Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
Front Immunol. 2021 Jan 28;11:594350. doi: 10.3389/fimmu.2020.594350. eCollection 2020.
Food allergy is a collective term for several immune-mediated responses to food. IgE-mediated food allergy is the best-known subtype. The patients present with a marked diversity of clinical profiles including symptomatic manifestations, threshold reactivity and reaction kinetics. In-vitro predictors of these clinical phenotypes are evasive and considered as knowledge gaps in food allergy diagnosis and risk management. Peanut allergy is a relevant disease model where pioneer discoveries were made in diagnosis, immunotherapy and prevention. This review provides an overview on the immune basis for phenotype variations in peanut-allergic individuals, in the light of future patient stratification along emerging omic-areas. Beyond specific IgE-signatures and basophil reactivity profiles with established correlation to clinical outcome, allergenomics, mass spectrometric resolution of peripheral allergen tracing, might be a fundamental approach to understand disease pathophysiology underlying biomarker discovery. Deep immune phenotyping is thought to reveal differential cell responses but also, gene expression and gene methylation profiles (eg, peanut severity genes) are promising areas for biomarker research. Finally, the study of microbiome-host interactions with a focus on the immune system modulation might hold the key to understand tissue-specific responses and symptoms. The immune mechanism underlying acute food-allergic events remains elusive until today. Deciphering this immunological response shall enable to identify novel biomarker for stratification of patients into reaction endotypes. The availability of powerful multi-omics technologies, together with integrated data analysis, network-based approaches and unbiased machine learning holds out the prospect of providing clinically useful biomarkers or biomarker signatures being predictive for reaction phenotypes.
食物过敏是对食物的几种免疫介导反应的总称。IgE 介导的食物过敏是最知名的亚型。患者表现出明显的临床表型多样性，包括症状表现、阈值反应性和反应动力学。这些临床表型的体外预测因素是难以捉摸的，被认为是食物过敏诊断和风险管理中的知识空白。花生过敏是一个相关的疾病模型，在该模型中，在诊断、免疫疗法和预防方面取得了开创性的发现。这篇综述提供了一个关于花生过敏个体表型变异的免疫基础的概述，考虑到未来沿着新兴的组学领域进行患者分层。除了与临床结果有明确相关性的特异性 IgE 特征和嗜碱性粒细胞反应特征外，过敏原组学、外周过敏原追踪的质谱分辨率，可能是理解潜在生物标志物发现的疾病病理生理学的基本方法。深度免疫表型分析被认为可以揭示不同的细胞反应，但也有研究表明，基因表达和基因甲基化谱（例如，花生严重程度基因）是生物标志物研究的有前途的领域。最后，研究微生物组-宿主相互作用，重点关注免疫系统调节，可能是理解组织特异性反应和症状的关键。急性食物过敏事件的免疫机制至今仍难以捉摸。解析这种免疫反应将能够识别新型生物标志物，用于将患者分层为反应内表型。强大的多组学技术的可用性，加上集成数据分析、基于网络的方法和无偏机器学习，有望提供具有临床应用价值的生物标志物或生物标志物特征，可预测反应表型。
