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Allergens. Heterogeneity of molecular sensitization profiles in grass pollen allergy--implications for immunotherapy?
Clin Exp Allergy. 2014; 44(5):778-86.CE

Abstract

BACKGROUND

Data on molecular allergy diagnostics in adults with grass pollen allergy with regard to conjunctival and nasal provocation test outcome and specific immunotherapy are lacking to date.

OBJECTIVE

To assess whether molecular allergy diagnostics for grass pollen allergens could help with predicting provocation test outcomes and serve as a basis for future component-resolved specific immunotherapy.

METHODS

Sera of 101 adults with grass pollen allergy was analysed for IgE against timothy grass pollen (Phleum pratense), rPhl p 1, rPhl p 2, nPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11 and rPhl p12 and correlated with the individuals' outcome in the nasal and conjunctival provocation tests and investigated in regard to a potential component-resolved specific immunotherapy.

RESULTS

An increasing number of sensitizations to timothy grass allergens was correlated to a positive reaction in the conjunctival (4.9 vs. 3.6, P = 0.003) and nasal provocation tests (4.5 vs. 2.2, P = 0.0175). In molecular sensitization profiles, a substantial heterogeneity was detected, with none of the patients exactly matching the allergen composition of a previously published component-resolved specific immunotherapy containing Phl p 1, Phl p 2, Phl p 5a/b and Phl p 6. The results indicate that in 95% of the patients, a proportion of 50% of timothy-IgE would be targeted with such a specific immunotherapy, while in 50% and 10% of patients, 80% and 90% of timothy-IgE would be targeted, respectively.

CONCLUSION AND CLINICAL RELEVANCE

Molecular allergy diagnostics is a prerequisite for future component-resolved specific immunotherapy due to the high heterogeneity of sensitization profiles. However, of current clinical relevance is the observed correlation between the number of sensitizations and provocation test outcome.

Authors+Show Affiliations

Department of Dermatology and Allergy, Technische Universität München, Munich, Germany; ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24598010

Citation

Darsow, U, et al. "Allergens. Heterogeneity of Molecular Sensitization Profiles in Grass Pollen Allergy--implications for Immunotherapy?" Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 44, no. 5, 2014, pp. 778-86.
Darsow U, Brockow K, Pfab F, et al. Allergens. Heterogeneity of molecular sensitization profiles in grass pollen allergy--implications for immunotherapy? Clin Exp Allergy. 2014;44(5):778-86.
Darsow, U., Brockow, K., Pfab, F., Jakob, T., Petersson, C. J., Borres, M. P., Ring, J., Behrendt, H., & Huss-Marp, J. (2014). Allergens. Heterogeneity of molecular sensitization profiles in grass pollen allergy--implications for immunotherapy? Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 44(5), 778-86. https://doi.org/10.1111/cea.12303
Darsow U, et al. Allergens. Heterogeneity of Molecular Sensitization Profiles in Grass Pollen Allergy--implications for Immunotherapy. Clin Exp Allergy. 2014;44(5):778-86. PubMed PMID: 24598010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allergens. Heterogeneity of molecular sensitization profiles in grass pollen allergy--implications for immunotherapy? AU - Darsow,U, AU - Brockow,K, AU - Pfab,F, AU - Jakob,T, AU - Petersson,C J, AU - Borres,M P, AU - Ring,J, AU - Behrendt,H, AU - Huss-Marp,J, PY - 2013/06/05/received PY - 2014/02/05/revised PY - 2014/02/12/accepted PY - 2014/3/7/entrez PY - 2014/3/7/pubmed PY - 2014/12/15/medline KW - Phleum pratense KW - allergenic molecules KW - combinatorial analysis KW - component-resolved diagnosis KW - component-resolved therapy KW - hay fever KW - molecular allergy diagnostics KW - nasal/conjunctival provocation test KW - specific IgE KW - timothy SP - 778 EP - 86 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin Exp Allergy VL - 44 IS - 5 N2 - BACKGROUND: Data on molecular allergy diagnostics in adults with grass pollen allergy with regard to conjunctival and nasal provocation test outcome and specific immunotherapy are lacking to date. OBJECTIVE: To assess whether molecular allergy diagnostics for grass pollen allergens could help with predicting provocation test outcomes and serve as a basis for future component-resolved specific immunotherapy. METHODS: Sera of 101 adults with grass pollen allergy was analysed for IgE against timothy grass pollen (Phleum pratense), rPhl p 1, rPhl p 2, nPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11 and rPhl p12 and correlated with the individuals' outcome in the nasal and conjunctival provocation tests and investigated in regard to a potential component-resolved specific immunotherapy. RESULTS: An increasing number of sensitizations to timothy grass allergens was correlated to a positive reaction in the conjunctival (4.9 vs. 3.6, P = 0.003) and nasal provocation tests (4.5 vs. 2.2, P = 0.0175). In molecular sensitization profiles, a substantial heterogeneity was detected, with none of the patients exactly matching the allergen composition of a previously published component-resolved specific immunotherapy containing Phl p 1, Phl p 2, Phl p 5a/b and Phl p 6. The results indicate that in 95% of the patients, a proportion of 50% of timothy-IgE would be targeted with such a specific immunotherapy, while in 50% and 10% of patients, 80% and 90% of timothy-IgE would be targeted, respectively. CONCLUSION AND CLINICAL RELEVANCE: Molecular allergy diagnostics is a prerequisite for future component-resolved specific immunotherapy due to the high heterogeneity of sensitization profiles. However, of current clinical relevance is the observed correlation between the number of sensitizations and provocation test outcome. SN - 1365-2222 UR - https://www.unboundmedicine.com/medline/citation/24598010/Allergens__Heterogeneity_of_molecular_sensitization_profiles_in_grass_pollen_allergy__implications_for_immunotherapy L2 - https://doi.org/10.1111/cea.12303 DB - PRIME DP - Unbound Medicine ER -