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Kouser L, Kappen J, Walton RP, et al. Update on Biomarkers to Monitor Clinical Efficacy Response During and Post Treatment in Allergen Immunotherapy. Curr Treat Options Allergy. 2017;4(1):43-53doi: 10.1007/s40521-017-0117-5.
Kouser, L., Kappen, J., Walton, R. P., & Shamji, M. H. (2017). Update on Biomarkers to Monitor Clinical Efficacy Response During and Post Treatment in Allergen Immunotherapy. Current treatment options in allergy, 4(1), 43-53. https://doi.org/10.1007/s40521-017-0117-5
Kouser, Lubna, et al. "Update on Biomarkers to Monitor Clinical Efficacy Response During and Post Treatment in Allergen Immunotherapy." Current treatment options in allergy vol. 4,1 (2017): 43-53. doi: https://doi.org/10.1007/s40521-017-0117-5
Kouser L, Kappen J, Walton RP, Shamji MH. Update on Biomarkers to Monitor Clinical Efficacy Response During and Post Treatment in Allergen Immunotherapy. Curr Treat Options Allergy. 2017;4(1):43-53. doi: 10.1007/s40521-017-0117-5. Epub 2017 Mar 10. PMID: 28413769; PMCID: PMC5375961.
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Curr Treat Options Allergy. 2017;4(1):43-53. doi: 10.1007/s40521-017-0117-5. Epub 2017 Mar 10.

Update on Biomarkers to Monitor Clinical Efficacy Response During and Post Treatment in Allergen Immunotherapy.

Current treatment options in allergy

Lubna Kouser, Jasper Kappen, Ross P Walton, Mohamed H Shamji

Affiliations

  1. Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, Faculty of Medicine, Imperial College London, National Heart and Lung Institute, London, SW7 2AZ UK.
  2. Department of Pulmonology, STZ centre of excellence for Asthma & COPD, Sint Franciscus Vlietland group, Kleiweg 500, 3045 PM Rotterdam, The Netherlands.
  3. Airway Disease Infection Section, Imperial College London, part of the Medical Research Council and Asthma UK Centre for Allergic Mechanisms of Asthma, St. Mary's Hospital, National Heart and Lung Institute (NHLI), London, W2 1PG UK.

PMID: 28413769 PMCID: PMC5375961 DOI: 10.1007/s40521-017-0117-5

Abstract

Allergen immunotherapy (AIT) is an immune modulating treatment for allergic diseases. Although highly effective, some patients do not respond to the treatment. To date there are no surrogate biomarkers that are predictive of the clinical response to AIT. More and more is known about the underlying immunological mechanism involved in AIT. Through modulation of both innate and adaptive immune responses, involving reduced ILC2 and enhanced Treg and Breg induction and functionality, along with induction of IgG4 antibody production which have the capacity to inhibit both allergen-induced basophil responsiveness and CD23-mediated IgE-facilitated allergen presentation, the result is an immune skewing towards a more balanced Type I response. So far, however there is not a clear correlation with the observed immunological changes and predictive correlates of clinical efficacy. The most promising biomarker of successful AIT is IgE-FAB as a reflection of functional IgG4. Cellular responses and cytokine analysis gives a great deal of insight into the mechanisms of AIT but may not represent useful or indeed reliable biomarkers in a clinical setting. There is a need for more research for confirmation and interpretation of the possible association with biomarkers and clinical response to AIT.

Keywords: AIT; Allergen immunotherapy; Biomarkers; ILC2; IgG4; Tregs

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