Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life - 18/04/17

Abstract |
Background |
The evolution of the IgE response to the numerous allergen molecules of Dermatophagoides pteronyssinus is still unknown.
Objectives |
We sought to characterize the evolutionary patterns of the IgE response to 12 molecules of D pteronyssinus from birth to adulthood and to investigate their determinants and clinical relevance.
Methods |
We investigated the clinical data and sera of 722 participants in the German Multicenter Allergy Study, a birth cohort started in 1990. Diagnoses of current allergic rhinitis (AR) related to mite allergy and asthma were based on yearly interviews at the ages of 1 to 13 years and 20 years. IgE to the extract and 12 molecules of D pteronyssinus were tested by means of ImmunoCAP and microarray technology, respectively, in sera collected at ages 1, 2, 3, 5, 6, 7, 10, 13, and 20 years. Exposure to mites at age 6 and 18 months was assessed by measuring Der p 1 weight/weight concentration in house dust.
Results |
One hundred ninety-one (26.5%) of 722 participants ever had IgE to D pteronyssinus extract (≥0.35 kUA/L). At age 20 years, their IgE recognized most frequently Der p 2, Der p 1, and Der p 23 (group A molecules; prevalence, >40%), followed by Der p 5, Der p 7, Der p 4, and Der p 21 (group B molecules; prevalence, 15% to 30%) and Der p 11, Der p 18, clone 16, Der p 14, and Der p 15 (group C molecules; prevalence, <10%). IgE sensitization started almost invariably with group A molecules and expanded sequentially first to group B and finally to group C molecules. Early IgE sensitization onset, parental hay fever, and higher exposure to mites were associated with a broader polymolecular IgE sensitization pattern. Participants reaching the broadest IgE sensitization stage (ie, ABC) had significantly higher risk of mite-related AR and asthma than unsensitized participants. IgE to Der p 1 or Der p 23 at age 5 years or less predicted asthma at school age.
Conclusions |
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.
Le texte complet de cet article est disponible en PDF.Key words : House dust mite allergy, recombinant allergens, microarray, allergic rhinitis, asthma, birth cohort, children, component-resolved diagnostics, Dermatophagoides pteronyssinus, IgE, prediction
Abbreviations used : AR, CRD, HDM, ISAAC, MAR, MAS, OR
Plan
| Supported by the Deutsche Forschungsgemeinschaft (DFG) MA-4740/1-1, in part by grants F4602 and F4605 of the Austrian Science Fund (FWF), and by the Christian Doppler Research Association, Vienna, Austria. The Multicenter Allergy Study was funded by grants from the German Federal Ministry of Education and Research (07015633, 07 ALE 27, 01EE9405/5, and 01EE9406) and the German Research Foundation (KE 1462/2-1). D.P. received a DAAD scholarship. O.T. received a Clemens von Pirquet Foundation scholarship. |
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| Disclosure of potential conflict of interest: C. Lupinek receives payment for lectures form Thermo Fisher Scientific and travel support from the American Academy of Allergy, Asthma & Immunology (AAAAI). R. Valenta receives research support from Austrian Science Fund FWF, Biomay AG, Thermo Fisher Scientific, and Christian Doppler Research Association; serves as a consultant for Biomay AG, Thermo Fisher Scientific, and Fresenius Medical Care; and receives payment for lectures from Thermo Fisher Scientific. P. M. Matricardi serves as a consultant for Thermo Fisher Scientific, HYCOR biomedical, and Euroimmun AG and receives grant support from Thermo Fisher Scientific. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 139 - N° 2
P. 541 - février 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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