Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life

Abstract

Parental hay fever and early exposure to D pteronyssinus allergens promote IgE polysensitization to several D pteronyssinus molecules, which in turn predicts current mite-related AR and current/future asthma. These results might inspire predictive algorithms and prevention strategies against the progression of IgE sensitization to mites toward AR and asthma.

Subcutaneous immunotherapy with purified Der p1 and 2 suppresses type 2 immunity in a murine asthma model

“…The HDM species Dermatophagoides pteronyssinus (Der p) has at least 23 major allergens9 that are thought to contribute to allergic sensitization through their proteolytic activity, activating cells of the innate immune system and priming an adaptive type 2 immune response 2, 9. In the MAS prospective birth cohort, sensitization patterns for HDM allergens were studied into detail by component‐resolved analysis 10. Herein, specific IgE (spIgE) for Der p1, 2, and 23 can be detected before sensitization to any of the other major allergens.…”

“…Moreover, sensitization to Der p1, 2, and 23 allergens has the highest prevalence, with more than half of the 20‐year‐old individuals having spIgE to group 1 and 2 allergens 10. Interestingly, early onset of sensitization to group 1, 2, or 23 allergens was associated with sensitization to more HDM allergens and with allergic rhinitis and asthma at school age, indicating the clinical relevance of these sensitization patterns 10. Treatment options for HDM allergy include allergen avoidance and SIT 11.…”

“…However, HDM extracts are variable in content of allergens,12, 13 and stability is limited 14. Given the fact that sensitization to Der p1 and 2 identifies more than 95% of HDM‐allergic individuals9, 13 and their causal role in early sensitization,10 SIT with purified Der p1 and 2 might be a more attractive therapeutic approach compared to the use of HDM extracts.…”

Mite allergens

“…Information about a detailed allergenicity evaluation is currently available for only 10% of all IgE binding proteins in the databases. Completing this task will allow a better assessment of the pathogenic role of each mite allergen as has been recently suggested for Der p 23 [17,18] and could be great independently of its IgE-binding frequency [19][20][21]. Recognizing that regional combinations of mite allergens are more appropriate and less expensive than large panels of just IgE-binding components will also help.…”

“…There are a number of mite IgE-binding components available for CDR, including species-specific and cross-reacting molecules, most of them with well-defined structural and epitope data, although not all with empirically demonstrated allergenicity. A necessary step, the determination of the IgE reactivity against mite components in different populations and environments, has partially accomplished [16][17][18]. However, the analyses of these data have been based on the frequency of IgE reactivity, not including other aspects of allergenicity.…”