03 Nov Mite Allergy Develops in Childhood “Like An Avalanche”
MedicalResearch.com Interview with:
Dr. Daniela Posa
Dr. Daniela Posa, MD
Department of Paediatric Pneumology & Immunology
Charité–Universitätsmedizin Berlin
Berlin, Germany
MedicalResearch.com: What is the background for this study?
Response: Allergy to house dust mites contributes to chronic rhinitis and asthma in hundreds million children and adults worldwide, causing tremendous health and economic burden in high- and middle-income countries. The disease is caused by antibodies called immunoglobulin E (IgE), it starts in childhood and can be controlled with drugs and allergen avoidance. However, there is no cure, hence primary and secondary prevention of mite allergy is a global research priority. We wanted to discover how allergy to mites starts and evolves and why some children develop more severe sensitization and symptoms than others.
MedicalResearch.com: What are the main findings?
a. The “ABC” of mite allergy – We found that mite allergy starts in children (often when they are still healthy) with an immune response to one or more of three molecules:
Der p 1, Der p 2 and Der p 23 (group “A”molecules); some children, but not others, then proceed with an allergic “cascade” involving other molecules (Der p 4, 5, 7, and 21 = group “B” molecules), and only a few children become sensitized also to Der p 11, 14, 15, and clone 16 (group “C” molecules). This phenomenon is defined the “molecular spreading” or simply “the ABC” progression of mite allergy.
b. Why some children become more allergic than others – We found that having parents with allergic rhinitis and heavy exposure to mite allergens in early childhood are the strongest determinants of a strong progression (“ABC”) allergy to mites. Moreover, children starting their allergic sensitization before the third birthday have the strongest spreading of their allergic sensitization.
c. Clinical relevance of “ABC” sensitization – We found that the children with IgE sensitization to more molecules (stage “ABC” of allergic sensitization) are at higher risk of allergic rhinitis and asthma.
d. Predicting asthma with a molecular diagnosis – We found that the children sensitized already at pre-school age to Der p 1 or Der p 23, but not those sensitized only to Der p 2, have higher risk of having allergic asthma at school age.
MedicalResearch.com: What should readers take away from your report?
Response: Mite allergy develops in childhood like an avalanche: it starts early with only one or a very few molecules and then grows to many. The greater is the spreading of molecular sensitization, the highest is the risk of developing asthma.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The study demonstrates that subjects with IgE sensitization to more molecules (stage “ABC” of allergic sensitization) are at higher risk of allergic rhinitis and asthma. These molecules can now be further investigated as targets and tools for prevention and therapy of allergic rhinitis and asthma triggered by House Dust Mites.
MedicalResearch.com: Is there anything else you would like to add?
Response: The results of our study may inspire predictive algorithms and prevention strategies against the progression of IgE sensitization to mites toward allergic rhinitis and asthma. Moreover, these findings open new avenues into the novel Era of ‘Precision Medicine’, producing molecular products for allergen immunotherapy, precisely tailored to the need of the individual patient.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Daniela Posa, Serena Perna, Yvonne Resch, Christian Lupinek, Valentina Panetta, Stephanie Hofmaier, Alexander Rohrbach, Laura Hatzler, Linus Grabenhenrich, Olympia Tsilochristou, Kuan-Wei Chen, Carl-Peter Bauer, Ute Hoffman, Johannes Forster, Fred Zepp, Antje Schuster, Ulrich Wahn, Thomas Keil, Susanne Lau, Susanne Vrtala, Rudolf Valenta, Paolo Maria Matricardi. 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, 2016; DOI: 10.1016/j.jaci.2016.08.014
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Last Updated on November 3, 2016 by Marie Benz MD FAAD