Natural Evolution of IgE Responses to Mite Allergens and Relationship to Progression of Allergic Disease: a Review

Abstract

Several cross-sectional and longitudinal studies confirmed the role of Der p 1 and Der p 2 as major allergenic proteins of the HDM. A newly identified player is the major allergen Der p 23. Apart from identifying the early sensitization towards this molecule as a risk factor for asthma in school age, a recent longitudinal study described sensitization patterns showing that the production of IgE usually starts towards a group of initiator proteins and may stay monomolecular or expand to an oligo- or even polymolecular stage. This phenomenon also correlates to clinical symptoms. A relation between a broad sensitization pattern and symptom severity has also been shown cross-sectionally. Individual sensitization profiles towards HDM allergens provide important information to evaluate a patient's current stage and risk for clinical symptoms. This knowledge paves the way for an early and adequate prevention and/or treatment.

Molecular Allergen Profiling of Dual Mite Sensitization in Severe Allergic Rhinitis

“…This observation was also described in grass pollen allergic patients indicating a close connection between wider sensitization profiles and higher IgE levels [23]. As observed by Posa and co-workers, a sensitization to Der p10 may be taken as a marker for broad sensitization, thus the immune response is more susceptible to be modified in the first, asymptomatic, mono-oligomolecular stages, early monitoring of the IgE response at a molecular level may be helpful to start an allergenspecific (immunotherapy)treatment at once [49,50].…”

Virus‐like particles displaying major house dust mite allergen Der p 2 for prophylactic allergen immunotherapy

“…1 Prophylactic AIT could represent an elegant strategy for primary prevention in high-risk children from atopic parents through the development of allergen-specific IgG capable to block any future allergen-IgE interaction. 2 Aiming at developing a safer, hypoallergenic, and more efficient prophylactic or therapeutic vaccine against house dust mite (HDM) allergy, we designed a virus-like particle (VLP) displaying multi-copies of the major HDM allergen Der p 2 using the SpyCatcher/SpyTag conjugation system. 3 activation by supra-optimal rDer p 2 concentrations, as evidenced for Qb-Fel d 1.…”

EAACI Guidelines on Allergen Immunotherapy: House dust mite‐driven allergic asthma

“…Substantial evidence associates allergic conditions such as asthma, allergic rhinitis (AR), atopic dermatitis (AD) with exposure to HDM, or other indoor allergens . Data from longitudinal investigations suggest that the development of sensitization to HDM occurs before polysensitization …”