Posa Daniela, Hofmaier Stephanie, Arasi Stefania, Matricardi Paolo Maria
Department of Paediatric Pneumology & Immunology, Charité - Universitätsmedizin Berlin, Augustenburger Platz, 1, 13353, Berlin, Germany.
Curr Allergy Asthma Rep. 2017 May;17(5):28. doi: 10.1007/s11882-017-0697-y.
Allergenic molecules of the house dust mite (HDM) are crucially important indoor allergens, contributing to allergic rhinitis and asthma around the globe. In the past years, recombinant molecules for diagnostics opened new pathways to investigate individual sensitization profiles and new chances for the prevention and treatment of HDM allergy. This review summarizes the latest findings on the evolution of IgE responses towards mite allergens.
Several cross-sectional and longitudinal studies confirmed the role of Der p 1 and Der p 2 as major allergenic proteins of the HDM. A newly identified player is the major allergen Der p 23. Apart from identifying the early sensitization towards this molecule as a risk factor for asthma in school age, a recent longitudinal study described sensitization patterns showing that the production of IgE usually starts towards a group of initiator proteins and may stay monomolecular or expand to an oligo- or even polymolecular stage. This phenomenon also correlates to clinical symptoms. A relation between a broad sensitization pattern and symptom severity has also been shown cross-sectionally. Individual sensitization profiles towards HDM allergens provide important information to evaluate a patient's current stage and risk for clinical symptoms. This knowledge paves the way for an early and adequate prevention and/or treatment.
屋尘螨（HDM）的变应原分子是至关重要的室内变应原，在全球范围内导致过敏性鼻炎和哮喘。在过去几年中，用于诊断的重组分子为研究个体致敏谱开辟了新途径，并为HDM过敏的预防和治疗带来了新机遇。本综述总结了关于IgE对螨变应原反应演变的最新发现。
多项横断面和纵向研究证实了Der p 1和Der p 2作为HDM主要变应原蛋白的作用。一个新发现的因素是主要变应原Der p 23。除了确定对该分子的早期致敏是学龄期哮喘的危险因素外，最近一项纵向研究描述了致敏模式，表明IgE的产生通常始于一组起始蛋白，可能保持单分子状态，也可能扩展到寡分子甚至多分子阶段。这种现象也与临床症状相关。横断面研究也显示了广泛的致敏模式与症状严重程度之间的关系。个体对HDM变应原的致敏谱为评估患者当前阶段和临床症状风险提供了重要信息。这些知识为早期和适当的预防和/或治疗铺平了道路。
