A real-life ImmunoCAT study: impact of molecular diagnosis through ImmunoCAPTM ISAC 112 on immunotherapy prescription in pollen-polysensitized patients in Catalonia, Spain
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Keywords
Asthma, pediatric, adolescent, change, immunotherapy, molecular diagnosis, personalized medicine, pollen polysensitized patients, rhinitis, rhinoconjunctivitis
Abstract
Background: Molecular diagnosis in allergology helps to identify multiple allergenic molecules simultaneously. The use of purified and/or recombinant allergens increases the accuracy of individual sensitization profiles in allergic patients.
Objective: To assess the impact of molecular diagnosis through the ImmunoCAPTM ISAC 112 microarray on etiological diagnosis and specific immunotherapy (SIT) prescription. This was compared to the use of conventional diagnoses in pediatric, adolescent, and young adult patients with rhinitis or rhinoconjunctivitis and/or allergic asthma, sensitized to three or more pollen allergens of different botanical species.
Methods: A multicenter, prospective, observational study was conducted in patients aged 3–25 years who received care at the Allergology service of 14 hospitals in Catalonia from 2017 to 2020. Allergology diagnosis was established based on the patient’s clinical assessment and the results of the skin prick test and specific immunoglobulin E assays. Subsequently, molecular diagnosis was conducted using ImmunoCAPTM ISAC® 112 to recombinant and/or purified allergen components.
Results: A total of 109 patients were included; 35 (32.1%) were pediatric patients and 74 (67.9%) were adolescents or young adults (mean age: 18 years), with 58.0% being females. A change of 51.0% was observed in SIT prescription following molecular etiological diagnosis by means of a multi-parameter microarray.
Conclusions: Molecular diagnosis by means of multi-parameter tests increases the accuracy of etiological diagnosis and helps to define an accurate composition of SIT.
References
2. Alvaro-Lozano M, Akdis CA, Akdis M, Alviani C, Angier E, Arasi S, et al. Allergen immunotherapy in children user’s guide. Pediatr Allergy Immunol. 2020 May 21;31(S25):1–101. 10.1111/pai.13189.
3. Valenta R, Lidholm J, Niederberger V, Hayek B, Kraft D, Grönlund H. The recombinant allergen-based concept of component-resolved diagnostics and immunotherapy (CRD and CRIT). Clin Exp Allergy. 1999 Jul;29(7):896–904. 10.1046/j.1365-2222.1999.00653.x
4. Sastre J, Sastre-Ibañez M. Molecular diagnosis and immunotherapy. Curr Opin Allergy Clin Immunol. 2016 Dec;16(6):565–70. 10.1097/ACI.0000000000000318
5. Vidal C, Enrique E, Gonzalo A, Moreno C, Tabar AI. Diagnosis and allergen immunotherapy treatment of polysensitised patients with respiratory allergy in Spain: An allergists’ consensus. Clin Transl Allergy. 2014 Jan 7;4(1):36. 10.1186/2045-7022-4-36
6. Ansotegui IJ, Melioli G, Canonica GW, Caraballo L, Villa E, Ebisawa M, et al. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper. World Allergy Organ J. 2020 Feb;13(2):100080.S1939455119312360
7. Sastre J, Landivar ME, Ruiz-García M, Andregnette-Rosigno MV., Mahillo I. How molecular diagnosis can change allergen-specific immunotherapy prescription in a complex pollen area. Allergy. 2012 May;67(5):709–11. 10.1111/j.1398-9995.2012.02808.x
8. Til-Pérez G, Carnevale C, Sarría-Echegaray PL, Arancibia-Tagle D, Chugo-Gordillo S, Tomás-Barberán MD. Sensitization profile in patients with respiratory allergic diseases: Differences between conventional and molecular diagnosis (a cross-sectional study). Clin Mol Allergy. 2019 Dec 2;17(1):8. 10.1186/s12948-019-0112-4
9. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008*. Allergy. 2008 Apr;63:8–160. 10.1111/j.1398-9995.2007.01620.x
10. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) Guía Española para el Manejo del Asma (GEMA 5.2, actualización 2022) [Internet]. [cited 2022] Available from: www.gemasma.com
11. Bousquet J, Heinzerling L, Bachert C, Papadopoulos NG, Bousquet PJ, Burney PG, et al. Practical guide to skin prick tests in allergy to aeroallergens. Allergy. 2012 Jan;67(1):18–24. 10.1111/j.1398-9995.2011.02728.x
12. Knibb RC, Alviani C, Garriga-Baraut T, Mortz CG, Vazquez-Ortiz M, Angier E, et al. The effectiveness of interventions to improve self-management for adolescents and young adults with allergic conditions: A systematic review. Allergy. 2020 Aug 27;75(8):1881–98. 10.1111/all.14269
13. Garriga-Baraut T, Moncín MMSM, Tena M, Labrador-Horrillo M. INMUNOCAT study: The impact of molecular diagnosis on immunotherapy prescription in pollen polysensitized patients from Catalonia. Clin Transl Allergy. 2023 May 3;13(5):e12246. 10.1002/clt2.12246
14. Depreux N, Quilez E, Roger A, Basagaña M. Component-resolved diagnosis: Impact on indications for therapy in patients with respiratory allergy and sensitization to multiple pollens in Catalonia, Spain. J Investig Allergol Clin Immunol. 2016;26(6):396–8. 10.18176/jiaci.0111
15. Peveri S, Pattini S, Costantino MT, Incorvaia C, Montagni M, Roncallo C, et al. Molecular diagnostics improves diagnosis and treatment of respiratory allergy and food allergy with economic optimization and cost saving. Allergol Immunopathol (Madr). 2019 Jan;47(1):64–72. 10.1016/j.aller.2018.05.008
16. Stringari G, Tripodi S, Caffarelli C, Dondi A, Asero R, Di Rienzo Businco A, et al. The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever. J Allergy Clin Immunol. 2014 Jul;134(1):75–81.e2. 10.1016/j.jaci.2014.01.042
17. Del-Río Camacho G, Montes Arjona AM, Fernández-Cantalejo Padial J, Rodríguez Catalán J. How molecular diagnosis may modify immunotherapy prescription in multi--sensitized pollen-allergic children. Allergol Immunopathol (Madr). 2018 Nov;46(6):552–6. 10.1016/j.aller.2018.03.002
18. Moreno C, Justicia JL, Quiralte J, Moreno-Ancillo Á, Iglesias-Cadarso A, Torrecillas M, et al. Olive, grass or both? Molecular diagnosis for the allergen immunotherapy selection in polysensitized pollinic patients. Allergy. 2014 Oct 69(10):1357–63. 10.1111/all.12474
19. Martínez-Cañavate Burgos A, Torres-Borrego J, Molina Terán AB, Corzo JL, García BE, Rodríguez Pacheco R, et al. Molecular sensitization patterns and influence of molecular diagnosis in immunotherapy prescription in children sensitized to both grass and olive pollen. Pediatr Allergy Immunol. 2018 Jun;29(4):369–74. 10.1111/pai.12866
20. Curin M, Reininger R, Swoboda I, Focke M, Valenta R, Spitzauer S. Skin prick test extracts for dog allergy diagnosis show considerable variations regarding the content of major and minor dog allergens. Int Arch Allergy Immunol. 2011;154(3):258–63. 10.1159/000321113
21. Bernardini R, Pucci N, Azzari C, Novembre E, De Martino M, Milani M. Sensitivity and specificity of different skin prick tests with latex extracts in pediatric patients with suspected natural rubber latex allergy–A cohort study. Pediatr Allergy Immunology. 2008 Jun;19(4):315–8. 10.1111/j.1399-3038.2007.00662.x
22. Izmailovich M, Semenova Y, Abdushukurova G, Mukhamejanova A, Dyussupova A, Faizova R, et al. Molecular aspects of allergen-specific immunotherapy in patients with seasonal allergic rhinitis. Cells. 2023 Jan 20;12(3):383. 10.3390/cells12030383
23. Ansotegui IJ, Melioli G, Canonica GW, Gómez RM, Jensen-Jarolim E, Ebisawa M, et al. A WAO–ARIA–GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020. World Allergy Org J. 2020 Feb;13(2):100091. 10.1016/j.waojou.2019.100091
24. Passalacqua G, Melioli G, Bonifazi F, Bonini S, Maggi E, Senna G, et al. The additional values of microarray allergen assay in the management of polysensitized patients with respiratory allergy. Allergy. 2013 Aug;68(8):1029–33. 10.1111/all.12194
25. Sastre J, Sastre-Ibañez M. Molecular diagnosis and immunotherapy. Curr Opin Allergy Clin Immunol. 2013 Dec;13(6):646–50. 10.1097/ACI.0000000000000318
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Laia Ferré-Ybarz, Allergy Department, Fundació Althaia Hospital, Manresa, Spain.