Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Abstract

In a large pediatric population, the complexity of IgE sensitization profiles against P. pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7, and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response.

Early molecular biomarkers predicting the evolution of allergic rhinitis and its comorbidities: A longitudinal multicenter study of a patient cohort

“…Phl p 1 is a marker of genuine sensitization to grass pollen and by far the most important initiator of grass pollen allergy. We and others have already shown that grass pollen–allergic patients are rarely not sensitized to Phl p 1. The present study adds that the lack of sIgE to Phl p 1, an infrequent condition also in this patient cohort, is a predictor of remission of grass pollen allergy in Italian children.…”

“…The baseline study recruited 1360 children affected by pollen‐induced AR who had never undergone AIT in 16 pediatric outpatient clinics between May 2009 and June 2011. Patients’ clinical features and allergic sensitization have been widely described in the previous articles . In those suffering from grass pollen–induced SAR, we showed a wide heterogeneity of molecular IgE sensitization profiles to Phleum pratense , and we identified three main serological biomarkers: Phl p 1 as a marker of grass pollen allergy, Phl p 7 as a specific biomarker of asthma among SAR patients, and Phl p 12 as a stronger biomarker of OAS .…”

“…Patients’ clinical features and allergic sensitization have been widely described in the previous articles . In those suffering from grass pollen–induced SAR, we showed a wide heterogeneity of molecular IgE sensitization profiles to Phleum pratense , and we identified three main serological biomarkers: Phl p 1 as a marker of grass pollen allergy, Phl p 7 as a specific biomarker of asthma among SAR patients, and Phl p 12 as a stronger biomarker of OAS . The usefulness of these biomarkers in the diagnostic workup of the child with grass pollen allergy needs to be tested in prospective studies of patient cohorts.…”

“Molecular extracts” for allergy diagnostics and therapy

“…Recombinant allergen molecules were proposed for a patient‐tailored allergen immunotherapy (component‐resolved immunotherapy, CRIT), individually designed after in vitro molecular assays (component‐resolved diagnostics, CRD) defining the patient's molecular IgE sensitization profile. Two factors undermined the implementation of this concept: (a) European regulations only allow the registration of pre‐defined mixtures; and (b) the molecular sensitization profiles of individual patients are extremely heterogeneous (eg, many dozens for grass pollen or Dermatophagoides pteronyssinus ) and vary by age or geographic region (eg, peanut) . Given the current regulations, manufacturers should register dozens of mixes of grass pollen or D. pteronyssinus molecules to provide a patient‐tailored CRIT for grass pollen or mite allergic patients.…”

“…The advent of molecular allergology had raised new hope for a better standardization of allergen products for diagnosis and therapy. 4,11 ; and (b) the molecular sensitization profiles of individual patients are extremely heterogeneous (eg, many dozens for grass pollen or Dermatophagoides pteronyssinus) [12][13][14] and vary by age or geographic region (eg, peanut). 15,16 Given the current regulations, manufacturers should register dozens of mixes of grass pollen or D. pteronyssinus molecules to provide a patient-tailored CRIT for grass pollen or mite allergic patients.…”