Understanding the Heterogeneity of Childhood Allergic Sensitization and Its Relationship with Asthma

Overview

Journal Curr Opin Allergy Clin Immunol

Specialty Allergy & Immunology

Date 2024 Feb 15

PMID 38359101

Authors

Adnan Custovic

Darije Custovic

Sara Fontanella

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: To review the current state of knowledge on the relationship between allergic sensitization and asthma; to lay out a roadmap for the development of IgE biomarkers that differentiate, in individual sensitized patients, whether their sensitization is important for current or future asthma symptoms, or has little or no relevance to the disease.

Recent Findings: The evidence on the relationship between sensitization and asthma suggests that some subtypes of allergic sensitization are not associated with asthma symptoms, whilst others are pathologic. Interaction patterns between IgE antibodies to individual allergenic molecules on component-resolved diagnostics (CRD) multiplex arrays might be hallmarks by which different sensitization subtypes relevant to asthma can be distinguished. These different subtypes of sensitization are associated amongst sensitized individuals at all ages, with different clinical presentations (no disease, asthma as a single disease, and allergic multimorbidity); amongst sensitized preschool children with and without lower airway symptoms, with different risk of subsequent asthma development; and amongst sensitized patients with asthma, with differing levels of asthma severity.

Summary: The use of machine learning-based methodologies on complex CRD data can help us to design better diagnostic tools to help practising physicians differentiate between benign and clinically important sensitization.

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References

Roberts G, Fontanella S, Selby A, Howard R, Filippi S, Hedlin G . Connectivity patterns between multiple allergen specific IgE antibodies and their association with severe asthma. J Allergy Clin Immunol. 2020; 146(4):821-830. DOI: 10.1016/j.jaci.2020.02.031. View

Koppelman G, Kersten E . Understanding How Asthma Starts: Longitudinal Patterns of Wheeze and the Chromosome 17q Locus. Am J Respir Crit Care Med. 2021; 203(7):793-795. PMC: 8017592. DOI: 10.1164/rccm.202102-0443ED. View

Belgrave D, Simpson A, Custovic A . Challenges in interpreting wheeze phenotypes: the clinical implications of statistical learning techniques. Am J Respir Crit Care Med. 2014; 189(2):121-3. DOI: 10.1164/rccm.201312-2206ED. View

Labrosse R, Graham F, Caubet J . Recent advances in the diagnosis and management of tree nut and seed allergy. Curr Opin Allergy Clin Immunol. 2022; 22(3):194-201. DOI: 10.1097/ACI.0000000000000826. View

Lazic N, Roberts G, Custovic A, Belgrave D, Bishop C, Winn J . Multiple atopy phenotypes and their associations with asthma: similar findings from two birth cohorts. Allergy. 2013; 68(6):764-70. DOI: 10.1111/all.12134. View

Saf S, Borres M, Sodergren E . Sesame allergy in children: New insights into diagnosis and management. Pediatr Allergy Immunol. 2023; 34(8):e14001. DOI: 10.1111/pai.14001. View

Custovic A, Custovic D, Kljaic Bukvic B, Fontanella S, Haider S . Atopic phenotypes and their implication in the atopic march. Expert Rev Clin Immunol. 2020; 16(9):873-881. DOI: 10.1080/1744666X.2020.1816825. View

Nakamura T, Haider S, Fontanella S, Murray C, Simpson A, Custovic A . Modelling trajectories of parentally reported and physician-confirmed atopic dermatitis in a birth cohort study. Br J Dermatol. 2021; 186(2):274-284. DOI: 10.1111/bjd.20767. View

Prosperi M, Belgrave D, Buchan I, Simpson A, Custovic A . Challenges in interpreting allergen microarrays in relation to clinical symptoms: a machine learning approach. Pediatr Allergy Immunol. 2013; 25(1):71-9. PMC: 4282342. DOI: 10.1111/pai.12139. View

10.

Oksel C, Granell R, Haider S, Fontanella S, Simpson A, Turner S . Distinguishing Wheezing Phenotypes from Infancy to Adolescence. A Pooled Analysis of Five Birth Cohorts. Ann Am Thorac Soc. 2019; 16(7):868-876. PMC: 6600832. DOI: 10.1513/AnnalsATS.201811-837OC. View

11.

Weinmayr G, Weiland S, Bjorksten B, Brunekreef B, Buchele G, Cookson W . Atopic sensitization and the international variation of asthma symptom prevalence in children. Am J Respir Crit Care Med. 2007; 176(6):565-74. DOI: 10.1164/rccm.200607-994OC. View

12.

Wickman M, Lupinek C, Andersson N, Belgrave D, Asarnoj A, Benet M . Detection of IgE Reactivity to a Handful of Allergen Molecules in Early Childhood Predicts Respiratory Allergy in Adolescence. EBioMedicine. 2017; 26:91-99. PMC: 5832567. DOI: 10.1016/j.ebiom.2017.11.009. View

13.

Illi S, von Mutius E, Lau S, Nickel R, Niggemann B, Sommerfeld C . The pattern of atopic sensitization is associated with the development of asthma in childhood. J Allergy Clin Immunol. 2001; 108(5):709-14. DOI: 10.1067/mai.2001.118786. View

14.

Marinho S, Simpson A, Soderstrom L, Woodcock A, Ahlstedt S, Custovic A . Quantification of atopy and the probability of rhinitis in preschool children: a population-based birth cohort study. Allergy. 2007; 62(12):1379-86. DOI: 10.1111/j.1398-9995.2007.01502.x. View

15.

Hallmark B, Wegienka G, Havstad S, Billheimer D, Ownby D, Mendonca E . Chromosome 17q12-21 Variants Are Associated with Multiple Wheezing Phenotypes in Childhood. Am J Respir Crit Care Med. 2021; 203(7):864-870. PMC: 8017591. DOI: 10.1164/rccm.202003-0820OC. View

16.

Haider S, Granell R, Curtin J, Fontanella S, Cucco A, Turner S . Modeling Wheezing Spells Identifies Phenotypes with Different Outcomes and Genetic Associates. Am J Respir Crit Care Med. 2022; 205(8):883-893. PMC: 9838626. DOI: 10.1164/rccm.202108-1821OC. View

17.

Just J, Bourgoin-Heck M, Amat F . Clinical phenotypes in asthma during childhood. Clin Exp Allergy. 2017; 47(7):848-855. DOI: 10.1111/cea.12939. View

18.

Shokouhi Shoormasti R, Rafaiani C, Fazlollahi M, Kazemnejad A, Mahloojirad M, Moslemi M . Molecular profile of specific IgE to allergenic components in allergic adults using allergen nano-bead array. Clin Exp Allergy. 2022; 52(8):942-953. DOI: 10.1111/cea.14113. View

19.

Howard R, Rattray M, Prosperi M, Custovic A . Distinguishing Asthma Phenotypes Using Machine Learning Approaches. Curr Allergy Asthma Rep. 2015; 15(7):38. PMC: 4586004. DOI: 10.1007/s11882-015-0542-0. View

20.

Farraia M, Mendes F, Sokhatska O, Rama T, Severo M, Custovic A . Component-resolved diagnosis in childhood and prediction of asthma in early adolescence: A birth cohort study. Pediatr Allergy Immunol. 2023; 34(12):e14056. DOI: 10.1111/pai.14056. View