Molecular profile clustering of IgE responses and potential implications for specific immunotherapyMatricardi, Paolo M.Current Opinion in Allergy and Clinical Immunology: August 2013 - Volume 13 - Issue 4 - p 438–445 doi: 10.1097/ACI.0b013e3283630ca5 Special Commentary Abstract Author Information Purpose of review To summarize recent data on molecular profiles of IgE sensitization in allergic patients and discuss how they can influence our understanding of allergen specific immunotherapy. Recent findings In childhood, Immunoglobulin E (IgE) sensitization to grass pollen starts preclinically as a weak, mono or oligomolecular response and evolves rapidly to become strong, polymolecular and associated with clinical manifestations. This immunological phenomenon has been defined ‘molecular spreading’ and it makes the IgE sensitization profiles to complex allergenic sources highly heterogeneous in the population. Summary The recent findings raise new questions: do different molecular sensitization profiles (e.g. to grass pollen) underlie different clinical responses to allergen-specific immunotherapy? Should the allergen-specific immunological intervention be anticipated at earlier stages of the IgE sensitization process? Should the regulatory rules for molecularly designed allergen-specific immunotherapy preparations consider the extreme heterogeneity of sensitization profiles in populations? Department of Pediatric Pneumology and Immunology, Charité Medical School, Berlin, Germany Correspondence to Paolo M. Matricardi, Department of Paediatric Pneumology and Immunology, Charitè Medical University, Augustenburgerplatz, 1, 13353 Berlin, Germany. Tel: +49 30 450 566 406; fax: +49 30 450 566 931; e-mail: email@example.com Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.