Dog allergy: can a prevalent or exclusive sensitization to Can f 5 be considered a lucky or negative event in “real life”?

Eur Ann Allergy Clin Immunol

et al. 2019

Self Cite

Recent studies have shown the increasing relevance of allergic sensitization to Can f 5, a prostatic kallicrein expressed in the prostate and detectable only in male dogs. The aim of the present study was to establish the frequency, level of sensitization and association with other dog allergens of Can f 5, as assessed by component resolved diagnosis (CRD ISAC 112, Ther-moFisher Scientific, Uppsala, Sweden) in North East Italy. A total of 1403 CRD ISAC 112 were examined retrospectively. Five hundred twenty subjects (37%) had a positive IgE response to at least one of the available animal allergens. Among these 520 subjects, 268 (51.5%) showed at least one sensitization to dog allergens. Among dog-sensitized individuals, 183 (69.02%) showed IgE against Can f 5, and 106 (57.92%) were sensitized exclusively against Can f 5. The average Can f 5 specific IgE was 8.810 ISU-E, with 77.6% of individuals showing medium or high values of specific IgE according to manufacturer's specifications. In conclusions, our data confirmed that there is a high number of patients sensitized to Can f 5, which have a high degree of allergic sensitization. These results should be taken into account by allergists managing dog allergic patients. In fact, clinical consequences of this sensitization regard respiratory allergy (burden of rhinitis/asthma), systemic reactions (anaphylaxis during sexual intercourse from cross-reaction with human prostatic antigen), allergen immunotherapy-AIT (likely ineffective in patients with exclusive sensitization), and preventive measures (possibility to own a female dog and a likely reduction of allergen passive transport). Further studies are needed to better explore these aspects in "real life". Can f 5, a newly described dog allergen, is a prostatic kallicrein, an androgen-regulated protein expressed in the prostate and detectable only in male dogs (6). Few studies have shown that the rate of a prevalent or exclusive allergic sensitization to Can f 5 is high, ranging between 37% and 52% in the case of dog Dog allergens are a common cause of allergic sensitization and triggering respiratory symptoms worldwide, especially in geographical areas characterized by a high level of pet ownership such as US and Northern Europe (1,2). It is well known that common dog allergens belong to lipocalins or albumins families of proteins (3-5).

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confidence: 99%

“…Possible topics associated with a prevalent or exclusive allergic sensitization to Can f 5. Adapted from(10). (The picture of the dog "Charlie" 2001 -2017 is property of GL).…”

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confidence: 99%

Frequency of allergic sensitization to Can f 5 in North East Italy. An analysis of 1403 ISACs 112 (Component Resolved Diagnosis) collected retrospectively

Villalta

Eur Ann Allergy Clin Immunol

et al. 2019

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“…Moreover, our Italian multicenter study has shown that a prevalent exposure to a male dog represents a risk factor for the presence of Can f 5 monosensitization (56). The results of this study emphasize the need of an adequate diagnosis and management of patients suffering from dog allergy, especially those with relevant clinical symptoms following dog exposure in order to prevent systemic SPH (57).…”

Section: F O R P U B L I C a T I O Nmentioning

confidence: 57%

Lessons from peculiar cases of anaphylaxis: why allergists should be prepared for the unexpected

Liccardi

Eur Ann Allergy Clin Immunol

Bilò

et al. 2022

Self Cite

sometimes anaphylaxis can occur with uncommon or peculiar characteristics which could delay diagnosis and therapeutic treatment. We aimed to describe less accounted / difficultto-approach shapes of anaphylaxis to facilitate clinicians to suspect these severe reactions even in uncommon conditions. Authorship: All authors contributed equally in the writing and revision of the manuscript. Conflict of interest and financial resources. All authors declare that they have no conflict of interest and that the study has been carried out without any financial support.

“…In addition to this probable effect on the efficacy of DAI, patients suffering from this specific sensitization might experience either favourable or unfavourable clinical conditions in "real life". 26 (Table 1).…”

Section: Prevalent Sensitization To Major Dog Allergens (Can F 2 and Can F 2) Or Multiple Sensitization To Other Allergens Of Furry Animamentioning

confidence: 99%

“…-Can f 5 should not cross-react to other mammalian "pan-allergens" belonging to albumins or lipocalins family. 26 Possible reduction of the occurrence of dog allergen «ubiquity» and consequent effects. -To the best of our knowledge, no studies have previously demonstrated a passive transport of Can f 5 in dog-free indoor environments.…”

Section: Possible Favourable Conditionsmentioning

confidence: 99%

Critical aspects in dog allergen immunotherapy (DAI). May Component Resolved Diagnosis (CRD) play a role in predicting the efficacy?

Liccardi

Calzetta

Human Vaccines & Immunotherapeutics

et al. 2018

We hypothesize that a pivotal condition determining the efficacy of dog allergen immunotherapy (DAI) might be the mono-sensitization to dog lipocalins (Can f 1-2) in individuals not directly or indirectly exposed to other furry animals. In fact, the concomitant sensitization to lipocalins and/or albumins, especially in those patients directly exposed to furry animals, may potentially stimulate patient's airways by inducing persistent inflammation and, thus, clinical symptoms. In these conditions, it is likely that DAI alone could be inadequate to reduce airway inflammation mediated by inhalation of dog allergens in patients with simultaneous exposure to other furry animals. Can f 5 has been found as exclusive allergen in about one third of dog-sensitized individuals. Considering the presence of different allergenic materials in extract of mammalian origin, it is evident that a standard DAI is not likely to be effective in Can f 5 prevalent or mono-sensitized individuals. Moreover, we would underline the need of collecting detailed information on the possible exposures to furry animals (other than the common pets), an information that usually is neglected in clinical practice. Furthermore, a detailed clinical history exploring the real significance of dog sensitization (mono or poly-sensitization, induction of clinical symptoms after exposure etc.) should be performed before prescribing DAI. In some patients, with potential high susceptibility to animal allergens, the use of CRD is essential to verify the presence of concomitant allergic sensitization to lipocalins and/or albumins belonging to other furry animals. The availability of CRD introduced the possibility of a better targeted prescription of DAI because it might be useful for point out the primary allergens and for the exclusion of cross-reactive ones.