Mechanisms and biomarkers of successful allergen-specific immunotherapy

Abstract

Allergen-specific immunotherapy (AIT) is considered the only curative treatment for allergic diseases mediated by immunoglobulin E (IgE). Currently, the route of administration depends both on the different types of causal allergens and on its effectiveness and safety profile. Several studies have reported the mechanisms and changes in humoral and cellular response underlying AIT; however, the full picture remains unknown. Knowledge of who can benefit from this type of treatment is urgently needed due to the patient safety risks and costs of AIT. In vivo or in vitro biomarkers have become a strategy to predict clinical outcomes in precision medicine. There are currently no standardized biomarkers that allow determining successful responses to AIT, however, some studies have found differences between responders and nonresponders. In addition, different candidates have been postulated that may have the potential to become biomarkers. In this review, we aim to summarize the findings to date related to biomarkers in different IgE-mediated allergic diseases (respiratory, food, and venom allergy) with the potential to define who will benefit from AIT.

Hot topics in allergen immunotherapy, 2023: Current status and future perspective

“…57 Although there are currently no validated biomarkers to indicate a good response to AIT, research has revealed distinctions between responder and non-responder patients. 26 Potential AIT biomarkers are shown in Table 2.…”

“… 18–21 Prevention of new allergen sensitizations and avoidance of progression to more severe diseases, such as the development of asthma after allergic rhinitis, 22 is the main clinical implications of immune tolerance 23,24 . Studies during the last three decades have demonstrated evidence that allergen tolerance utilizes similar mechanisms as shown in other diseases, such as autoimmunity, tumour tolerance and organ transplantation 25,26 …”

“…23,24 Studies during the last three decades have demonstrated evidence that allergen tolerance utilizes similar mechanisms as shown in other diseases, such as autoimmunity, tumour tolerance and organ transplantation. 25,26…”

Allergen immunotherapy in allergic diseases

“…One mogu varirati od lokaliziranih i izoli ranih pa do sistemskih i životno opasnih. 15,16,17 Kasnu fazu alergijske reakcije, tj. kroničnu upalu, podržava učestalo ili stalno izlaganje alergenu.…”

“…innate lymphoid cells, ILC) pridonose razvoju i održa nju alergenspecifične tolerancije. 17,30 AITa, imaju povišenu ekspresiju DCreg i sniženu ekspresiju dendritičkih stanica tipa 2 (eng. dendritic type 2 cells, DC2) koje potiču diferencijaciju Th2 sta nica.…”