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Molecular diagnosis and immunotherapy

Sastre, Joaquín

Current Opinion in Allergy and Clinical Immunology: December 2013 - Volume 13 - Issue 6 - p 646–650
doi: 10.1097/ACI.0b013e328364f4c6
IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush

Purpose of review To describe the recent insights of how molecular diagnosis can be useful to improve indication and selection of suitable allergens for specific immunotherapy and to increase its safety.

Recent findings As specific allergen immunotherapy is allergen-specific, the identification of the disease-eliciting allergen is a prerequisite for accurate prescription of anti-allergic treatment. In areas of complex sensitization to aeroallergens or in hymenoptera venom allergy, the use of molecular diagnosis has demonstrated that it may change indication and selection of allergens for immunotherapy in a large proportion of patients when compared with the use of skin prick testing and/or specific IgE determination with commercial extracts. These changes in the prescription of immunotherapy after using molecular diagnosis have been demonstrated to be cost-effective in some scenarios. Some patterns of sensitization to grass or olive pollen allergens may identify patients with higher risk of adverse reaction during immunotherapy.

Summary Molecular diagnosis, together with other tools and patients’ clinical history, can help clinicians better select the most appropriate patients and allergens for specific immunotherapy and, in some cases, predict the risk of adverse reactions.

Allergy Department Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES, Institute Carlos III, Ministry of Economy and Competetiveness), Madrid, Spain

Correspondence to Joaquín Sastre, MD, PhD, Allergy Department, Fundación Jiménez Díaz, Av. Reyes Católicos 2 28040 Madrid, Spain. Tel: +34 91 5498225; fax: +34 91 5499498; e-mail: jsastre@fjd.es

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