Since the discovery of immunoglobulin E (IgE) as a mediator of allergic diseases in 1967, our knowledge about the immunological mechanisms of IgE‐mediated allergies has remarkably increased. In addition to understanding the immune response and clinical symptoms, allergy diagnosis and management depend strongly on the precise identification of the elicitors of the IgE‐mediated allergic reaction. In the past four decades, innovations in bioscience and technology have facilitated the identification and production of well‐defined, highly pure molecules for component‐resolved diagnosis (CRD), allowing a personalized diagnosis and management of the allergic disease for individual patients. The first edition of the “EAACI Molecular Allergology User's Guide” (MAUG) in 2016 rapidly became a key reference for clinicians, scientists, and interested readers with a background in allergology, immunology, biology, and medicine. Nevertheless, the field of molecular allergology is moving fast, and after 6 years, a new EAACI Taskforce was established to provide an updated document. The Molecular Allergology User's Guide 2.0 summarizes state‐of‐the‐art information on allergen molecules, their clinical relevance, and their application in diagnostic algorithms for clinical practice. It is designed for both, clinicians and scientists, guiding health care professionals through the overwhelming list of different allergen molecules available for testing. Further, it provides diagnostic algorithms on the clinical relevance of allergenic molecules and gives an overview of their biology, the basic mechanisms of test formats, and the application of tests to measure allergen exposure.

BackgroundExposure to horses can cause severe allergic reactions in sensitized individuals. The breed, American Bashkir Curly Horse is categorized as hypoallergenic, primarily due to reports of allergic patients experiencing fewer symptoms while handling this special breed. The possible reasons for this phenomenon could be lower allergen production and/or reduced allergen release into the air because of increased sebum content in their skin and hair compared to other breeds. Therefore, the aim of the current study was to compare different horse breeds in relation to allergen content in hair and airborne dust samples.MethodsIn total, 224 hair samples from 32 different horse breeds were investigated. Personal nasal filters were used to collect airborne dust during the grooming of 20 Curly Horses and 20 Quarter Horses. Quantitative analysis of all samples was performed using two newly developed immunoassays for the detection of horse dander (HD) antigens and the major allergen Equ c 1 and the commercial assay for Equ c 4. Results were analyzed using multiple linear regression models for hair samples and the Mann Whitney U test for airborne samples.ResultsHorse antigen and allergen levels differed up to four orders of magnitude between individual animals. Despite enormous variability, levels of HD antigen, Equ c 1 and Equ c 4 in hair were significantly related to the breed and gender combined with the castration status of male animals. Curly Horses had significantly higher concentrations of all three tested parameters compared to the majority of the investigated breeds (medians: 11800 μg/g for HD antigen, 2400 μg/g for Equ c 1, and 258 kU/g for Equ c 4). Tinker Horses, Icelandic Horses and Shetland Ponies were associated with approximately 7-fold reduced levels of HD antigen and Equ c 1, and up to 25-fold reduced levels of Equ c 4 compared to Curly Horses. Compared to mares, stallions displayed increased concentrations of HD antigens, Equ c 1 and Equ c 4 by a factor 2.2, 3.5 and 6.7, respectively. No difference was observed between mares and geldings. No differences in airborne allergen concentrations collected with personal nasal filters during grooming were found between Curly and Quarter Horses.ConclusionBreed and castration status had a significant influence on the antigen and allergen levels of horse hair. However, these differences were smaller than the wide variability observed among individual horses. Compared to other breeds, Curly Horses were not associated with lower allergen levels in hair and in air samples collected during grooming. Our approach provides no molecular explanation why Curly Horses are considered to be hypoallergenic.

Objectives In veterinary settings, high exposures to animal allergens and microbial agents can be expected. However, occupational exposure levels are largely unknown. The objective of this study was to estimate the allergen, endotoxin, and β-(1,3)-glucan concentrations in small animal practices and in the homes of practice employees. Methods Dust samples were collected using electrostatic dust fall collectors in diverse rooms of 36 small animal practices, as well as in employees’ homes. Major animal allergens (Fel d 1, Can f 1, Ory c 3, Cav p 1, Equ c 1, Bos d 2), domestic mite (DM) allergens, and β-(1,3)-glucan levels were measured using enzyme immunoassays. Endotoxin was determined using the Limulus amoebocyte lysate assay. Influences on exposure levels were analyzed using multilevel models. Results The levels of Can f 1, Fel d 1, Ory c 3, and Cav p 1 were up to 30 times higher in practices compared with homes without animals, but significantly lower compared with the homes with the respective pet. Although horses were not treated in the practices, Equ c 1 was found in 87.5% of samples, with the highest concentrations measured in changing rooms. DM levels were significantly lower in practices than in all private homes, and endotoxin levels were similar to those in homes with pets. In the practice itself, exposure levels were significantly influenced by animal presence, type of the room, and area per employee; whereas, room volume and diverse cleaning measures had mostly no effect. Conclusions Exposure to animal allergens is high in veterinary practices, but it does not reach levels of households with pets. Domestic mite allergen and endotoxin exposure seem to be low for workers in veterinary practices. The high Equ c 1 detection rate strongly indicates dispersal of allergens, most likely through clothing and hair.