En route to personalized medicine: uncovering distinct IgE reactivity pattern to house dust mite components in Brazilian and Austrian allergic patients

Abstract

Aim Molecular sensitization profile analyses of allergic individuals to the house dust mites (HDM) Blomia tropicalis and Dermatophagoides pteronyssinus from Brazil and Austria, in the attempt to comprehend the individual contribution of the molecular components in the diagnosis of HDM allergy. Methodology These analyses were made using a new in vitro multiplex allergen assay which allows simultaneous measurement of specific IgE against the whole allergen extract as well its components. Results and Conclusion The data showed that in Brazil the inclusion of the molecular components Blo t 5 and/or Blo t 21 major allergens and Blo t 2 can increase the sensitivity and specificity of the assay for the diagnosis of allergy to B. tropicalis, using matrix‐based methodologies. Also we highlighted, for the first time, the importance of Blo t 2 analysis for a sensitive diagnosis, since some individuals were sensitized only to this molecular component. Regarding the sensitization profile of individuals sensitized to D. pteronyssinus, we point out the importance of analyzing the molecular components Der p23 and Der p 7, in addition to Der p 1 and Der p 2 for an accurate diagnosis based on matrices.

Recombinant T‐cell epitope conjugation: A new approach for Dermatophagoides hypoallergen design

“…It has been shown that the Der p 23 allergen is as important as Der p 1 and Der p 2 in the process of allergic sensitization in individuals sensitized to D. pteronyssinus in the population of Salvador 35 . These data corroborate our findings, where comparable levels of IgE reactivity to Der p 23 and Der p 2 were shown, with Der p 23 being slightly more frequent than Der p 2 and Der p 1.…”

“…#, * , § p < .05; ##, ** , § § p < .01; ###, *** , § § § p < .0001 main D. pteronyssinus allergens in the present study was similar toprevious reports from Thailand, USA and Europe 17,18,[32][33][34]. It has been shown that the Der p 23 allergen is as important as Der p 1 and Der p 2 in the process of allergic sensitization in individuals sensitized to D. pteronyssinus in the population of Salvador 35. These data corroborate our findings, where comparable levels of IgE reactivity to Der p 23 and Der p 2 were shown, with Der p 23 being slightly more frequent than Der p 2 and Der p 1.…”

The Allergenic Activity of Blo t 2, a Blomia tropicalis IgE-Binding Molecule

“…A more recent publication showed that this detergent may affect protein folding of insoluble proteins [ 36 ], then, the final impact on Blo t 2 is unknown. Despite demonstrating that rBlo t 2 is biologically actively inducing allergic reactions and also similar rates of IgE binding to other similar studies [ 6 , 16 ], physico-chemical characterization of rBlo t 2 will confirm if the recombinant has the optimum folding to represent its natural counterpart. Additionally, the animal model must be replicated to validate our findings.…”

“…Others analyzed the prevalence of sensitization to Blo t 2, reporting similar rates to ours [ 12 , 13 , 14 ]. Since the frequency of positive IgE responses to Blo t 2 were as high as those reported for other clinically relevant allergens such as Blo t 5 and Blo t 21, and monosensitization to Blo t 2 is common [ 16 ], it was proposed as a component that improves the diagnostic performance of molecular panels to detect sensitization to B. tropicalis . Classification of specific IgE values into intensity ranges indicated that most positive patients had low intensity responses, as also observed by others [ 6 , 16 ].…”

Good clinical practice recommendations in allergen immunotherapy: Position paper of the Brazilian Association of Allergy and Immunology – ASBAI

“…In Brazil, allergens derived from house dust mites are associated with the development of AR and asthma, and also atopic dermatitis. 57 , 58 , 59 , 60 , 61 , 62 , 63 The formulation of the extract used for AIT should be chosen based on the skin prick test result and/or serum level of specific IgE.…”