Abstract
Pollen allergens are one of the main causes of type I allergies affecting up to 30 % of the population in industrialized countries. Climatic changes affect the duration and intensity of pollen seasons and may together with pollution contribute to increased incidences of respiratory allergy and asthma. Allergenic grasses, trees, and weeds often present similar habitats and flowering periods compromising clinical anamnesis. Molecule-based approaches enable distinction between genuine sensitization and clinically mostly irrelevant IgE cross-reactivity due to, e. g., panallergens or carbohydrate determinants. In addition, sensitivity as well as specificity can be improved and lead to identification of the primary sensitizing source which is particularly beneficial regarding polysensitized patients. This review gives an overview on relevant pollen allergens and their usefulness in daily practice. Appropriate allergy diagnosis is directly influencing decisions for therapeutic interventions, and thus, reliable biomarkers are pivotal when considering allergen immunotherapy in the context of precision medicine.
Highlights
Allergic reactions to pollen represent the most frequent type I allergies affecting up to 30 % of the industrialized population
Clinical anamnesis of pollen allergies to identify the disease-eliciting source can be hampered by similar habitat and flowering periods of certain plants and the fact that symptoms may be elicited by pollen transported far by the wind [5]
Skin prick tests and specific IgE detection using crude pollen extracts are currently performed in routine allergy diagnosis
Summary
Allergic reactions to pollen represent the most frequent type I allergies affecting up to 30 % of the industrialized population (www.eaaci.org). Skin prick tests and specific IgE detection using crude pollen extracts are currently performed in routine allergy diagnosis. Though refinement of diagnosis with purified molecules was proven effective, in vivo diagnosis using components is nowadays widely restricted to GMP-produced material Alternatives such as the basophil activation test (BAT), an in vitro method to monitor upregulation of activation markers CD63 and CD203 upon allergen-triggered activation of primary basophils, or mediator release assays with passively sensitized basophils, which measure either histamine or β-hexosaminidase, may help to circumvent this problem. Allergen microarrays with more than 100 purified allergen molecules (ImmunoCAP ISAC) enable simultaneous IgE measurement using only minute amounts of blood These multiplex assays offer an attractive alternative to refine allergy diagnosis, monitor disease progression as well as therapeutic outcomes [14]. Polcalcin Phenylcoumaran Polygalacturonase Plant invertase/pectin 1,3 beta-glucanase Pectate benzylic ether methylesterase (PR-2)
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