nano-Bead Array. Clin Exp Allergy 2022; 52:942-953. [PMID: 35174570 DOI: 10.1111/cea.14113] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND An increasing interest in the field of molecular diagnosis of allergy has been developed in recent years and it goes to be as the routine in-vitro protocol in allergy diagnosis. Friendly Allergen Nano-bead Array (FABER) is a new multiplex assay for the evaluation of specific IgE against 244 allergens including whole extracts and allergenic molecules. The research intended to assess the pattern of IgE sensitization to allergenic components of allergens in allergic adults using FABER 244. METHODS Sixty patients with allergic diseases entered this cross-sectional study. Specific IgE to 122 whole allergens extracts and 122 allergenic components was assessed using an allergen nano-bead array (FABER) for all patients. This test includes inhalant and food allergens. RESULTS Thirty-seven patients were male (61.7%). The mean (SD) age of patients was 30.73(±6.87) years. As the allergen nano-bead array results showed, Lolium perenne (63.3%), Phleum pretense (60%), and Platanus acerifolia (51.7%) were considered as the most common IgE-sensitizations to the aeroallergen extracts. Moreover, Lol p 1, Phl p 1.0102, and Cup a 1 were found as the most frequent allergenic components in our allergic patients. Among protein families, CCD bearing proteins, expansin, cysteine protease, and profilin families illustrated the highest allergic sensitization. CONCLUSIONS The results of the present study demonstrated that despite the higher prevalence of sensitization to Salsola kali (47.2%) using extract-based assays in the previous phase of this research, allergenic components of grasses (Lol p 1, Phl p 1.0102), Cup a 1 as well as Sal k1 as the major components of Cupressuss arizonica and Salsola kali showed the higher sensitization, respectively in adults' allergic patients using FABER test.
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Affiliation(s)
| | - Chiara Rafaiani
- Associated Centers for Molecular Allergology, CAAM, Rome, Italy
| | - Mohammad Reza Fazlollahi
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Mahloojirad
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Moslemi
- Blood Transfusion Organization Research Center, Tehran, Iran
| | - Javid Morad Abbasi
- Asthma and Allergy Center, Tehran Medical Sciences Branch of Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Mostafa Moin
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pourpak
- Immunology, Asthma, and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Adriano Mari
- Associated Centers for Molecular Allergology, CAAM, Rome, Italy
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Stas M, Aerts R, Hendrickx M, Delcloo A, Dendoncker N, Dujardin S, Linard C, Nawrot T, Van Nieuwenhuyse A, Aerts JM, Van Orshoven J, Somers B. Exposure to green space and pollen allergy symptom severity: A case-crossover study in Belgium. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 781:146682. [PMID: 33812114 DOI: 10.1016/j.scitotenv.2021.146682] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/04/2021] [Accepted: 03/18/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND The prevalence of pollen allergy has increased due to urbanization, climate change and air pollution. The effects of green space and air pollution on respiratory health of pollen allergy patients are complex and best studied in spatio-temporal detail. METHODS We tracked 144 adults sensitized to Betulaceae pollen during the tree pollen season (January-May) of 2017 and 2018 and assessed their spatio-temporal exposure to green space, allergenic trees, air pollutants and birch pollen. Participants reported daily symptom severity scores. We extracted 404 case days with high symptom severity scores and matched these to 404 control days. The data were analyzed using conditional logistic regression with a 1:1 case-crossover design. RESULTS Case days were associated with exposure to birch pollen concentration (100 grains/m3) [adjusted odds ratio 1.045 and 95% confidence interval (1.014-1.078)], O3 concentration (10 μg/m3) [1.504 (1.281-1.766)] and PM10 concentration (10 μg/m3) [1.255 (1.007-1.565)] on the day of the severe allergy event and with the cumulative exposure of one and two days before. Exposure to grass cover (10% area fraction) [0.655 (0.446-0.960)], forest cover (10% area fraction) [0.543 (0.303-0.973)] and density of Alnus (10%) [0.622 (0.411-0.942)] were protective for severe allergy, but only on the day of the severe allergy event. Increased densities of Betula trees (10%) were a risk factor [unadjusted OR: 2.014 (1.162-3.490)]. CONCLUSION Exposure to green space may mitigate tree pollen allergy symptom severity but only when the density of allergenic trees is low. Air pollutants contribute to more severe allergy symptoms. Spatio-temporal tracking allows for a more realistic exposure assessment.
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Affiliation(s)
- Michiel Stas
- Division Forest, Nature and Landscape, Department Earth and Environmental Sciences, KU Leuven, Celestijnenlaan 200E-2411, BE-3001 Leuven, Belgium; Measure, Model & Manage Bioresponses (M3-BIORES), Division Animal and Human Health Engineering, Department of Biosystems (BIOSYST), KU Leuven, Kasteelpark Arenberg 30-2472, B-3001 Leuven, Belgium.
| | - Raf Aerts
- Division Forest, Nature and Landscape, Department Earth and Environmental Sciences, KU Leuven, Celestijnenlaan 200E-2411, BE-3001 Leuven, Belgium; Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), J. Wytsmanstraat 14, B-1050 Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, KU Leuven, Kasteelpark Arenberg 31-3245, BE-3001 Leuven, Belgium; Center for Environmental Sciences, Hasselt University, Campus Diepenbeek, Agoralaan Gebouw D, B-3590 Hasselt, Belgium; Mycology and Aerobiology, Sciensano (Belgian Institute of Health), J. Wytsmanstraat 14, B-1050 Brussels, Belgium.
| | - Marijke Hendrickx
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), J. Wytsmanstraat 14, B-1050 Brussels, Belgium.
| | - Andy Delcloo
- Royal Meteorological Institute of Belgium, Ringlaan 3 Avenue Circulaire, B-1180 Brussels, Belgium; Department of Physics and Astronomy, Ghent University, Proeftuinstraat 86, B-9000 Ghent, Belgium.
| | - Nicolas Dendoncker
- Department of Geography, University of Namur, Rue de Bruxelles 61, B-5000 Namur, Belgium; Institute for Life, Earth and Environment (ILEE), University of Namur, Rue de Bruxelles 61, B-5000 Namur, Belgium.
| | - Sebastien Dujardin
- Department of Geography, University of Namur, Rue de Bruxelles 61, B-5000 Namur, Belgium; Institute for Life, Earth and Environment (ILEE), University of Namur, Rue de Bruxelles 61, B-5000 Namur, Belgium.
| | - Catherine Linard
- Department of Geography, University of Namur, Rue de Bruxelles 61, B-5000 Namur, Belgium; Institute for Life, Earth and Environment (ILEE), University of Namur, Rue de Bruxelles 61, B-5000 Namur, Belgium.
| | - Tim Nawrot
- Center for Environmental Sciences, Hasselt University, Campus Diepenbeek, Agoralaan Gebouw D, B-3590 Hasselt, Belgium; Centre Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok d box 7001, B-3000 Leuven, Belgium.
| | - An Van Nieuwenhuyse
- Centre Environment and Health, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok d box 7001, B-3000 Leuven, Belgium; Department of Health Protection, Laboratoire national de santé (LNS), 1, Rue Louis Rech, L-3555 Dudelange, Luxembourg.
| | - Jean-Marie Aerts
- Measure, Model & Manage Bioresponses (M3-BIORES), Division Animal and Human Health Engineering, Department of Biosystems (BIOSYST), KU Leuven, Kasteelpark Arenberg 30-2472, B-3001 Leuven, Belgium.
| | - Jos Van Orshoven
- Division Forest, Nature and Landscape, Department Earth and Environmental Sciences, KU Leuven, Celestijnenlaan 200E-2411, BE-3001 Leuven, Belgium.
| | - Ben Somers
- Division Forest, Nature and Landscape, Department Earth and Environmental Sciences, KU Leuven, Celestijnenlaan 200E-2411, BE-3001 Leuven, Belgium.
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Čelakovská J, Bukač J, Cermákova E, Vaňková R, Skalská H, Krejsek J, Andrýs C. Analysis of Results of Specific IgE in 100 Atopic Dermatitis Patients with the Use of Multiplex Examination ALEX2-Allergy Explorer. Int J Mol Sci 2021; 22:ijms22105286. [PMID: 34067936 PMCID: PMC8156228 DOI: 10.3390/ijms22105286] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/19/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Background and aim: Progress in laboratory diagnostics of IgE-mediated allergy is the use of component-resolved diagnosis. Our study analyses the results of specific IgE to 295 allergen reagents (117 allergenic extracts and 178 molecular components) in patients suffering from atopic dermatitis (AD) with the use of ALEX2 Allergy Explorer. Method: The complete dermatological and allergological examination, including the examination of the sensitization to molecular components with ALEX2 Allergy Explorer testing, was performed. The statistical analysis of results was performed with these methods: TURF (total unduplicated reach and frequency), best reach and frequency by group size, two-sided tests, Fisher’s exact test, and chi-square test (at an expected minimum frequency of at least 5). Results: Altogether, 100 atopic dermatitis patients were examined: 48 men, 52 women, the average age 40.9 years, min. age 14 years, max. age 67 years. The high and very high level of specific IgE was reached in 75.0% of patients to 18 molecular components: from PR-10 proteins (Aln g 1, Bet v 1, Cor a1.0103, Cor a1.0401, Fag s 1), lipocalin (Can f 1), NPC2 family (Der f 2, Der p 2), uteroglobin (Fel d 1), from Alternaria alternata (Alt a 1), Beta expansin (Lol p 1, Phl p 1), molecular components from Timothy, cultivated rye (Secc pollen) and peritrophin-like protein domain Der p 23. The high and very high level of specific IgE to other lipocalins (Fel d 7, Can f 4), to arginine kinase (Bla g 9, German cockroach), and to allergen extracts Art v (mugwort), and Cyn d (Bermuda grass) reached 52.0% of patients. The severity of AD is in significant relation to the sensitization to molecular components of storage mites (Gly d 2, Lep d 2—NPC2 family), lipocalins (Can f 1, Can f 2, Can f 4, and Can f 6), arginine kinase (Asp f 6, Bla g 9, Der p 20, Pen m 2), uteroglobin (Fel d 1, Ory c 3), Mn superoxide dismutase (Mala s 11), PR-10 proteins (Fag s 1, Mal d 1, Cor a 1.0401, Cor a 1.0103), molecular components of the peritrophin-like domain (Der p 21, Der p 23), and to Secc pollen. In the subgroup of patients suffering from bronchial asthma, the significant role play molecular components from house dust mites and storage mites (Lep d 2, Der p 2, Der f 2—NPC2 family), cysteine protease (Der p 1), peritrophin-like protein domain (Der p 21, Der p 23), enolase from Alternaria alternata (Alt a 6), and Beta expansin Phl p 1. Conclusion: The results of our study demonstrate the detailed profile of sensitization to allergens reagents (allergen extract and molecular components) in patients with atopic dermatitis. We show the significance of disturbed epidermal barrier, resulting in increased penetration of allergens. We confirmed the significant relationship between the severity of AD, the occurrence of bronchial asthma and allergic rhinitis, and high levels of specific IgE to allergen reagents. Our results may be important for regime measures and immunotherapy; Der p 23 shall be considered as an essential component for the diagnosis and specific immunotherapy of house dust mite allergy.
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Affiliation(s)
- Jarmila Čelakovská
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, 50002 Hradec Králové, Czech Republic
- Correspondence:
| | - Josef Bukač
- Department of Medical Biophysic, Medical Faculty of Charles University, 50002 Hradec Králové, Czech Republic; (J.B.); (E.C.)
| | - Eva Cermákova
- Department of Medical Biophysic, Medical Faculty of Charles University, 50002 Hradec Králové, Czech Republic; (J.B.); (E.C.)
| | - Radka Vaňková
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, 50002 Hradec Králové, Czech Republic; (R.V.); (J.K.); (C.A.)
| | - Hana Skalská
- Department of Informatics and Quantitative Methods, Faculty of Informatics and Management, University of Hradec Kralove, 50003 Hradec Králové, Czech Republic;
| | - Jan Krejsek
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, 50002 Hradec Králové, Czech Republic; (R.V.); (J.K.); (C.A.)
| | - Ctirad Andrýs
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, 50002 Hradec Králové, Czech Republic; (R.V.); (J.K.); (C.A.)
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Čelakovská J, Bukač J, Vaňková R, Krejsek J, Andrýs C. Food allergy to apple, peach and celery in atopic dermatitis patients, analysis of sensitisation to molecular components. FOOD AGR IMMUNOL 2021. [DOI: 10.1080/09540105.2021.1911957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- J. Čelakovská
- Faculty Hospital and Medical Faculty of Charles University, Department of Dermatology and Venereology, Hradec Králové, Czech Republic
| | - J. Bukač
- Medical Faculty of Charles University, Department of Medical Biophysic, Hradec Králové, Czech Republic
| | - R. Vaňková
- Faculty Hospital and Medical Faculty of Charles University, Department of Clinical Immunology and Allergy, Hradec Králové, Czech Republic
| | - J. Krejsek
- Faculty Hospital and Medical Faculty of Charles University, Department of Clinical Immunology and Allergy, Hradec Králové, Czech Republic
| | - C. Andrýs
- Faculty Hospital and Medical Faculty of Charles University, Department of Clinical Immunology and Allergy, Hradec Králové, Czech Republic
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Atopic Dermatitis and Sensitisation to Molecular Components of Alternaria, Cladosporium, Penicillium, Aspergillus, and Malassezia-Results of Allergy Explorer ALEX 2. J Fungi (Basel) 2021; 7:jof7030183. [PMID: 33806376 PMCID: PMC8001933 DOI: 10.3390/jof7030183] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 02/07/2023] Open
Abstract
Progress in laboratory diagnostics of IgE-mediated allergies is being made through the use of component-resolved diagnosis. The aim of our study is to analyze the sensitization profile to allergen reagents in patients suffering from atopic dermatitis with the use of the ALEX 2–Allergy Explorer and especially to show the sensitization to molecular components of molds and yeast. The complete dermatological and allergological examination including the examination of the sensitization to allergen reagents with Allergy Explorer ALEX 2 testing was performed. The relation between the sensitization to molecular components of molds and yeast and the severity of atopic dermatitis, and the occurrence of bronchial asthma and allergic rhinitis was evaluated. Altogether, 100 atopic dermatitis patients were examined—48 men and 52 women, with an average age of 40.9 years. The sensitization to Mala s 6, Mala s 11, Sac c, Asp f 6, Cla h and Cla h 8 correlates to the severity of atopic dermatitis. The sensitization to Sac c, Alt a 6, Cla h, Cla h 8 was observed significantly more frequently in patients suffering from bronchial asthma to Mala s 6 in patients suffering from allergic rhinitis. In patients with severe form of atopic dermatitis (AD), a very high level of specific IgE was recorded to Mala s 11 (in 36%) and to Asp f 6 (in 12%).
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11
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Traina G, Martelli A, Barberi S, Licari A, Marseglia GL, Tosca MA, Ciprandi G. Evaluation of safety and tolerability of a rush up-dosing allergen-specific immunotherapy with grass pollen, birch, hazel, and alder allergoid in children with allergic rhinoconjunctivitis, with or without asthma. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021037. [PMID: 33682836 PMCID: PMC7975937 DOI: 10.23750/abm.v92i1.9096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 02/11/2020] [Indexed: 11/24/2022]
Abstract
Background: Usually, the number of injections required to achieve the maintenance dose in subcutaneous immunotherapy (SCIT) is relatively small for some of the currently used allergens, but this may still be uncomfortable for patients, thus compromising adherence and compliance. Objective: The purpose of this study was to evaluate the safety and tolerability of a dose acceleration of a conventional induction schedule using an allergoid extract of grass pollen, birch, hazel, and alder, needed to achieve the ideal maintenance dose. Methods: In this open-label study, 34 patients with allergic rhinoconjunctivitis, with or without asthma, were treated with SCIT using an allergoid for grass pollen or birch or mix trees with an increase in accelerated induction dose comprising only 3 injections, one per week, compared to a conventional induction pattern in five injections (once a week). Safety determination was assessed by evaluating local and systemic adverse events. Tolerability was evaluated by patients and physicians who performed the treatment. Results: No treatment-related adverse events were observed in any of the patients undergoing rush SCIT. No local reactions, no systemic reactions of any degree (WAO Grade) have been observed. Tolerability has always been rated as very good by both patients and physician. Conclusions: The induction phase, needed to achieve the monthly maintenance dose for a pollen extract, can be greatly accelerated, ensuring a tolerability comparable to that of the conventional schedule. (www.actabiomedica.it)
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Vaňková R, Čelakovská J, Bukač J, Krčmová I, Krejsek J, Andrýs C. Sensitization to Molecular Components in 104 Atopic Dermatitis Patients in Relation to Subgroups of Patients Suffering from Bronchial Asthma and Allergic Rhinitis. ACTA MEDICA (HRADEC KRÁLOVÉ) 2020; 63:164-175. [PMID: 33355077 DOI: 10.14712/18059694.2020.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease. The progression from AD to bronchial asthma (AB) and allergic rhinitis (AR) is called atopic march. The aim of this study was to evaluate the difference in the sensitization to molecular components in patients suffering from AD in relation to subgroups of patients with AR and AB. MATERIAL AND METHODS The complete dermatological and allergological examinations were performed. Specific IgE antibodies against 112 molecular components were measured with the multiplex ImmnoCAP ISAC test. RESULTS Altogether 104 atopic dermatitis patients (50 men, 54 women) at the average age 40.1 years were examined. The sensitization to molecular components was confirmed in 93.3% of patients. The sensitization to components of mites, grasses, trees, animals, moulds, and shrimps was significantly more frequent in patients with severe form of AD and the sensitization to components of grasses, trees, and moulds was significantly higher in subgroup of patients with AB. In subgroup of patients suffering from AR the higher occurrence of pollen-derived and pollen-food derived PR-10 proteins, grasses, mites, and animals was observed also. CONCLUSIONS We have confirmed the significant differences in the sensitization to molecular components in patients suffering from severe form of AD, and in subgroups of patients suffering from AB and AR. These molecular components may play the important role in the consecutive development of different allergy pathologies called atopic march.
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Affiliation(s)
- Radka Vaňková
- Department of Clinical Immunology and Allergology, University Hospital Hradec Králové and Faculty of Medicine in Hradec Králové, Charles University, Czech Republic
| | - Jarmila Čelakovská
- Department of Dermatology and Venereology, University Hospital Hradec Králové and Faculty of Medicine in Hradec Králové, Charles University, Czech Republic.
| | - Josef Bukač
- Department of Medical Biophysic, University Hospital Hradec Králové and Faculty of Medicine in Hradec Králové, Charles University, Czech Republic
| | - Irena Krčmová
- Department of Clinical Immunology and Allergology, University Hospital Hradec Králové and Faculty of Medicine in Hradec Králové, Charles University, Czech Republic
| | - Jan Krejsek
- Department of Clinical Immunology and Allergology, University Hospital Hradec Králové and Faculty of Medicine in Hradec Králové, Charles University, Czech Republic
| | - Ctirad Andrýs
- Department of Clinical Immunology and Allergology, University Hospital Hradec Králové and Faculty of Medicine in Hradec Králové, Charles University, Czech Republic
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13
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Aglas L, Bethanis A, Chrusciel P, Stolz F, Gruen M, Jaakkola UM, Jongejan L, Yatkin E, Van Ree R. In vivo Induction of Functional Inhibitory IgG Antibodies by a Hypoallergenic Bet v 1 Variant. Front Immunol 2020; 11:2118. [PMID: 33013894 PMCID: PMC7494741 DOI: 10.3389/fimmu.2020.02118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/05/2020] [Indexed: 01/27/2023] Open
Abstract
Allergic sensitization to the major allergen Bet v 1 represents the dominating factor inducing a vast variety of allergic symptoms in birch pollen allergic patients worldwide, including the pollen food allergy syndrome. In order to overcome the huge socio-economic burden associated with allergic diseases, allergen-specific immunotherapy (AIT) as a curative strategy to manage the disease was introduced. Still, many hurdles related to this treatment exist making AIT not the patients’ first choice. To improve the current situation, the development of hypoallergen-based drug products has raised attention in the last decade. Herein, we investigated the efficacy of the novel AIT candidate BM4, a hypoallergenic variant of Bet v 1, to induce treatment-relevant cross-reactive Bet v 1-specific IgG antibodies in two different mammals, Wistar rats and New Zealand White rabbits. We further analyzed the cross-reactivity of BM4-induced Wistar rat antibodies with the birch pollen-associated food allergens Mal d 1 and Cor a 1, and the functional capability of the induced antibodies to act as IgE-blocking IgG antibodies. Enzyme-linked immunosorbent assay (ELISA) was used to determine the titers of rat IgG1, IgG2a, IgG2b, and IgE, as well as rabbit IgG and IgE antibodies. To address the functional relevance of the induced IgG antibodies, the capacity of rat sera to suppress binding of human IgE to Bet v 1 was investigated by using an inhibition ELISA and an IgE-facilitated allergen-binding inhibition assay. We found that the treatment with BM4 induced elevated Bet v 1-specific IgG antibody titers in both mammalian species. In Wistar rats, high BM4-specific IgG1, IgG2a, and IgG2b titers (104 to 106) were induced, which cross-reacted with wild-type Bet v 1, and the homologous allergens Mal d 1 and Cor a 1. Rat allergen-specific IgG antibodies sustained upon treatment discontinuation. Sera of rats immunized with BM4 were able to significantly suppress binding of human IgE to the wild-type allergens and CD23-mediated human IgE-facilitated Bet v 1 binding on B cells. By contrast, treatment-induced IgE antibody levels were low or undetectable. In summary, BM4 induced a robust IgG immune response that efficiently blocked human IgE-binding to wild-type allergens, underscoring its potential therapeutic value in AIT.
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Affiliation(s)
- Lorenz Aglas
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | | | | | - Frank Stolz
- Biomay AG, Vienna Competence Center, Vienna, Austria
| | - Melanie Gruen
- Department of Biosciences, University of Salzburg, Salzburg, Austria
| | | | | | - Emrah Yatkin
- Central Animal Laboratory, University of Turku, Turku, Finland
| | - Ronald Van Ree
- Amsterdam University Medical Centers, Amsterdam, Netherlands
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14
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Gökkaya M, Damialis A, Nussbaumer T, Beck I, Bounas-Pyrros N, Bezold S, Amisi MM, Kolek F, Todorova A, Chaker A, Aglas L, Ferreira F, Redegeld FA, Brunner JO, Neumann AU, Traidl-Hoffmann C, Gilles S. Defining biomarkers to predict symptoms in subjects with and without allergy under natural pollen exposure. J Allergy Clin Immunol 2020; 146:583-594.e6. [DOI: 10.1016/j.jaci.2020.02.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 01/11/2023]
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15
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Čelakovská J, Bukač J, Vaňková R, Krcmova I, Krejsek J, Andrýs C. ISAC multiplex testing – results of examination in 100 patients suffering from atopic dermatitis. FOOD AGR IMMUNOL 2020. [DOI: 10.1080/09540105.2020.1799947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- J. Čelakovská
- Department of Dermatology and Venereology, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - J. Bukač
- Department of Medical Biophysics, Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - R. Vaňková
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - I. Krcmova
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - J. Krejsek
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
| | - C. Andrýs
- Department of Clinical Immunology and Allergy, Faculty Hospital and Medical Faculty of Charles University, Hradec Králové, Czech Republic
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16
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Westman M, Åberg K, Apostolovic D, Lupinek C, Gattinger P, Mittermann I, Andersson N, Melén E, Bergström A, Antó JM, Bousquet J, Valenta R, Wickman M, van Hage M. Sensitization to grass pollen allergen molecules in a birth cohort—natural Phl p 4 as an early indicator of grass pollen allergy. J Allergy Clin Immunol 2020; 145:1174-1181.e6. [DOI: 10.1016/j.jaci.2020.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/19/2019] [Accepted: 01/09/2020] [Indexed: 12/20/2022]
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17
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Jones PJ, Koolhof IS, Wheeler AJ, Williamson GJ, Lucani C, Campbell SL, Bowman DMJS, Johnston FH. Can smartphone data identify the local environmental drivers of respiratory disease? ENVIRONMENTAL RESEARCH 2020; 182:109118. [PMID: 32069747 DOI: 10.1016/j.envres.2020.109118] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/09/2019] [Accepted: 01/03/2020] [Indexed: 06/10/2023]
Abstract
Asthma and allergic rhinitis (or hay fever) are ubiquitous, chronic health conditions that seasonally affect a sizeable proportion of the population. Both are commonly triggered or exacerbated by environmental conditions including aeroallergens, air quality and weather. Smartphone technology offers new opportunities to identify environmental drivers by allowing large-scale, real-time collection of day-to-day symptoms. As yet, however, few studies have explored the potential of this technology to provide useful epidemiological data on environment-symptom relationships. Here, we use data from the smartphone app 'AirRater' to examine relationships between asthma and allergic rhinitis symptoms and weather, air quality and pollen loads in Hobart, Tasmania, Australia. We draw on symptom data logged by app users over a three-year period and use time-series analysis to assess the relationship between symptoms and environmental co-variates. Symptoms are associated with particulate matter (IRR 1.06, 95% CI: 1.04-1.08), maximum temperature (IRR 1.28, 95% CI: 1.13-1.44) and pollen taxa including Betula (IRR 1.04, 95% CI: 1.02-1.07), Cupressaceae (IRR 1.02, 95% CI: 1.01-1.04), Myrtaceae (IRR 1.06, 95% CI: 1.02-1.10) and Poaceae (IRR 1.05, 95% CI: 1.01-1.09). The importance of these pollen taxa varies seasonally and more taxa are associated with allergic rhinitis (eye/nose) than asthma (lung) symptoms. Our results are congruent with established epidemiological evidence, while providing important local insights including the association between symptoms and Myrtaceae pollen. We conclude that smartphone-sourced data can be a useful tool in environmental epidemiology.
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Affiliation(s)
- Penelope J Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Iain S Koolhof
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Amanda J Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, 3000, Australia.
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Christopher Lucani
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Sharon L Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Public Health Services, Department of Health, Hobart, TAS, 7000, Australia.
| | - David M J S Bowman
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Public Health Services, Department of Health, Hobart, TAS, 7000, Australia.
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18
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Vachová M, Panzner P, Vlas T, Vítovcová P. Analysis of Sensitization Profiles in Central European Allergy Patients Focused on Animal Allergen Molecules. Int Arch Allergy Immunol 2020; 181:278-284. [PMID: 32018259 DOI: 10.1159/000505518] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/17/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Frequently observed multiple sensitizations to several animals highlights the importance of a molecular diagnosis, distinguishing between sensitizations specific to single species and sensitizations due to cross-reactivity. OBJECTIVE The aim of our study was to assess the usefulness of a molecular diagnosis in the description of sensitization profiles in allergy patients living in Central Europe, with a particular focus on animal-derived molecules. METHODS The molecular diagnosis was performed using the ImmunoCAP ISAC microarray. Results of 1,255 allergy patients were subjected to statistical analysis. RESULTS The highest sensitization rates were observed for uteroglobin Fel d 1 (31.8%) and kallikrein Can f 5 (16.4%), followed by animal lipocalins Can f 1 (13.9%), Equ c 1 (6.2%), Fel d 4 (5.3%), Can f 2 (4.2%), and Mus m 1 (4.1%). Sensitization rates to serum albumins Fel d 2, Can f 3, Equ c 3, and Bos d 6 were very low, with the highest being 3.2% to Fel d 2. Detailed subanalysis confirmed the dominant role of Fel d 1 or Can f 5 and/or Can f 1 in cat- or dog-sensitized patients, respectively. Further analysis focused on lipocalins and albumins confirmed a high rate of cosensitizations within both groups. CONCLUSION The sensitization to animal allergen molecules is very frequent in Central Europe. The most common is sensitization to species-specific cat uteroglobin Fel d 1 and dog kallikrein Can f 5, followed by sensitizations to animal lipocalins. Our data suggest that commonly observed multiple sensitizations detected by extract approach can be explained not only by true cosensitization, but also by cross-reactivity, mainly in the frame of lipocalins. Cross-reactive serum albumins are minor sensitizers and are probably not important from this point of view.
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Affiliation(s)
- Martina Vachová
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia,
| | - Petr Panzner
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Tomáš Vlas
- Department of Immunology and Allergology, University Hospital in Pilsen, Pilsen, Czechia
| | - Petra Vítovcová
- Department of Immunology and Allergology, University Hospital in Pilsen, Pilsen, Czechia
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Zielen S, Plückhahn K, Akboga Y, Rieker-Schwienbacher J, Thieme U, Rosewich M. Fast up-dosing with a birch allergoid is safe and well tolerated in allergic rhinitis patients with or without asthma. Immunotherapy 2020; 11:177-187. [PMID: 30730274 DOI: 10.2217/imt-2018-0143] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Subcutaneous immunotherapy is effective in treating allergic rhinoconjunctivitis and asthma, but is still inconvenient when heavy schedules are used. A faster dose escalation is desirable. MATERIALS & METHODS In this open-label, Phase II trial, 130 adults were randomized 1:1 to receive a birch pollen allergoid subcutaneous immunotherapy. Group I with four weekly injections and Group II with seven weekly injections. Safety, tolerability and immunogenicity were assessed. RESULTS Mild-to-moderate treatment-related adverse events were reported for 57.7% of the patients (Group I: 36, Group II: 39). Tolerability was assessed by physicians and rated as 'good' or 'very good' for 55 patients in Group I (87.3%) and for 63 patients in Group II (94.0%). Levels of IgG and IgG4 increased before and after treatment significantly (p < 0.0001) in both groups. CONCLUSION Standard versus fast dose escalation is comparable in terms of safety and tolerability.
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Affiliation(s)
- Stefan Zielen
- Department for Children & Adolescents, Division for Allergology, Pneumology & Cystic Fibrosis, University Hospital Goethe University, Frankfurt am Main, 60590, Germany
| | | | | | | | - Uta Thieme
- HNO Practice Dr. Uta Thieme, Duisburg, 47051, Germany
| | - Martin Rosewich
- Department for Children & Adolescents, Division for Allergology, Pneumology & Cystic Fibrosis, University Hospital Goethe University, Frankfurt am Main, 60590, Germany
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Biedermann T, Winther L, Till SJ, Panzner P, Knulst A, Valovirta E. Birch pollen allergy in Europe. Allergy 2019; 74:1237-1248. [PMID: 30829410 DOI: 10.1111/all.13758] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/22/2019] [Accepted: 01/28/2019] [Indexed: 12/25/2022]
Abstract
Birch and other related trees of the families Betulaceae and Fagaceae (alder, hazel, oak, hornbeam, chestnut, and beech) constitute the birch homologous group. This grouping is primarily based on the extensive IgE cross-reactivity of allergen homologs to the major birch allergen Bet v 1. Birch pollen is the most dominant tree pollen in Northern and Central Europe and is a major cause of allergic rhinitis and, possibly, asthma symptoms. Over the last few decades, levels of birch pollen have risen and the period of exposure has increased due to climate changes. Subsequently, the prevalence of birch pollen sensitization has also increased. The cross-reactivity and sequential pollen seasons within the birch homologous group create a prolonged symptomatic allergy period beyond birch pollen alone. Furthermore, many plant food allergens contain homologs to Bet v 1, meaning that the majority of patients with birch pollen allergy suffer from secondary pollen food syndrome (PFS). As a result, the negative impact on health-related quality of life (HRQoL) in patients allergic to birch pollen is significant. The purpose of this manuscript was to narratively review topics of interest such as taxonomy, cross-reactivity, prevalence, clinical relevance, PFS, and HRQoL with regard to birch pollen allergy from a European perspective.
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Affiliation(s)
- T. Biedermann
- Department of Dermatology and Allergology Technical University of Munich Munich Germany
| | - L. Winther
- Allergy Clinic Department of Dermato‐Allergology Gentofte Hospital Copenhagen Denmark
| | - S. J. Till
- Kings College London Guy's Hospital London UK
| | - P. Panzner
- Department of Immunology and Allergology Faculty of Medicine in Pilsen Charles University Prague Czech Republic
| | - A. Knulst
- Department of Dermatology/Allergology University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - E. Valovirta
- Department of Lung Diseases and Clinical Allergology University of Turku and Allergy Clinic Terveystalo, Turku Finland
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Najafi N, Hofer G, Gattinger P, Smiljkovic D, Blatt K, Selb R, Stoecklinger A, Keller W, Valent P, Niederberger V, Thalhamer J, Valenta R, Flicker S. Fusion proteins consisting of Bet v 1 and Phl p 5 form IgE-reactive aggregates with reduced allergenic activity. Sci Rep 2019; 9:4006. [PMID: 30850635 PMCID: PMC6408504 DOI: 10.1038/s41598-019-39798-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 01/28/2019] [Indexed: 11/16/2022] Open
Abstract
The cross-linking of effector cell-bound IgE antibodies by allergens induces the release of inflammatory mediators which are responsible for the symptoms of allergy. We demonstrate that a recombinant hybrid molecule consisting of the major birch (Bet v 1) and grass (Phl p 5) pollen allergen exhibited reduced allergenic activity as compared to equimolar mixes of the isolated allergens in basophil activation experiments. The reduced allergenic activity of the hybrid was not due to reduced IgE reactivity as demonstrated by IgE binding experiments using sera from allergic patients. Physicochemical characterization of the hybrid by size exclusion chromatography, dynamic light scattering, negative-stain electron microscopy and circular dichroism showed that the hybrid occurred as folded aggregate whereas the isolated allergens were folded monomeric proteins. IgG antibodies raised in rabbits against epitopes of Bet v 1 and Phl p 5 showed reduced reactivity with the hybrid compared to the monomeric allergens. Our results thus demonstrate that aggregation can induce changes in the conformation of allergens and lead to the reduction of allergenic activity. This is a new mechanism for reducing the allergenic activity of allergens which may be important for modifying allergens to exhibit reduced side effects when used for allergen-specific immunotherapy.
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Affiliation(s)
- N Najafi
- Division of Immunopathology, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - G Hofer
- Institute of Molecular Biosciences, BioTechMed Graz, University of Graz, Graz, Austria
| | - P Gattinger
- Division of Immunopathology, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - D Smiljkovic
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - K Blatt
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - R Selb
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - A Stoecklinger
- Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - W Keller
- Institute of Molecular Biosciences, BioTechMed Graz, University of Graz, Graz, Austria
| | - P Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - V Niederberger
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - J Thalhamer
- Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - R Valenta
- Division of Immunopathology, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,NRC Institute of Immunology FMBA of Russia, Moscow, Russia.,Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
| | - S Flicker
- Division of Immunopathology, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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Klingebiel C, Chantran Y, Arif‐Lusson R, Ehrenberg AE, Östling J, Poisson A, Liabeuf V, Agabriel C, Birnbaum J, Porri F, Sarrat A, Apoil P, Vivinus M, Garnier L, Chiriac AM, Caimmi D, Bourrain J, Demoly P, Guez S, Boralevi F, Lovato B, Palussière C, Leroy S, Bourrier T, Giovannini‐Chami L, Gouitaa M, Aferiat‐Derome A, Charpin D, Sofalvi T, Cabon‐Boudard I, Massabie‐Bouchat Y, Hofmann B, Bonardel N, Dron‐Gonzalvez M, Sterling B, Carsin A, Vivinus S, Poitevin B, Nicolau L, Liautard G, Soler C, Mezouar S, Annesi‐Maesano I, Mège J, Lidholm J, Vitte J. Pru p 7 sensitization is a predominant cause of severe, cypress pollen‐associated peach allergy. Clin Exp Allergy 2019; 49:526-536. [DOI: 10.1111/cea.13345] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 11/11/2018] [Accepted: 12/12/2018] [Indexed: 12/21/2022]
Affiliation(s)
| | - Yannick Chantran
- UPMC Univ Paris 06 INSERM UMRS 938 Centre de Recherche Saint‐Antoine, team “Immune System, Neuroinflammation and Neurodegenerative Diseases” Hôpital Saint‐Antoine Sorbonne Universités Paris France
- Immunology Department AP‐HP Saint‐Antoine Hospital Paris France
| | - Rihane Arif‐Lusson
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
| | | | | | - Alain Poisson
- Service de Pneumo‐Allergologie Hôpital Saint Joseph Marseille France
| | - Valérie Liabeuf
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Dermatologie‐Vénéréologie Marseille France
| | - Chantal Agabriel
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Pédiatrie Multidisciplinaire Marseille France
| | - Joëlle Birnbaum
- Service de Pneumologie et Allergologie CH du Pays d'Aix Aix‐en‐Provence France
| | - Françoise Porri
- Service de Pneumo‐Allergologie Hôpital Saint Joseph Marseille France
| | - Anne Sarrat
- Laboratoire d'Immunologie et Immunogénétique GH Pellegrin CHU Bordeaux Bordeaux France
| | - Pol‐André Apoil
- Institut Fédératif de Biologie Hôpital Purpan, CHU Toulouse Toulouse France
| | - Mylène Vivinus
- Laboratoire d'Immunologie Hôpital de l'Archet CHU Nice Nice France
| | - Lorna Garnier
- Laboratoire d'Immunologie CH Lyon Sud CHU Lyon Pierre‐Bénite France
| | - Anca Mirela Chiriac
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
- Sorbonne Universités INSERM UMRS 1136 IPLESP, team EPAR Paris France
| | - Davide‐Paolo Caimmi
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
- Sorbonne Universités INSERM UMRS 1136 IPLESP, team EPAR Paris France
| | - Jean‐Luc Bourrain
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
| | - Pascal Demoly
- Département de pneumologie et addictologie CHU Montpellier Hôpital Arnaud‐de‐Villeneuve Univ Montpellier Montpellier France
- Sorbonne Universités INSERM UMRS 1136 IPLESP, team EPAR Paris France
| | - Stéphane Guez
- Unité d'allergologie, GH Pellegrin, CHU Bordeaux Bordeaux France
| | - Franck Boralevi
- Unité de Dermatologie Pédiatrique Hôpital Pellegrin‐Enfants, CHU Bordeaux Bordeaux France
| | | | | | - Sylvie Leroy
- Service de Pneumologie Hôpital Pasteur CHU Nice Nice France
| | | | | | - Marion Gouitaa
- Aix‐Marseille Univ APHM, Hôpital Nord Service de Pneumologie Marseille France
| | | | - Denis Charpin
- Aix‐Marseille Univ APHM, Hôpital Timone Unité de Pneumologie Marseille France
| | - Tünde Sofalvi
- Aix‐Marseille Univ APHM, Hôpital Nord Service de Pneumologie Marseille France
| | - Isabelle Cabon‐Boudard
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Chirurgie Pédiatrique Marseille France
| | | | | | | | | | - Benoît Sterling
- Medical Office Marseille France
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Pneumo‐Pédiatrie Marseille France
| | - Ania Carsin
- Aix‐Marseille Univ APHM, Hôpital Timone Service de Pneumo‐Pédiatrie Marseille France
| | - Serge Vivinus
- Service de Pneumologie Hôpital Pasteur CHU Nice Nice France
| | | | | | | | | | - Soraya Mezouar
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
| | | | - Jean‐Louis Mège
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
| | | | - Joana Vitte
- Aix‐Marseille Univ IRD APHM MEPHI IHU Méditerranée Infection Marseille France
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Panzner P, Vachová M, Vlas T, Vítovcová P, Brodská P, Malý M. Cross-sectional study on sensitization to mite and cockroach allergen components in allergy patients in the Central European region. Clin Transl Allergy 2018; 8:19. [PMID: 29881542 PMCID: PMC5985581 DOI: 10.1186/s13601-018-0207-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/23/2018] [Indexed: 01/19/2023] Open
Abstract
Background The major sources of allergens in the indoor air include house dust mites, dander derived from domestic animals and rodents, cockroach, and several fungi. Mites are the main cause of allergies in some countries with a warmer climate, but the epidemiological significance of mite and cockroach allergens in Central Europe has not been established yet. Methods We assessed sensitization profiles of allergy patients in a Central European region in regard to sensitization to mites and cockroach. We used molecular diagnosis by means of the microarray ISAC, and we investigated 1766 patients with clinical suspicion to an allergic disorder. 1255 of them were positive to at least one allergen component, and this group was subjected to statistical analysis. Results The sensitization to at least one mite-specific molecule (Der p 1, 2, Der f 1, 2) was observed relatively frequently in 32.7% of patients. Specific IgE to mite group 2 molecules is almost fully cross-reactive. Group 1 allergens are also cross-reactive, but in some patients, a species-specific response was observed. Relatively high rate of sensitization both to group 1 and 2 allergens in our patients indicates the greater role of co-sensitizations. Isolated sensitizations to molecules derived from glyciphagid mites Lep d 2 and/or Blo t 5 without sensitization to other mite-derived molecules were observed only exceptionally (in 0.6% of cases). True sensitization to at least one cockroach-specific molecule (Bla g 1, 2, 5) was very rare (in 0.6% of cases), and nearly all of them were co-sensitizations with other noncockroach-derived molecules. Sensitization to an inhaled tropomyosin was observed rarely in 2.2% of patients (Der p 10 in 1.9% and Bla g 7 in 1.5%). Co-sensitization of inhaled tropomyosins with the respective mite- or cockroach-specific molecules was observed only in the minority of patients suggesting the different route of sensitization being more frequent. Conclusions The majority of patients are co-sensitized to several molecules of the respective allergen source. The knowledge of this molecular spectrum of sensitization is important for optimal diagnosis and treatment in respect to allergen content in mite extracts used for diagnostic and therapeutic purposes. In regard to the sensitization patterns of Central European patients, it is necessary to point out the importance of quantifying at least three major mite components Der f 1, Der p 1 and Der f 2 (or Der p 2).
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Affiliation(s)
- Petr Panzner
- 1Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Martina Vachová
- 1Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Tomáš Vlas
- 2Department of Immunology and Allergology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Petra Vítovcová
- 2Department of Immunology and Allergology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Petra Brodská
- 3Department of Dermatovenerology, Faculty Hospital in Pilsen, Pilsen, Czech Republic
| | - Marek Malý
- 4The National Institute of Public Health, Prague, Czech Republic
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ANALYSIS OF SENSITIZATION FEATURES TO WEED POLLEN AND EFFICACY OF ALLERGEN IMMUNOTHERAPY IN PATIENTS OF THE CENTRAL AND WESTERN REGIONS IN UKRAINE. WORLD OF MEDICINE AND BIOLOGY 2018. [DOI: 10.26724/2079-8334-2018-4-66-56-62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25
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Jensen-Jarolim E, Jensen AN, Canonica GW. Debates in allergy medicine: Molecular allergy diagnosis with ISAC will replace screenings by skin prick test in the future. World Allergy Organ J 2017; 10:33. [PMID: 28959378 PMCID: PMC5604284 DOI: 10.1186/s40413-017-0162-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/07/2017] [Indexed: 02/06/2023] Open
Abstract
In today's clinical practice patients' skin is used as screening organ for diagnosing type 1 allergy. According to European guidelines skin prick testing with a panel of 18 allergen extracts is recommended, in the US between 10 to 50 allergens are used. The specificity and sensitivity of skin testing is individually highly variable depending on age, body mass, and skin barrier status. In atopic inflammation skin testing gives more false positive results. Smaller skin area and strain limits prick testing in small children. Although the risk for systemic reactions in skin prick testing is very small, emergency medications must be available. Considering the fact that IgE is the only reliable biomarker for type I allergy, upfront IgE screening with ISAC, followed by fewer skin tests to approve positive sensitizations, is proposed. It is time to arrive in the age of molecular allergy diagnosis in daily patient care.
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Affiliation(s)
- E. Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- The interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, University of Vienna, Vienna, Austria
| | - A. N. Jensen
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
| | - G. W. Canonica
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University & Research Hospital, Rozzano, Milan, Italy
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26
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Tscheppe A, Breiteneder H. Recombinant Allergens in Structural Biology, Diagnosis, and Immunotherapy. Int Arch Allergy Immunol 2017; 172:187-202. [PMID: 28467993 DOI: 10.1159/000464104] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The years 1988-1995 witnessed the beginning of allergen cloning and the generation of recombinant allergens, which opened up new avenues for the diagnosis and research of human allergic diseases. Most crystal and solution structures of allergens have been obtained using recombinant allergens. Structural information on allergens allows insights into their evolutionary biology, illustrates clinically observed cross-reactivities, and makes the design of hypoallergenic derivatives for allergy vaccines possible. Recombinant allergens are widely used in molecule-based allergy diagnosis such as protein microarrays or suspension arrays. Recombinant technologies have been used to produce well-characterized, noncontaminated vaccine components with known biological activities including a variety of allergen derivatives with reduced IgE reactivity. Such recombinant hypoallergens as well as wild-type recombinant allergens have been used successfully in several immunotherapy trials for more than a decade to treat birch and grass pollen allergy. As a more recent application, the development of antibody repertoires directed against conformational epitopes during immunotherapy has been monitored by recombinant allergen chimeras. Although much progress has been made, the number and quality of recombinant allergens will undoubtedly increase and keep improving our knowledge in basic scientific investigations, diagnosis, and therapy of human allergic diseases.
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Affiliation(s)
- Angelika Tscheppe
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
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27
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Stemeseder T, Klinglmayr E, Moser S, Lueftenegger L, Lang R, Himly M, Oostingh GJ, Zumbach J, Bathke AC, Hawranek T, Gadermaier G. Cross-sectional study on allergic sensitization of Austrian adolescents using molecule-based IgE profiling. Allergy 2017; 72:754-763. [PMID: 27753449 DOI: 10.1111/all.13071] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Allergen-specific IgE antibodies are a hallmark of type I allergy. The aim of this cross-sectional study was to analyze the sensitization profiles of an Austrian adolescent population utilizing molecule-based IgE diagnosis. METHODS Serum samples of 501 nonselected pupils from Salzburg, Austria, were tested in ImmunoCAP ISAC® for IgE reactivity to 112 single allergens. Sensitization profiles were assessed and statistically coordinated with reported allergies. RESULTS In the population aged 12-21 years, 53.5% showed IgE reactivity to at least one allergen tested. The highest prevalence was found for Phl p 1 from grass pollen (26.5%), group 2 mite allergens (18.2%), Bet v 1 from birch pollen (16.3%) and Fel d 1 from cat (14.4%). The majority of participants showed a complex sensitization profile and reacted on average to 9 allergens. Pollen sensitization was highly prevalent (41.7%) and mainly driven by group I grass and PR-10 allergens of the Betulaceae family, while Pla l 1 represented the most relevant weed. Diagnosed and self-reported allergies were noted in 21.9% and 45.5% of participants, respectively, and correlated well with in vitro results. Among atopic individuals, 71.4% reported to suffer from at least one allergy; concordance was found for grass and cat sensitization, while venom- and weed pollen-positive individuals were frequently asymptomatic. CONCLUSIONS More than half of the tested adolescent population had already established an atopic status presenting a complex IgE reactivity profile dominated by pollen sensitization. Detailed molecule-based analysis allows determining relevant biomarkers and monitoring of the atopic status in populations.
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Affiliation(s)
- T. Stemeseder
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
| | - E. Klinglmayr
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
| | - S. Moser
- School of Education; University of Salzburg; Salzburg Austria
- TUM School of Education; Technical University of Munich; Munich Germany
| | - L. Lueftenegger
- Department of Dermatology; Paracelsus Medical University Salzburg; Salzburg Austria
- Biomedical Sciences; Salzburg University of Applied Sciences; Puch Salzburg Austria
| | - R. Lang
- Department of Dermatology; Paracelsus Medical University Salzburg; Salzburg Austria
| | - M. Himly
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
| | - G. J. Oostingh
- Biomedical Sciences; Salzburg University of Applied Sciences; Puch Salzburg Austria
| | - J. Zumbach
- School of Education; University of Salzburg; Salzburg Austria
| | - A. C. Bathke
- Department of Mathematics; University of Salzburg; Salzburg Austria
| | - T. Hawranek
- Department of Dermatology; Paracelsus Medical University Salzburg; Salzburg Austria
| | - G. Gadermaier
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
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29
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van Hage M, Schmid-Grendelmeier P, Skevaki C, Plebani M, Canonica W, Kleine-Tebbe J, Nystrand M, Jafari-Mamaghani M, Jakob T. Performance evaluation of ImmunoCAP® ISAC 112: a multi-site study. Clin Chem Lab Med 2017; 55:571-577. [PMID: 27816950 DOI: 10.1515/cclm-2016-0586] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/20/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND After the re-introduction of ImmunoCAP® ISAC sIgE 112 on the market, we undertook a study to evaluate the performance of this multiplex-based immunoassay for IgE measurements to allergen components. METHODS The study was carried out at 22 European and one South African site. Microarrays from different batches, eight specific IgE (sIgE) positive, three sIgE negative serum samples and a calibration sample were sent to participating laboratories where assays were performed according to the manufacturer's instructions. RESULTS For both the negative and positive samples results were consistent between sites, with a very low frequency of false positive results (0.014%). A similar pattern of results for each of the samples was observed across the 23 sites. Homogeneity analysis of all measurements for each sample were well clustered, indicating good reproducibility; unsupervised hierarchical clustering and classification via random forests, showed clustering of identical samples independent of the assay site. Analysis of raw continuous data confirmed the good accuracy across the study sites; averaged standardized, site-specific ISU-E values fell close to the center of the distribution of measurements from all sites. After outlier filtering, variability across the whole study was estimated at 25.5%, with values of 22%, 27.1% and 22.4% for the 'Low', 'Moderate to High' and 'Very High' concentration categories, respectively. CONCLUSIONS The study shows a robust performance of the ImmunoCAP® ISAC 112 immunoassay at different sites. Essentially the same results were obtained irrespective of assay site, laboratory-specific conditions and instruments, operator, or the use of microarrays from different batches.
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30
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Specific IgE and IgG measured by the MeDALL allergen-chip depend on allergen and route of exposure: The EGEA study. J Allergy Clin Immunol 2017; 139:643-654.e6. [DOI: 10.1016/j.jaci.2016.05.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 03/21/2016] [Accepted: 05/02/2016] [Indexed: 12/20/2022]
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Patelis A, Borres MP, Kober A, Berthold M. Multiplex component-based allergen microarray in recent clinical studies. Clin Exp Allergy 2016; 46:1022-32. [PMID: 27196983 DOI: 10.1111/cea.12761] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/13/2016] [Accepted: 05/14/2016] [Indexed: 01/07/2023]
Abstract
During the last decades component-resolved diagnostics either as singleplex or multiplex measurements has been introduced into the field of clinical allergology, providing important information that cannot be obtained from extract-based tests. Here we review recent studies that demonstrate clinical applications of the multiplex microarray technique in the diagnosis and risk assessment of allergic patients, and its usefulness in studies of allergic diseases. The usefulness of ImmunoCAP ISAC has been validated in a wide spectrum of allergic diseases like asthma, allergic rhinoconjunctivitis, atopic dermatitis, eosinophilic esophagitis, food allergy and anaphylaxis. ISAC provides a broad picture of a patient's sensitization profile from a single test, and provides information on specific and cross-reactive sensitizations that facilitate diagnosis, risk assessment, and disease management. Furthermore, it can reveal unexpected sensitizations which may explain anaphylaxis previously categorized as idiopathic and also display for the moment clinically non-relevant sensitizations. ISAC can facilitate a better selection of relevant allergens for immunotherapy compared with extract testing. Microarray technique can visualize the allergic march and molecular spreading in the preclinical stages of allergic diseases, and may indicate that the likelihood of developing symptomatic allergy is associated with specific profiles of sensitization to allergen components. ISAC is shown to be a useful tool in routine allergy diagnostics due to its ability to improve risk assessment, to better select relevant allergens for immunotherapy as well as detecting unknown sensitization. Multiplex component testing is especially suitable for patients with complex symptomatology.
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Affiliation(s)
- A Patelis
- Departement of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - M P Borres
- Immunodiagnostics, Thermo Fisher Scientific, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - A Kober
- Immunodiagnostics, Thermo Fisher Scientific, Uppsala, Sweden
| | - M Berthold
- Immunodiagnostics, Thermo Fisher Scientific, Uppsala, Sweden
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Abstract
Pollen allergens are one of the main causes of type I allergies affecting up to 30% of the population in industrialized countries. Climatic changes affect the duration and intensity of pollen seasons and may together with pollution contribute to increased incidences of respiratory allergy and asthma. Allergenic grasses, trees, and weeds often present similar habitats and flowering periods compromising clinical anamnesis. Molecule-based approaches enable distinction between genuine sensitization and clinically mostly irrelevant IgE cross-reactivity due to, e. g., panallergens or carbohydrate determinants. In addition, sensitivity as well as specificity can be improved and lead to identification of the primary sensitizing source which is particularly beneficial regarding polysensitized patients. This review gives an overview on relevant pollen allergens and their usefulness in daily practice. Appropriate allergy diagnosis is directly influencing decisions for therapeutic interventions, and thus, reliable biomarkers are pivotal when considering allergen immunotherapy in the context of precision medicine.
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Affiliation(s)
- Isabel Pablos
- />Department of Molecular Biology, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - Sabrina Wildner
- />Christian Doppler Laboratory for Biosimilar Characterization, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - Claudia Asam
- />Department of Molecular Biology, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - Michael Wallner
- />Department of Molecular Biology, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
| | - Gabriele Gadermaier
- />Department of Molecular Biology, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
- />Christian Doppler Laboratory for Biosimilar Characterization, University of Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria
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Chaker AM, Al-Kadah B, Luther U, Neumann U, Wagenmann M. An accelerated dose escalation with a grass pollen allergoid is safe and well-tolerated: a randomized open label phase II trial. Clin Transl Allergy 2016; 6:4. [PMID: 26839682 PMCID: PMC4736162 DOI: 10.1186/s13601-016-0093-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/15/2016] [Indexed: 11/20/2022] Open
Abstract
Background
The number of injections in the dose escalation of subcutaneous immunotherapy (SCIT) is small for some currently used hypoallergenic allergoids, but can still be inconvenient to patients and can impair compliance. The aim of this trial was to compare safety and tolerability of an accelerated to the conventional dose escalation scheme of a grass pollen allergoid.
Methods In an open label phase II trial, 122 patients were 1:1 randomized for SCIT using a grass pollen allergoid with an accelerated dose escalation comprising only 4 weekly injections (Group I) or a conventional dose escalation including 7 weekly injections (Group II). Safety determination included the occurrence of local and systemic adverse events. Tolerability was assessed by patients and physicians. Results Treatment-related adverse events were observed in 22 (36.1 %) patients in Group I and 15 (24.6 %) in Group II. Local reactions were reported by 18 patients in Group I and 11 in Group II. Five Grade 1 systemic reactions (WAO classification) were observed in Group I and 2 in Group II. Grade 2 reactions occurred 3 times in Group I and 2 times in Group II. Tolerability was rated as “good” or “very good” by 53 (86.9 %) patients in Group I and 59 (100 %) in Group II by investigators. Forty-eight patients in Group I (80.0 %) and 54 in Group II (91.5 %) rated tolerability as “good” or “very good”. Conclusions The dose escalation of a grass pollen allergoid can be accelerated with safety and tolerability profiles comparable to the conventional dose escalation.
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Affiliation(s)
- A M Chaker
- Department of Otolaryngology and ZAUM, Klinikum rechts der Isar, Technische Universität and Helmholtz Center Munich, Ismaninger Straße 22, 81675 Munich, Germany
| | - B Al-Kadah
- Department of Otorhinolaryngology, Saarland University Medical Centre, Kirrberger Straße, 66421 Homburg, Saar, Germany
| | - U Luther
- Joint Practice of Dermatologists, Allergology - Phlebology, Kaiser-Joseph-Str. 145, 79098 Freiburg im Breisgau, Germany
| | - U Neumann
- ENT Medicine, Bahnhofstr. 18, 39326 Wolmirstedt, Germany
| | - M Wagenmann
- Department of Otorhinolaryngology, University Hospital Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
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Valenta R, Wollmann E. Bedeutung rekombinanter Allergene und Allergenderivate. ALLERGOLOGIE 2016. [DOI: 10.1007/978-3-642-37203-2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Asero R, Tripodi S, Dondi A, Di Rienzo Businco A, Sfika I, Bianchi A, Candelotti P, Caffarelli C, Povesi Dascola C, Ricci G, Calamelli E, Maiello N, Miraglia Del Giudice M, Frediani T, Frediani S, Macrì F, Moretti M, Dello Iacono I, Patria MF, Varin E, Peroni D, Comberiati P, Chini L, Moschese V, Lucarelli S, Bernardini R, Pingitore G, Pelosi U, Tosca M, Cirisano A, Faggian D, Plebani M, Verga C, Matricardi PM. Prevalence and Clinical Relevance of IgE Sensitization to Profilin in Childhood: A Multicenter Study. Int Arch Allergy Immunol 2015; 168:25-31. [PMID: 26528861 DOI: 10.1159/000441222] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/16/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Little is known about the prevalence and clinical relevance of hypersensitivity to the plant panallergen profilin in children. OBJECTIVES The present study aimed to investigate prevalence, risk factors and clinical relevance of profilin sensitization in a large cohort of Italian children of different ages living in different geographic areas. METHODS Children with pollen allergy enrolled by 16 pediatric outpatient clinics sited in three main geographic areas of Italy were studied. SPT were carried out with commercial pollen extracts and a commercial purified date palm pollen profilin. IgE specific for allergenic pollen molecules, Phl p 12 (grass profilin) and Pru p 3 (peach lipid transfer protein) were tested by ImmunoCAP FEIA. RESULTS IgE to Phl p 12 (≥0.35 kU/l) was observed in 296 of the 1,271 participants (23%), including 17 of the 108 (16%) preschool children. Profilin SPT was positive (≥3 mm) in 320/1,271 (25%) participants. The two diagnostic methods were concordant in 1,151 (91%, p < 0.0001) cases. Phl p 12 IgE prevalence declined from northern to southern Italy and was directly associated with IgE to Phl p 1 and/or Phl p 5 and Ole e 1. Among children with IgE to Phl p 12, OAS was provoked by kiwi, melon, watermelon, banana, apricot and cucumber. CONCLUSIONS Profilin sensitization is very frequent among pollen-allergic children, occurs at a very young age and contributes to the development of childhood OAS with a typical pattern of offending foods. Pediatricians should always consider IgE sensitization to profilin while examining pollen-allergic children, even if they are at preschool age.
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Affiliation(s)
- Riccardo Asero
- Allergology Service, San Carlo Clinic, Paderno Dugnano, Italy
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Asam C, Hofer H, Wolf M, Aglas L, Wallner M. Tree pollen allergens-an update from a molecular perspective. Allergy 2015; 70:1201-11. [PMID: 26186076 PMCID: PMC5102629 DOI: 10.1111/all.12696] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2015] [Indexed: 12/30/2022]
Abstract
It is estimated that pollen allergies affect approximately 40% of allergic individuals. In general, tree pollen allergies are mainly elicited by allergenic trees belonging to the orders Fagales, Lamiales, Proteales, and Pinales. Over 25 years ago, the gene encoding the major birch pollen allergen Bet v 1 was the first such gene to be cloned and its product characterized. Since that time, 53 tree pollen allergens have been identified and acknowledged by the WHO/IUIS allergen nomenclature subcommittee. Molecule‐based profiling of allergic sensitization has helped to elucidate the immunological connections of allergen cross‐reactivity, whereas advances in biochemistry have revealed structural and functional aspects of allergenic proteins. In this review, we provide a comprehensive overview of the present knowledge of the molecular aspects of tree pollen allergens. We analyze the geographic distribution of allergenic trees, discuss factors pivotal for allergic sensitization, and describe the role of tree pollen panallergens. Novel allergenic tree species as well as tree pollen allergens are continually being identified, making research in this field highly competitive and instrumental for clinical applications.
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Affiliation(s)
- C. Asam
- Department of Molecular Biology University of Salzburg Salzburg Austria
| | - H. Hofer
- Department of Molecular Biology University of Salzburg Salzburg Austria
| | - M. Wolf
- Department of Molecular Biology University of Salzburg Salzburg Austria
| | - L. Aglas
- Department of Molecular Biology University of Salzburg Salzburg Austria
| | - M. Wallner
- Department of Molecular Biology University of Salzburg Salzburg Austria
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Gallerano D, Cabauatan CR, Sibanda EN, Valenta R. HIV-Specific Antibody Responses in HIV-Infected Patients: From a Monoclonal to a Polyclonal View. Int Arch Allergy Immunol 2015; 167:223-41. [PMID: 26414324 DOI: 10.1159/000438484] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
HIV infections represent a major global health threat, affecting more than 35 million individuals worldwide. High infection rates and problems associated with lifelong antiretroviral treatment emphasize the need for the development of prophylactic and therapeutic immune intervention strategies. It is conceivable that insights for the design of new immunogens capable of eliciting protective immune responses may come from the analysis of HIV-specific antibody responses in infected patients. Using sophisticated technologies, several monoclonal neutralizing antibodies were isolated from HIV-infected individuals. However, the majority of polyclonal antibody responses found in infected patients are nonneutralizing. Comprehensive analyses of the molecular targets of HIV-specific antibody responses identified that during natural infection antibodies are mainly misdirected towards gp120 epitopes outside of the CD4-binding site and against regions and proteins that are not exposed on the surface of the virus. We therefore argue that vaccines aiming to induce protective responses should include engineered immunogens, which are capable of focusing the immune response towards protective epitopes.
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Affiliation(s)
- Daniela Gallerano
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
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Markerallergene und Panallergene bei Baum- und Gräserpollenallergie. ALLERGO JOURNAL 2015. [DOI: 10.1007/s15007-015-0872-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gangl K, Niederberger V, Valenta R, Nandy A. Marker allergens and panallergens in tree and grass pollen allergy. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40629-015-0055-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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40
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Weber RW. Allergen of the month--Utah juniper. Ann Allergy Asthma Immunol 2015; 113:A21. [PMID: 25256031 DOI: 10.1016/j.anai.2014.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Linhart B, Focke-Tejkl M, Weber M, Narayanan M, Neubauer A, Mayrhofer H, Blatt K, Lupinek C, Valent P, Valenta R. Molecular evolution of hypoallergenic hybrid proteins for vaccination against grass pollen allergy. THE JOURNAL OF IMMUNOLOGY 2015; 194:4008-18. [PMID: 25786690 DOI: 10.4049/jimmunol.1400402] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 02/15/2015] [Indexed: 11/19/2022]
Abstract
More than 10% of the population in Europe and North America suffer from IgE-associated allergy to grass pollen. In this article, we describe the development of a vaccine for grass pollen allergen-specific immunotherapy based on two recombinant hypoallergenic mosaic molecules, designated P and Q, which were constructed out of elements derived from the four major timothy grass pollen allergens: Phl p 1, Phl p 2, Phl p 5, and Phl p 6. Seventeen recombinant mosaic molecules were expressed and purified in Escherichia coli using synthetic genes, characterized regarding biochemical properties, structural fold, and IgE reactivity. We found that depending on the arrangement of allergen fragments, mosaic molecules with strongly varying IgE reactivity were obtained. Based on an extensive screening with sera and basophils from allergic patients, two hypoallergenic mosaic molecules, P and Q, incorporating the primary sequence elements of the four grass pollen allergens were identified. As shown by lymphoproliferation experiments, they contained allergen-specific T cell epitopes required for tolerance induction, and upon immunization of animals induced higher allergen-specific IgG Abs than the wild-type allergens and a registered monophosphoryl lipid A-adjuvanted vaccine based on natural grass pollen allergen extract. Moreover, IgG Abs induced by immunization with P and Q inhibited the binding of patients' IgE to natural allergens from five grasses better than IgG induced with the wild-type allergens or an extract-based vaccine. Our results suggest that vaccines based on the hypoallergenic grass pollen mosaics can be used for immunotherapy of grass pollen allergy.
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Affiliation(s)
- Birgit Linhart
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Margarete Focke-Tejkl
- Christian Doppler Laboratory for Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Milena Weber
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Meena Narayanan
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Hannes Mayrhofer
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Katharina Blatt
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Christian Lupinek
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Peter Valent
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, 1090 Vienna, Austria; Christian Doppler Laboratory for Allergy Research, Medical University of Vienna, 1090 Vienna, Austria;
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Westman M, Lupinek C, Bousquet J, Andersson N, Pahr S, Baar A, Bergström A, Holmström M, Stjärne P, Lødrup Carlsen KC, Carlsen KH, Antó JM, Valenta R, van Hage M, Wickman M. Early childhood IgE reactivity to pathogenesis-related class 10 proteins predicts allergic rhinitis in adolescence. J Allergy Clin Immunol 2014; 135:1199-206.e1-11. [PMID: 25528361 DOI: 10.1016/j.jaci.2014.10.042] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/25/2014] [Accepted: 10/20/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Component-resolved diagnosis might improve the prediction of future allergy in young children. OBJECTIVE We sought to investigate the association between IgE reactivity to the pathogenesis-related class 10 (PR-10) protein family and allergic rhinitis to birch pollen (ARbp) from early childhood up to age 16 years. METHOD Questionnaire data and sera obtained at 4, 8, and 16 years of age from the Barn/Children Allergi/Allergy Milieu Stockholm Epidemiologic (BAMSE) study birth cohort were used. Sera from 764 children were analyzed for IgE reactivity to 9 PR-10 allergen proteins at the 3 time points by using an allergen chip based on ISAC technology. ARbp was defined as upper airway symptoms during birch pollen exposure. RESULTS IgE reactivity to Bet v 1 was found in 12%, 17%, and 25% of children at 4, 8, and 16 years of age. IgE reactivity of PR-10 proteins showed a hierarchic intrarelationship: Bet v 1 > Mal d 1 > Cor a 1.04 > Ara h 8 > Pru p 1 > Aln g 1 > Api g 1 > Act d 8 > Gly m 4. There was an increased risk of incidence and persistence of ARbp up to age 16 years with increasing levels of Bet v 1-specific IgE or increasing numbers of IgE-reactive PR-10 proteins at 4 years. Children with severe ARbp at age 16 years had higher levels of Bet v 1-specific IgE at age 4 years compared with children with mild symptoms. CONCLUSION ARbp at age 16 years can be predicted by analysis of IgE reactivity to PR-10 proteins in early childhood.
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Affiliation(s)
- Marit Westman
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden.
| | - Christian Lupinek
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Jean Bousquet
- University Hospital of Montpellier, Hôpital Arnaud de Villeneuve, Montpellier, INSERM 1018, Villejuif, France
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Pahr
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Alexandra Baar
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mats Holmström
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Pär Stjärne
- Department of Clinical Science, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden; Department of Ear, Nose and Throat Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Kaj-Håkon Carlsen
- Department of Pediatrics, University of Oslo, Oslo University Hospital, Oslo, Norway
| | - Josep M Antó
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Marianne van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Magnus Wickman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden
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Asero R. Looking for sensitization profiles in different populations by recombinant allergens. Int Arch Allergy Immunol 2014; 164:106-8. [PMID: 24943849 DOI: 10.1159/000363448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
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