BOLETÍN BIBLIOGRÁFICO
DE INMUNOTERAPIA
Artículo destacado – Abril 2020
1
El diagnóstico molecular puede ser clave.
Molecular profiling of allergen-specific antibody responses may enhance success of specific immunotherapy.
Rodríguez-Domínguez A, Berings M, Rohrbach A, Huang HJ, Curin M, Gevaert P et al
J Allergy Clin Immunol. 2020 Apr 13. pii: S0091-6749(20)30479-6. doi: 10.1016/j.jaci.2020.03.029. [Epub ahead of print].
BACKGROUND
House dust mites (HDM) are one of the most important allergen sources containing many different allergenic molecules. The analysis of patients from a double-blind, placebo-controlled allergen-specific immunotherapy (AIT) study indicated that patients may benefit to a different extent from AIT depending on their molecular sensitization profiles.
OBJECTIVES
To investigate in a real-life setting if stratification of HDM allergic patients according to molecular analysis may enhance AIT success.
METHODS
Serum and nasal secretion samples from HDM allergic patients (n=24) (baseline, 7, 15, 33 and 52 weeks) who had received one year treatment with a well-defined subcutaneous AIT form (Alutard SQ 510) were tested for IgE and IgG reactivity to 15 micro-arrayed HDM allergen molecules with ImmunoCAP ISAC 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 (CSMS) and visual analogue (VAS).
RESULTS
Alutard SQ 510 induced protective IgG mainly against Der p 1 and Der p 2 and to a lower 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 only sensitized to Der p 1 and/or Der p 2 as compared to patients with additional IgE specificities.
CONCLUSIONS
Stratification of HDM allergic patients according to molecular sensitization profiles and molecular monitoring of AIT-induced IgG responses may enhance success of AIT.