Department of Immunology and Pathology, Central Clinical School, Monash University, Melbourne, VIC, Australia.
Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Monash University, and Alfred Hospital, Melbourne, VIC, Australia.
Allergy. 2021 Nov;76(11):3374-3382. doi: 10.1111/all.15036. Epub 2021 Aug 16.
Over the past two decades, precision medicine has advanced diagnostics and treatment of allergic diseases. Component-resolved analysis of allergen sensitization facilitates stratification of patients. Furthermore, new formulations of allergen immunotherapy (AIT) products can more effectively deliver the relevant components. Molecular insights from the identification of allergen component sensitization and clinical outcomes of treatment with new AIT formulations can now be utilized for a deeper understanding of the nature of the pathogenic immune response in allergy and how this can be corrected by AIT. Fundamental in these processes are the allergen-specific B and T cells. Within the large B- and T-cell compartments, only those that specifically recognize the allergen with their immunoglobulin (Ig) or T-cell receptor (TCR), respectively, are of clinical relevance. With peripheral blood allergen-specific B- and T-cell frequencies below 1%, bulk cell analysis is typically insufficiently sensitive. We here review the latest technologies to detect allergen-specific B and T cells, as well as new developments in utilizing these tools for diagnostics and therapy monitoring to advance precision medicine for allergic diseases.
在过去的二十年中，精准医学已经推动了过敏性疾病的诊断和治疗。过敏原致敏的成分分析有助于对患者进行分层。此外，过敏原免疫疗法 (AIT) 产品的新配方可以更有效地传递相关成分。从鉴定过敏原成分致敏和新 AIT 制剂治疗的临床结果中获得的分子见解，现在可以用于更深入地了解过敏中致病免疫反应的性质，以及 AIT 如何纠正这种反应。在这些过程中，过敏原特异性 B 和 T 细胞是基础。在大型 B 细胞和 T 细胞群中，只有那些分别用其免疫球蛋白 (Ig) 或 T 细胞受体 (TCR) 特异性识别过敏原的细胞才具有临床意义。由于外周血过敏原特异性 B 和 T 细胞频率低于 1%，通常细胞群分析不够敏感。我们在此回顾了最新的检测过敏原特异性 B 和 T 细胞的技术，以及利用这些工具进行诊断和治疗监测以推进过敏性疾病精准医学的新进展。
