Update on Biomarkers to Predict Responders to Allergen Immunotherapy

Opinion statement

Most investigations aiming to identify biomarkers (BMKs) have focused on immunological changes reflecting our understanding of allergen-specific immunotherapy (AIT) mechanisms of action. The upregulation of allergen-specific regulatory CD4⁺ T cells, the downregulation or anergy of Th2 cells, the induction of specific "blocking" IgG4s, and the decrease of basophil activation are all thought to contribute to AIT efficacy. To this date, however, none of these immunological alterations can be used to predict AIT efficacy. Changes in the blood at the level of dendritic cells (DCs) reflecting the induction of regulatory DCs concomitantly with a downregulation of pro-allergic DC2s are the only parameters which have been correlated at an individual patient level with AIT efficacy. In this context, the search for BMKs should be extended beyond currently existing boundaries.

To this aim, the combined use of "Omics" technologies, encompassing comprehensive genome, transcriptome and proteome-wide analyses, is being implemented to compare biological samples obtained from clinical responders and non-responders. Such a non-hypothesis driven approach, referred to as the "panorOmic" view, will lead to the discovery of completely novel molecules. In order to predict the patient's specific response to AIT, future BMKs will likely emerge as algorithms combining information on the patient's disease, as well as his/her immune status and exposome.

http://ift.tt/2li2mMQ