Biomarkers of AIT: Models of prediction of efficacy.

Allergologie Select Pub Date : 2022-11-21 eCollection Date: 2022-01-01 DOI:10.5414/ALX02333E
Tiak Ju Tan, María I Delgado-Dolset, María M Escribese, Domingo Barber, Janice A Layhadi, Mohamed H Shamji
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引用次数: 3

Abstract

Allergic rhinitis is an IgE-mediated inflammation that remains a clinical challenge, affecting 40% of the UK population with a wide range of severity from nasal discomfort to life-threatening anaphylaxis. It can be managed by pharmacotherapeutics and in selected patients by allergen immunotherapy (AIT), which provides long-term clinical efficacy, especially during peak allergy season. However, there are no definitive biomarkers for AIT efficacy. Here, we aim to summarize the key adaptive, innate, humoral, and metabolic advances in biomarker identification in response to AIT. Mechanisms of efficacy consist of an immune deviation towards TH1-secreting IFN-γ, as well as an induction of IL10+ cTFR and TREG have been observed. TH2 cells undergo exhaustion after AIT due to chronic allergen exposure and correlates with the exhaustion markers PD-1, CTLA-4, TIGIT, and LAG3. IL10+ DCREG expressing C1Q and STAB are induced. KLRG1+ IL10+ ILC2 were shown to be induced in AIT in correlation with efficacy. BREG cells secreting IL-10, IL-35, and TGF-β are induced. Blocking antibodies IgG, IgA, and IgG4 are increased during AIT; whereas inflammatory metabolites, such as eicosanoids, are reduced. There are multiple promising biomarkers for AIT currently being evaluated. A panomic approach is essential to better understand cellular, molecular mechanisms and their correlation with clinical outcomes. Identification of predictive biomarkers of AIT efficacy will hugely impact current practice allowing physicians to select eligible patients that are likely to respond to treatment as well as improve patients' compliance to complete the course of treatment.

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AIT的生物标志物:预测疗效的模型。
过敏性鼻炎是一种ige介导的炎症,仍然是一个临床挑战,影响着40%的英国人口,其严重程度从鼻腔不适到危及生命的过敏反应。它可以通过药物治疗和特定患者的过敏原免疫治疗(AIT)来管理,这提供了长期的临床疗效,特别是在过敏高峰季节。然而,对于AIT的疗效并没有明确的生物标志物。在这里,我们的目的是总结关键的适应性,先天,体液和代谢的生物标志物鉴定的进展,以应对AIT。已观察到其作用机制包括对分泌th1的IFN-γ的免疫偏离,以及对il - 10+ cTFR和TREG的诱导。慢性过敏原暴露导致AIT后TH2细胞耗竭,并与耗竭标志物PD-1、CTLA-4、TIGIT和LAG3相关。诱导表达C1Q和STAB的IL10+ DCREG。KLRG1+ IL10+ ILC2在AIT中的诱导作用与疗效相关。诱导BREG细胞分泌IL-10、IL-35和TGF-β。阻断抗体IgG、IgA和IgG4在AIT期间升高;而炎性代谢物,如类二十烷酸,则会减少。目前正在评估多个有前景的AIT生物标志物。一个全面的方法是必不可少的,以更好地了解细胞,分子机制及其与临床结果的相关性。识别AIT疗效的预测性生物标志物将极大地影响当前的实践,使医生能够选择可能对治疗有反应的合格患者,并提高患者完成治疗过程的依从性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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