Multiplex IgE diagnostic test: house dust mite sensitization dissected using six allergenic molecule groups
Alessandri C, Ferrara R, Ml, Bernardi, Zennaro D, Rafaiani C, Ciancamerla M, Tuppo L, Giangrieco I, Tamburrini M, Ciardiello MA, Mari, A
Allergy 72: 662-662. (2017)
Introduction:Dermatophagoides pteronyssinus, Dermatophagoidesfarinae, Euroglyphus Maynei, Blomia tropicalis are house dust mites(HDM), representing the main sources of indoor allergens, with con-centration highly dependent upon the domestic environmental con-ditions and external climate. 37 proteins from HDM’s described asallergens.Objectives:To define the sensitization patterns to HDM allergensand extract available in the test in a population of 1751 patients,tested for routine allergy diagnosis.Results:Der f 1, Der f 2, Der p 1, Der p 2, Der p 7, Der p 9, Der p10, Der p 23, Eur m 2 and Blomia tropicalis extract were availablefor testing in a nanobead-based IVD test for specific IgE detectionbearing 122 molecular allergens and 122 allergenic extracts, all cou-pled to chemically activated nanoparticles. Out of the 1751 analyzedpatients 641 (36.61%) turned out to be sensitized to at least oneHDM protein. The sensitization prevalence of each allergen was asfollows: Der p 2 88%, Der f 2 85%, Eur m 2 52%, Der p 23 48%,Der p 1 44%, Der f 1 37%, Der p 7 24%, Der p 9 7%, Blo t extract13%. Pattern of sensitization and specific IgE concentration were dif-ferent, resulting in different patient clustering. Analyzing the data bypatients’age, all proteins behave quite similarly, with sensitizationpeaks in the second and third decades of life.Conclusions:Although the proteolytic activity of mite group oneallergens is claimed as a cause of the high prevalence of HDM sensiti-zation, Der p 1 and Der f 1 do not represent the most common sensiti-zation in mite allergic patients. This evidence is further supported bythe low sensitization prevalence to Der p 9, another proteases. GroupDer p 2 and Der p 23, whose biological function is almost unknown,represent the most common sensitizers. From a therapeutic perspec-tive and considering the need of a personalized medicine, knowledgeabout single patient IgE profile leads to the selection of the most suit-able extract for immunotherapy. This implies that the allergy investiga-tion should be carried out in the most extensive and comprehensivemanner starting with mite allergy representing one of the most com-mon allergy worldwide. The test is the newest in vitro test for specificIgE detection, including molecules and extracts, actually allowing totest the patients’responses to the broadest spectrum of availableHDM allergens in the routine setting.
