Molecular profiling of allergen-specific antibody responses may enhance success of specific immunotherapy.
Adult
Animals
Antigens, Dermatophagoides
/ immunology
Arthropod Proteins
/ immunology
Cysteine Endopeptidases
/ immunology
Desensitization, Immunologic
/ methods
Epitopes
/ immunology
Female
Humans
Hypersensitivity
/ immunology
Immunoglobulin E
/ metabolism
Immunoglobulin G
/ metabolism
Injections, Subcutaneous
Male
Plant Extracts
/ therapeutic use
Protein Array Analysis
Pyroglyphidae
House dust mite
IgE
IgG
IgG(1)
IgG(2)
IgG(3)
IgG(4,) IgG subclass
allergen microarray
basophil activation
immunotherapy
recombinant allergens
Journal
The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
12
12
2019
revised:
28
02
2020
accepted:
26
03
2020
pubmed:
17
4
2020
medline:
16
3
2021
entrez:
17
4
2020
Statut:
ppublish
Résumé
House dust mites (HDMs) are among the most important allergen sources containing many different allergenic molecules. Analysis of patients from a double-blind, placebo-controlled allergen-specific immunotherapy (AIT) study indicated that patients may benefit from AIT to different extents depending on their molecular sensitization profiles. Our aim was to investigate in a real-life setting whether stratification of patients with HDM allergy according to molecular analysis may enhance AIT success. Serum and nasal secretion samples from patients with HDM allergy (n = 24) (at baseline, 7, 15, 33, and 52 weeks) who had received 1 year of treatment with a well-defined subcutaneous AIT form (Alutard SQ 510) were tested for IgE and IgG reactivity to 15 microarrayed HDM allergen molecules with ImmunoCAP Immuno-solid-phase Allergen Chip technology. IgG subclass levels to allergens and peptides were determined by ELISA, and IgG blocking was assessed by basophil activation. In vitro parameters were related to reduction of symptoms determined by combined symptom medication score and visual analog scale score. Alutard SQ 510 induced protective IgG mainly against Dermatophagoides pteronyssinus (Der p) 1 and Der p 2 and to a lesser extent to Der p 23, but not to the other important allergens such as Der p 5, Der p 7, and Der p 21, showing better clinical efficacy in patients sensitized only to Der p 1 and/or Der p 2 as compared with patients having additional IgE specificities. Stratification of patients with HDM allergy according to molecular sensitization profiles and molecular monitoring of AIT-induced IgG responses may enhance the success of AIT.
Sections du résumé
BACKGROUND
House dust mites (HDMs) are among the most important allergen sources containing many different allergenic molecules. Analysis of patients from a double-blind, placebo-controlled allergen-specific immunotherapy (AIT) study indicated that patients may benefit from AIT to different extents depending on their molecular sensitization profiles.
OBJECTIVE
Our aim was to investigate in a real-life setting whether stratification of patients with HDM allergy according to molecular analysis may enhance AIT success.
METHODS
Serum and nasal secretion samples from patients with HDM allergy (n = 24) (at baseline, 7, 15, 33, and 52 weeks) who had received 1 year of treatment with a well-defined subcutaneous AIT form (Alutard SQ 510) were tested for IgE and IgG reactivity to 15 microarrayed HDM allergen molecules with ImmunoCAP Immuno-solid-phase Allergen Chip technology. IgG subclass levels to allergens and peptides were determined by ELISA, and IgG blocking was assessed by basophil activation. In vitro parameters were related to reduction of symptoms determined by combined symptom medication score and visual analog scale score.
RESULTS
Alutard SQ 510 induced protective IgG mainly against Dermatophagoides pteronyssinus (Der p) 1 and Der p 2 and to a lesser extent to Der p 23, but not to the other important allergens such as Der p 5, Der p 7, and Der p 21, showing better clinical efficacy in patients sensitized only to Der p 1 and/or Der p 2 as compared with patients having additional IgE specificities.
CONCLUSION
Stratification of patients with HDM allergy according to molecular sensitization profiles and molecular monitoring of AIT-induced IgG responses may enhance the success of AIT.
Identifiants
pubmed: 32298697
pii: S0091-6749(20)30479-6
doi: 10.1016/j.jaci.2020.03.029
pii:
doi:
Substances chimiques
Alutard SQ allergen
0
Antigens, Dermatophagoides
0
Arthropod Proteins
0
Dermatophagoides pteronyssinus antigen p 2
0
Epitopes
0
Immunoglobulin G
0
Plant Extracts
0
Immunoglobulin E
37341-29-0
Cysteine Endopeptidases
EC 3.4.22.-
Dermatophagoides pteronyssinus antigen p 1
EC 3.4.22.-
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1097-1108Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.