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Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma: An EAACI Position Paper
- Source :
- Allergy 72, 1156-1173 (2017)
- Publication Year :
- 2017
- Publisher :
- Wiley, 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. 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?). 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. 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.
- Subjects :
- 0301 basic medicine
Allergen immunotherapy
Allergy
Immunology
Provocation test
Immunoglobulin E
03 medical and health sciences
0302 clinical medicine
medicine
Immunology and Allergy
Humans
Asthma
Conjunctivitis, Allergic
biology
Allergen Immunotherapy
Basophil Activation
Biomarkers
Ige-fab
Igg4
business.industry
Allergens
medicine.disease
Prognosis
Rhinitis, Allergic
Lymphocyte Subsets
Basophils
Clinical trial
Basophil activation
030104 developmental biology
Treatment Outcome
030228 respiratory system
Desensitization, Immunologic
Immunoglobulin G
biology.protein
Biomarker (medicine)
Cytokines
business
Subjects
Details
- Language :
- German
- Database :
- OpenAIRE
- Journal :
- Allergy 72, 1156-1173 (2017)
- Accession number :
- edsair.doi.dedup.....575876858e39ace2d75b6ba488d194ca