Molecular profiles of IgE to Phleum pratense in children with grass pollen allergy: Implications for specific immunotherapy

详细信息    查看全文

• 作者：Salvatore Tripodi ; MD^a ; Tullio Frediani ; MD^b ; Sandra Lucarelli ; MD^b ; Francesco Macrì ; MD^b ; Giuseppe Pingitore ; MD^c ; Andrea Di Rienzo Businco ; MD^a ; Arianna Dondi ; MD^d ; Paola Pansa ; MD^b ; Giovanni Ragusa ; MD^b ; Riccardo Asero ; MD^e ; Diego Faggian ; MSc^f ; Mario Plebani ; MD^f ; Paolo Maria Matricardi ; MD^g ; ^{paolo.matricardi@charite.de}
• 关键词：Allergenic molecules ; atopy ; children ; classification ; combinatorial analysis ; component-resolved diagnosis ; component-resolved therapy ; epidemiology ; grass pollen ; hay fever ; molecular profiles ; Phleum pratense ; specific IgE
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2012
• 出版时间：March, 2012
• 年：2012
• 卷：129
• 期：3
• 页码：834-839.e8
• 全文大小：1436 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Background

The so-called component-resolved immunotherapy of allergies proposes an immunization tailored to the molecular sensitization profiles of individual patients.

Objectives

We sought (1) to investigate the profiles of IgE sensitization to Phleum pratense in children with grass pollen allergy and (2) to define the compatibility of these profiles with a mixture of recombinant allergenic molecules of P pratense previously proposed for specific immunotherapy.

Methods

We examined 200 children (age, 4-18 years; 126 boys) with allergic rhinitis, asthma, or both ascertained through validated questionnaires. Each child underwent skin prick testing (ALK-Abell¨®) and serum IgE assays (ImmunoCAP, Phadia) with 9 pollen extracts. Sera reacting against P pratense were tested for the individual molecules (rPhl p 1, rPhl p 2, rPhl p 4, nPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, and Phl p 12). Through a combinatorial approach, the IgE individual sensitization profiles were matched against an experimental allergen-specific immunotherapy (SIT) preparation containing Phl p 1, Phl p 2, Phl p 5, and Phl p 6.

Results

Among the 176 of 200 children with IgE sensitization to P pratense extract, 39 profiles of sensitization to the 8 allergenic molecules tested (cutoff, 0.35 kU/L) were identified. This high heterogeneity was reduced by considering only 6 or 4 P pratense molecules but not by increasing the cutoff levels of IgE positivity. The molecular profile of the experimental SIT preparation matched that of 7 (4 % ) of 176 patients only; the remaining 169 patients were classified in 4 mismatch categories: underpowered (29 % ), overpowered (32 % ), underpowered/overpowered (32 % ), and unrelated (3 % ).

Conclusions

IgE sensitization profiles to P pratense are highly heterogeneous. Molecularly designed SIT preparations tailored to patients?needs should consider this high heterogeneity and be driven by locally performed population studies.