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

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:139

Article

Posa, Daniela¹  Perna, Serena¹  Resch, Yvonne³  Lupinek, Christian³  Panetta, Valentina⁵  Hofmaier, Stephanie¹  Rohrbach, Alexander¹  Hatzler, Laura¹  Grabenhenrich, Linus²  Tsilochristou, Olympia¹  Chen, Kuan-Wei³  Bauer, Carl-Peter⁶  Hoffman, Ute⁶  Forster, Johannes⁷  Zepp, Fred⁸  Schuster, Antje⁹  Wahn, Ulrich¹  Keil, Thomas¹⁰  Lau, Susanne¹  Vrtala, Susanne^3,4  Valenta, Rudolf^3,4  Matricardi, Paolo Maria^1,3 

[1] Charite, Dept Paediat Pneumol & Immunol, Augustenburger Pl 1, D-13353 Berlin, Germany

[2] Charite, Inst Social Med Epidemiol & Hlth Econ, Berlin, Germany

[3] Med Univ Vienna, Div Immunopathol, Dept Pathophysiol & Allergy Res, Ctr Pathophysiol Infectiol & Immunol, Vienna, Austria

[4] Med Univ Vienna, Christian Doppler Lab Dev Allergen Chips, Vienna, Austria

[5] Laltrastatistica srl, Consultancy & Training, Biostat, Rome, Italy

[6] Tech Univ Munich, Dept Pediat, D-80290 Munich, Germany

[7] St Josefs Hosp, Dept Pediat St Hedwig, Freiburg, Germany

[8] Univ Med Mainz, Dept Pediat & Adolescent Med, Mainz, Germany

[9] Heinrich Heine Univ, Dept Pediat, Dusseldorf, Germany

[10] Univ Wurzburg, Inst Clin Epidemiol & Biometry, Wurzburg, Germany

关键词: House dust mite allergy;    recombinant allergens;    microarray;    allergic rhinitis;    asthma;    birth cohort;    children;    component-resolved diagnostics;    Dermatophagoides pteronyssinus;    IgE;    prediction;   

DOI  :  10.1016/j.jaci.2016.08.014

来源: Elsevier

【 摘 要 】

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 kU(A)/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 miterelated 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 miterelated 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.

【 授权许可】

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