Researchers from IBIMA Plataforma BIONAND and the Regional University Hospital of Málaga have published the results of a study that confirms that patients with respiratory allergy without systemic sensitization (local allergy) produce allergen-specific antibodies in their respiratory mucosa
A multidisciplinary team from the Biomedical Research Institute of Málaga and Platform in Nanomedicine (IBIMA Plataforma BIONAND) has published a revolutionary study that identifies the mechanisms involved in the local respiratory allergy response and opens the door to the possibility of achieving a better diagnosis and a more appropriate treatment for these patients.
The work has been published in the journal Allergy and is led by researchers from the group ALLERGIC DISEASES TO MEDICATION AND ALLERGENS whose researchers in charge are the professor of the University of Málaga and scientific coordinator of the area “Autoimmune, Infectious Diseases, Inflammation and Allergy” of IBIMA Plataforma Bionand, María José Torres, and Dr. Cristobalina Mayorga, co-investigator responsible for the allergy group.
Respiratory allergy (rhinitis, conjunctivitis and asthma) is one of the main chronic diseases in children and adults. This pathology significantly affects the quality of life of patients who suffer from it and is related to poor school performance and a very considerable decrease in work productivity. All this entails high costs and reduces the life and professional possibilities of the patients. Some types of respiratory allergy appear systemically (affecting different organs at the same time), in the skin or in the blood (these cases are called atopic allergy), but up to 25% of allergic patients, despite having similar symptoms, may have negative results in all the classic tests to evaluate sensitization.
This clinical scenario is called local allergy and results in a high number of patients remaining undiagnosed. However, both atopic and local patients respond positively to specific interventions such as allergen immunotherapy (administration of small and increasing doses of the substance that produces the allergy, aiming to reduce symptoms in future exposures to the causative agent). Diagnosing local respiratory allergy requires to carry out controlled allergen exposure tests (administration of small amounts of the substance producing the allergic reaction until the allergic reaction occurs and the symptoms experienced by the patient are evaluated) using nasal, conjunctival or bronchial routes.
These tests are time-consuming and laborious and, in addition, require trained personnel and technical resources. Therefore, they are not implemented in all healthcare centers, which limits the identification of allergic triggers of respiratory disease in non-atopic patients (those who test negative in the aforementioned tests). Thus, the access of patients with local allergy to allergen immunotherapy is more restricted, which makes it easier for the disease to become more severe (e.g., onset of asthma in patients with rhinitis).
The work published by Drs. Almudena Testera, Carmen Rondon and Ibon Eguiluz, demonstrates that patients with local allergy have a synthesis of allergen-specific IgE (Immunoglobulin E, a type of antibody) in the respiratory mucosa. Until now, the involvement of IgE in this disease had been doubted, hindering the development of easier diagnostic techniques and the understanding of the mechanism of action of allergen immunotherapy.
The demonstration of the role of specific IgE in local allergy has allowed the use of in vitro tests (laboratory tests with a blood sample from the patient), such as the mast cell or basophil activation test, for the diagnosis of local allergy. These tests are carried out on a blood sample collected from patients without the need for them to be experiencing an allergic response at the time, which is much easier, faster and safer for the patient than controlled allergen exposure. Thus, it is easier to identify patients with local respiratory allergy and treat them with allergen immunotherapy, resulting in a lower prevalence of severe respiratory allergy phenotypes later in life.