Lutkova T.S., Karzakova L.M., Zhuravleva N.V., Andreeva N.P., Ukhterova N.D., Komelyagina N.A., Gavrilova E.S., Kudryashov S.I.
Modern Approaches to the Diagnosis and Therapy of Allergic Diseases
Currently, great efforts are being made to optimize diagnostic and therapeutic standards in allergology. The introduction of biological drugs (omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab) into clinical practice increases the need for biomarkers of allergic diseases that make it possible to adequately choose a treatment regimen, determine the duration of therapy with expensive biopreparations. The article discusses the possibilities of using biomarkers developed in recent years thanks to the so-called "omics" technologies in clinical practice. Biomarkers used for the diagnosis and treatment of bronchial asthma, atopic dermatitis, allergic rhinitis, food allergies, hypersensitivity to drugs, as well as for evaluating the effectiveness of allergen – specific immunotherapy are considered. The introduction of biomarkers into clinical practice has made it possible to carry out endotyping of some allergic diseases, which opens up prospects for new approaches to classification of these diseases, development of individual treatment targets and indications for administering personalized therapy. Endotyping of diseases is expected to be transferred to the category of diagnostic tests. However, it is necessary to overcome a number of problems before the treatment based on endotype determination will be introduced into everyday practice in allergic diseases and bronchial asthma. Currently, most of the research on the endotyping of diseases is carried out in severe forms of allergic diseases. It is beyond argument that the best ways to treat allergic diseases will be found in the near future, with a therapeutic approach focused on a specific patient, taking into account the patient's wishes, the presence of contraindications, the psychological characteristics of the patient, his expected adherence to therapy and possible side effects.
- Barbarot S., Auziere S., Gadkari A. et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy, 2018, 73(6), pp. 1284–1293.
- Bateman E.D., Boushey H.A., Bousquet J. et al. Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study. J. Respir. Crit. Care Med., 2004, vol. 170, no. 8, pp. 836–844.
- Breiteneder H., Peng Y.Q., Agache I. et al. Biomarkers for diagnosis and prediction of therapy responses in allergic diseases and asthma. Allergy, 2020, 75(12), pp. 3039–3068.
- Busse W.W., Morgan W.J., Gergen P.J. et al. Randomized trial of omalizumab (anti-IgE) for asthma in inner-city N. Engl. J. Med., 2011, vol. 364, no. 11, pp. 1005–1015.
- Caubet J.C., Lin J., Ahrens B., et al. Natural tolerance development in cow’s milk allergic children: IgE and IgG4 epitope binding. Allergy, 2017, vol. 72(11), 1677–1685.
- Datema M.R., Eller E., Zwinderman A.H. et al. Ratios of specific IgG4 over IgE antibodies do not improve prediction of peanut allergy nor of its severity compared to specific IgE alone. Clin Exp Allergy., 2019, vol. 49(2), pp. 216–226.
- De Meulder B, Lefaudeux D, Bansal AT, et al. A computational framework for complex disease stratification from multiple large-scale BMC Syst Biol., 2018, vol. 12(1), p. 60.
- Diamant , Vijverberg S., Alving K. et al. Toward clinically applicable biomarkers for asthma: an EAACI position paper. Allergy, 2019, vol. 74(10), pp. 1835–1851.
- Dona I., Perez-Sanchez N., Eguiluz-Gracia I. et al. Progress in understanding hypersensitivity reactions to nonsteroidal anti-inflammatory drugs. Allergy, 2020, 75(3), pp. 561–575.
- Eguiluz-Gracia , Tay T.R., Hew M. et al. Recent developments and highlights in biomarkers in allergic diseases and asthma. Allergy, 2018, vol. 73(12), pp. 2290–2305.
- Galli S.J., Tsai M., Piliponsky A.M. The development of allergic inflammation. Nature, 2008, 454(7203), pp. 445–454.
- Green R.H. et al. Analysis of induced sputum in adults with asthma: identification of subgroup with isolated sputum neutrophilia and poor response to inhaled Thorax, 2002, vol. 57, pp. 875–879.
- Hung L., Obernolte H., Sewald K., Eiwegger T. Human ex vivo and in vitro disease models to study food allergy. Asia Pac Allergy, 2019, vol. 9(1). DOI: e4 5415/apallergy.2019.9.e4.
- Kawakami T., Blank U. From IgE to omalizumab. J Immunol., 2016, vol. 197, pp. 4187–4192. DOI: 4049/jimmunol.1601476.
- Kortekaas K.I., Callebaut I., Alpizar Y.A. et al. MP29-02 reduces nasal hyperreactivity and nasal mediators in patients with house dust mite-allergic Allergy, 2018, vol. 73(5), pp. 1084–1093.
- Leckie M.J., ten Brinke A., Khan J. et al. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic Lancet, 2000, vol. 356, no. 9248, pp. 2144–2148.
- Lee H.Y., Ye Y.M., Kim S.H. et al. Identification of phenotypic clusters of nonsteroidal anti-inflammatory drugs exacerbated respiratory Allergy, 2017, vol. 72(4), pp. 616–626.
- Lei D.K., Saltoun C. Allergen immunotherapy: definition, indications, and reactions. Allergy Asthma Proc., 2019, vol. 40(6), pp. 369–371.
- Locksley M. Asthma and allergic inflammation. Cell., 2010, vol. 140, pp. 777–783.
- Lunjani N., Satitsuksanoa P., Lukasik Z., Sokolowska M., Eiwegger T., O’Mahony L. Recent developments and highlights in mechanisms of allergic diseases: Allergy, 2018, vol.73(12), pp. 2314–2327.
- Maio , Baldacci S., Bresciani M. et al. RItA: the Italian severe/uncontrolled asthma registry. Allergy, 2018, vol. 73, no. 3, pp. 683–695
- Mayorga C., Fernandez T.D., Montanez M.I., Moreno E., Torres M.J. Recent developments and highlights in drug Allergy, 2019, vol. 74(12), pp. 2368–238.
- Monino-Romero S., Lexmond W.S., Singer J. et al. Soluble FcvarepsilonRI: a biomarker for IgE-mediated Allergy, 2019, vol. 74(7), pp. 1381–1384.
- Normansell R., Kew K.M., Bridgman A.L. Sublingual immunotherapy for asthma. Cochrane Database Syst Rev., 2015, 8: CD011293. DOI: 10.1002/14651858. cd011293.pub2.
- Pavord I.D. Oral corticosteroid-dependent asthma: current knowledge and future needs. Opin. Pulm. Med., 2019, vol. 25, no. 1, pp. 51–58.
- Rodrigo-Muñoz J.M., Cañas J.A., Sastre B. et al. Asthma diagnosis using integrated analysis of eosinophil microRNAs. Allergy, 2019, vol. 74(3), pp. 507–517.
- Romano A., Atanaskovic-Markovic M., Barbaud A. et al. Towards a more precise diagnosis of hypersensitivity to beta-lactams an EAACI position Allergy, 2020, vol. 75(6), pp. 1300–1315.
- Samitas K., Carter A., Kariyawasam H.H., Xanthou G. Upper and lower airway remodelling mechanisms in asthma, allergic rhinitis and chronic rhinosinusitis: the one airway concept revisited. Allergy, 2018, 73(5), pp. 993–1002.
- Santesso N., Glenton C., Dahm P. et al. GRADE guidelines 26: Informative statements to communicate the findings of systematic reviews of J Clin Epidemiol., 2020, vol. 119, pp.126–135.
- Seys S.F., Quirce S., Agache I. et al. Severe asthma: Entering an era of new concepts and emerging therapies: highlights of the 4th international severe asthma forum, Madrid, 2018. Allergy, 2019, 74(11), pp. 2244–224.
- Shamji M.H., Kappen J.H., Akdis M. et al. Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma: an EAACI Position Paper. Allergy, 2017, vol. 72(8), pp. 1156–1173.
- Spellberg B., Edwards J.E., Jr Type 1/type 2 immunity in infectious diseases. Clin Infect Dis., 2001, 32, pp. 76–102.
- Su M.W., Lin W.C., Tsai C.H. et al. Childhood asthma clusters reveal neutrophil-predominant phenotype with distinct gene expression. Allergy, 2018, vol. 73(10), 2024–2032.
- Suaini N.H.A., Wang Y. Soriano V.X. et al. Genetic determinants of paediatric food allergy: asystematic Allergy, 2019, vol. 74(9), pp. 1631–1648.
- Tsabouri S., Tseretopoulou X., Priftis K., Ntzani E.E. Omalizumab for the treatment of inadequately controlled allergic rhinitis: a systematic review and meta-analysis of randomized clinical trials. JAllergy Clin Immunol Pract., 2014, vol. 2(3), pp. 332–340.
- Varona R., Ramos T., Escribese M.M. et al. Persistent regulatory T-cell response 2 years after 3 years of grass tablet SLIT: links to reduced eosinophil counts, sIgE levels, and clinical benefit. Allergy, 2019, 74(2), pp. 349–360.
- Voehringer D., Reese T.A., Huang X., Shinkai K., Locksley R.M. Type 2 immunity is controlled by IL-4/IL-13 expression in hematopoietic non-eosinophil cells of the innate immune J Exp Med., 2006, vol. 203, pp. 1435–1446.
- Wahn U., Bachert C., Heinrich J., Richter H., Zielen S. Real-world benefits of allergen immunotherapy for birch pollen-associated allergic rhinitis and Allergy, 2019, vol. 74(3), pp. 594–604.
- Wambre E., Bajzik V., DeLong J.H. et al. A phenotypically and functionally distinct human TH2 cell subpopulation is associated with allergic Sci Transl Med., 2017, vol. 9(401): eaam9171 10.1126/scitranslmed.aam9171.186.
- Weinstein S.F., Katial R., Jayawardena S. et al. Efficacy and safety of dupilumab in perennial allergic rhinitis and comorbid asthma. J Allergy Clin Immunol., 2018, 142(1), pp. 171–177.
- Lutkova Tatyana S.
- Candidate of Medical Sciences, Associate Professor of Internal Diseases Department, Chuvash State University, Russia, Cheboksary (firstname.lastname@example.org; ORCID: https://orcid.org/0000-0003-2368-5084)
- Karzakova Luiza M.
- Doctor of Medical Sciences, Professor, Head of Internal Diseases Department, Chuvash State University, Russia, Cheboksary (email@example.com; ORCID: https://orcid.org/0000-0002-5899-6352)
- Zhuravleva Nadezhda V.
- Candidate of Medical Sciences, Associate Professor of Internal Medicine Department, Chuvash State University, Russia, Cheboksary (firstname.lastname@example.org; ORCID: https://orcid.org/0000-0001-6470-7724)
- Andreeva Nataliya P.
- Candidate of Medical Sciences, Allergist-Immunologist, City Children's Clinical Hospital, Russia, Cheboksary (email@example.com; )
- Ukhterova Nadezhda D.
- Candidate of Medical Sciences, Associate Professor of Internal Medicine Department, Chuvash State University, Russia, Cheboksary (firstname.lastname@example.org; ORCID: https://orcid.org/0000-0003-1808-6845)
- Komelyagina Nadezhda A.
- Candidate of Medical Sciences, Associate Professor, Department of Internal Diseases, Chuvash State University, Russia, Cheboksary (email@example.com; ORCID: https://orcid.org/0000-0002-4155-4849)
- Gavrilova Elvira S.
- Candidate of Medical Sciences, Associate Professor of Department of Internal Diseases, Chuvash State University, Russia, Cheboksary (firstname.lastname@example.org; ORCID: https://orcid.org/0000-0001-6962-4266)
- Kudryashov Sergei I.
- Candidate of Medical Sciences, Assistant Lecturer of Internal Diseases Department, Chuvash State University, Russia, Cheboksary (email@example.com; ORCID: https://orcid.org/0000-0003-2277-9425)
Lutkova T.S., Karzakova L.M., Zhuravleva N.V., Andreeva N.P., Ukhterova N.D., Komelyagina N.A., Gavrilova E.S., Kudryashov S.I. Modern Approaches to the Diagnosis and Therapy of Allergic Diseases [Electronic resource] // Acta medica Eurasica. – 2021. – №3. P. 60-68. – URL: http://acta-medica-eurasica.ru/en/single/2021/3/7/. DOI: 10.47026/2413-4864-2021-3-60-68.