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Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma: an EAACI Position Paper.
- Source :
-
Allergy [Allergy] 2017 Aug; Vol. 72 (8), pp. 1156-1173. Date of Electronic Publication: 2017 Apr 06. - Publication Year :
- 2017
-
Abstract
- Background: Allergen immunotherapy (AIT) is an effective treatment for allergic rhinoconjunctivitis (AR) with or without asthma. It is important to note that due to the complex interaction between patient, allergy triggers, symptomatology and vaccines used for AIT, some patients do not respond optimally to the treatment. Furthermore, there are no validated or generally accepted candidate biomarkers that are predictive of the clinical response to AIT. Clinical management of patients receiving AIT and efficacy in randomised controlled trials for drug development could be enhanced by predictive biomarkers.<br />Method: The EAACI taskforce reviewed all candidate biomarkers used in clinical trials of AR patients with/without asthma in a literature review. Biomarkers were grouped into seven domains: (i) IgE (total IgE, specific IgE and sIgE/Total IgE ratio), (ii) IgG-subclasses (sIgG1, sIgG4 including SIgE/IgG4 ratio), (iii) Serum inhibitory activity for IgE (IgE-FAB and IgE-BF), (iv) Basophil activation, (v) Cytokines and Chemokines, (vi) Cellular markers (T regulatory cells, B regulatory cells and dendritic cells) and (vii) In vivo biomarkers (including provocation tests?).<br />Results: All biomarkers were reviewed in the light of their potential advantages as well as their respective drawbacks. Unmet needs and specific recommendations on all seven domains were addressed.<br />Conclusions: It is recommended to explore the use of allergen-specific IgG4 as a biomarker for compliance. sIgE/tIgE and IgE-FAB are considered as potential surrogate candidate biomarkers. Cytokine/chemokines and cellular reponses provided insight into the mechanisms of AIT. More studies for confirmation and interpretation of the possible association with the clinical response to AIT are needed.<br /> (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Allergens immunology
Asthma immunology
Basophils immunology
Basophils metabolism
Biomarkers
Conjunctivitis, Allergic immunology
Cytokines metabolism
Humans
Immunoglobulin E immunology
Immunoglobulin G immunology
Lymphocyte Subsets immunology
Lymphocyte Subsets metabolism
Prognosis
Rhinitis, Allergic immunology
Treatment Outcome
Asthma diagnosis
Asthma therapy
Conjunctivitis, Allergic diagnosis
Conjunctivitis, Allergic therapy
Desensitization, Immunologic methods
Rhinitis, Allergic diagnosis
Rhinitis, Allergic therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1398-9995
- Volume :
- 72
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Allergy
- Publication Type :
- Academic Journal
- Accession number :
- 28152201
- Full Text :
- https://doi.org/10.1111/all.13138