Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Clin Exp Allergy. 2019 Jan;49(1):17-26. doi: 10.1111/cea.13291. Epub 2018 Oct 31.
In vitro allergy diagnostics are currently based on the detection of specific IgE binding on intact allergens or a mixture thereof. This approach has drawbacks as it may yield false-negative and/or false-positive results. Thus, we reviewed the impact of known B-cell epitopes of food allergens to predict transience or persistence, tolerance or allergy and the severity of an allergic reaction and to examine new epitope mapping strategies meant to improve serum-based allergy diagnostics. Recent epitope mapping approaches have been worthwhile in epitope identification and may increase the specificity of allergy diagnostics by using epitopes predominately recognized by allergic patients in some cases. However, these approaches did not lead to discrimination between clinically relevant and irrelevant epitopes so far, since the polyclonal serum IgE-binding epitope spectrum seems to be too individual, independent of the disease status of the patients. New epitope mapping strategies are necessary to overcome these obstacles. The use of patient-derived monoclonal antibodies instead of patient sera for functional characterization of clinically relevant and irrelevant epitope combinations, distinguished by their ability to induce degranulation, might be a promising approach to gain more insight into the allergic reaction and to improve serum-based allergy diagnostics.
目前，体外过敏诊断基于对完整过敏原或其混合物上特异性 IgE 结合的检测。这种方法有其缺点，因为它可能产生假阴性和/或假阳性结果。因此，我们回顾了食物过敏原的已知 B 细胞表位对预测短暂性或持续性、耐受性或过敏以及过敏反应严重程度的影响，并研究了旨在改善基于血清的过敏诊断的新表位作图策略。最近的表位作图方法在表位识别方面是有价值的，并且在某些情况下可以通过使用主要被过敏患者识别的表位来提高过敏诊断的特异性。然而，到目前为止，这些方法并没有导致对临床相关和不相关表位的区分，因为多克隆血清 IgE 结合表位谱似乎过于个体化，与患者的疾病状态无关。需要新的表位作图策略来克服这些障碍。使用源自患者的单克隆抗体而不是患者血清来对临床相关和不相关表位组合进行功能表征，这些表位组合通过其诱导脱颗粒的能力来区分，可能是深入了解过敏反应并改善基于血清的过敏诊断的有前途的方法。
