Campana Raffaela, Dzoro Sheron, Mittermann Irene, Fedenko Elena, Elisyutina Olga, Khaitov Musa, Karaulov Alexander, Valenta Rudolf
aDivision of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria bNRC Institute of Immunology FMBA cDepartment of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia.
Curr Opin Allergy Clin Immunol. 2017 Aug;17(4):269-277. doi: 10.1097/ACI.0000000000000378.
Molecular allergology uses pure, mainly recombinant and structurally defined allergen molecules and allergen-derived epitopes to study mechanisms of IgE-associated allergy, to diagnose, and even predict the development of allergic manifestations and to treat and prevent IgE-associated allergies. Atopic dermatitis, a chronic inflammatory skin disease is almost always associated with IgE sensitization to allergens. However, also non-IgE-mediated pathomechanisms seem to be operative in atopic dermatitis and it is often difficult to identify the disease-causing allergens. Here we review recent work showing the usefulness of molecular allergology to study mechanisms of atopic dermatitis, for diagnosis and eventually for treatment and prevention of atopic dermatitis.
IgE sensitization to airborne, food-derived, microbial allergens, and autoallergens has been found to be associated with atopic dermatitis. Using defined allergen molecules and non-IgE-reactive allergen derivatives, evidence could be provided for the existence of IgE- and non-IgE-mediated mechanisms of inflammation in atopic dermatitis. Furthermore, effects of epicutaneous allergen administration on systemic allergen-specific immune responses have been studied. Multi-allergen tests containing micro-arrayed allergen molecules have been shown to be useful for the identification of culprit allergens in atopic dermatitis and may improve the management of atopic dermatitis by allergen-specific immunotherapy, allergen avoidance, and IgE-targeting therapies in a personalized medicine approach.
Molecular allergology allows for dissection of the pathomechanisms of atopic dermatitis, provides new forms of allergy diagnosis for identification of disease-causing allergens, and opens the door to new forms of management by allergen-specific and T cells-targeting or IgE-targeting interventions in a personalized medicine approach.
分子过敏学利用纯的、主要是重组的且结构明确的过敏原分子和过敏原衍生表位来研究IgE相关过敏的机制、进行诊断，甚至预测过敏表现的发展，并治疗和预防IgE相关过敏。特应性皮炎是一种慢性炎症性皮肤病，几乎总是与对过敏原的IgE致敏相关。然而，非IgE介导的发病机制似乎也在特应性皮炎中起作用，并且通常难以确定致病过敏原。在此，我们综述了近期的研究工作，这些工作表明分子过敏学在研究特应性皮炎机制、诊断以及最终治疗和预防特应性皮炎方面的有用性。
已发现对空气传播的、食物来源的、微生物过敏原和自身过敏原的IgE致敏与特应性皮炎相关。使用明确的过敏原分子和非IgE反应性过敏原衍生物，可以为特应性皮炎中IgE介导和非IgE介导的炎症机制的存在提供证据。此外，还研究了经皮给予过敏原对全身过敏原特异性免疫反应的影响。已证明包含微阵列过敏原分子的多过敏原测试可用于识别特应性皮炎中的致病过敏原，并可能通过个性化医疗方法中的过敏原特异性免疫疗法、避免接触过敏原和IgE靶向疗法来改善特应性皮炎的管理。
分子过敏学有助于剖析特应性皮炎的发病机制，为识别致病过敏原提供新的过敏诊断形式，并通过个性化医疗方法中的过敏原特异性和T细胞靶向或IgE靶向干预为新的管理形式打开大门。
