How molecular diagnosis may modify immunotherapy prescription in multi-sensitized pollen-allergic children

Camacho, Genoveva del Río; Arjona, A. Montes; Padial, J Fernández-Cantalejo; Catalán, J Rodríguez

doi:10.1016/j.aller.2018.03.002

Cited by 18 publications

(7 citation statements)

References 13 publications

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“…Moreover, CRD can predict the severity of disease progression and find cross-reactions of different components, which is of great significance in the diagnosis and treatment of allergies. 7,15,25,26 Now component resolved diagnostic technologies have recently been introduced into egg white allergen sensitized to sIgE, and Gal d 1 has been proved to be the major allergen, which is in line with our research, using the AUC from ROC curve analysis. However, there was still a margin in sensitization to egg yolk allergen components: especially if the patient is allergic to only one egg allergen, the patient may not have obvious clinical symptoms.…”

Section: Discussionsupporting

confidence: 85%

Component resolved diagnosis of egg yolk is an indispensable part of egg allergy

Huang

Shao

Li³

et al. 2021

aei

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Introduction and objectives: It was urgent to explain the role of egg yolk allergen sensitization to the egg allergic population and we would evaluate the diagnostic value of allergen components in whole eggs, including egg white and egg yolk.Materials and methods: Firstly, we collected 99 positive and 21 negative sera against egg allergy. Then we used modified enzyme linked immunosorbent assay (ELISA) to survey specific IgE (sIgE) to all-proven and single component in eggs, Ovomucoid (Gal d 1), Ovalbumin (Gal d 2), Ovotransferrin (Gal d 3), Lysozyme C (Gal d 4), Serum Albumin (Gal d 5), and YGP42(Gal d 6) in allergic and non-allergic populations. Last but not least, we studied the sIgE reactivities to egg allergen components by receiver operating characteristic (ROC) analysis.Results: Among egg-allergic individuals, nearly 10% were sensitized to five of six egg allergen components, and the cross-reaction frequency between two egg yolk allergens with Gal d 1 was about 30% in the groups diagnosed with egg allergy or non-allergy. The best component-combination diagnosis in egg allergy of Gal d 1+ Gal d 6 demonstrated the largest area under curve (AUC) of 0.994.Conclusions: Our results suggested that there were individual differences in allergenicity of different egg allergen components, especially in the samples negative to egg allergy diagnosed but sensitive to egg yolk components. It was indicated that component resolved diagnosis of egg yolk improved the value for egg allergy management indispensably.

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Section: Discussionsupporting

confidence: 85%

Component resolved diagnosis of egg yolk is an indispensable part of egg allergy

Huang

Shao

Li³

et al. 2021

aei

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“…This is particularly true when allergen immunotherapy (AIT) is provided to the patient. Even though large discussions on this topic are still ongoing, suggestive data seems to indicate that AIT is probably more effective in patients sensitized to genuine allergens, [38][39][40][41][42][43]42,43 while its activity is less impressive in patients with a sensitization to cross-reacting components or pan-allergens. In this context, the in vitro evidence of specific IgE involvement in the patient's symptoms associated with the detection of IgE specific for genuine components seems to be the entry level diagnostic for patients that could have a real modification of their allergy by AIT.…”

Section: Diagnostic Strategymentioning

confidence: 99%

IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper

Ansotegui

Melioli

Canonica

et al. 2020

World Allergy Organization Journal

350

275

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Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.

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“…By focusing on applications for personalized medicine, numerous studies have assessed the benefits of attaining with PAMD@ a more appropriate prescription for AIT. Table 1 summarizes the observations from these studies 28‐37 . A vast literature is available, as recently reviewed, 38,39 also for the advantages of PAMD@ in the diagnosis of food allergy compared with the conventional diagnosis, but this will not be treated here since the purpose of our analysis is to examine the progress achieved by PAMD@ in the appropriate prescription of AIT.…”

Section: Modern Ait As a Prototype Of Personalized Medicinementioning

confidence: 99%

Personalized medicine for allergy treatment: Allergen immunotherapy still a unique and unmatched model

Incorvaia

Al‐Ahmad

Ansotegui

et al. 2020

Allergy

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The introduction of personalized medicine (PM) has been a milestone in the history of medical therapy, because it has revolutionized the previous approach of treating the disease with that of treating the patient. It is known today that diseases can occur in different genetic variants, making specific treatments of proven efficacy necessary for a given endotype. Allergic diseases are particularly suitable for PM, because they meet the therapeutic success requirements, including a known molecular mechanism of the disease, a diagnostic tool for such disease, and a treatment blocking the mechanism. The stakes of PM in allergic patients are molecular diagnostics, to detect specific IgE to single‐allergen molecules and to distinguish the causative molecules from those merely cross‐reactive, pursuit of patient's treatable traits addressing genetic, phenotypic, and psychosocial features, and omics, such as proteomics, epi‐genomics, metabolomics, and breathomics, to forecast patient's responsiveness to therapies, to detect biomarker and mediators, and to verify the disease control. This new approach has already improved the precision of allergy diagnosis and is likely to significantly increase, through the higher performance achieved with the personalized treatment, the effectiveness of allergen immunotherapy by enhancing its already known and unique characteristics of treatment that acts on the causes.

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How molecular diagnosis may modify immunotherapy prescription in multi-sensitized pollen-allergic children

Cited by 18 publications

References 13 publications

Component resolved diagnosis of egg yolk is an indispensable part of egg allergy

Component resolved diagnosis of egg yolk is an indispensable part of egg allergy

IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper

Personalized medicine for allergy treatment: Allergen immunotherapy still a unique and unmatched model

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