TY - JOUR
T1 - Precision medicine in hymenoptera venom allergy
T2 - diagnostics, biomarkers, and therapy of different endotypes and phenotypes
AU - Blank, Simon
AU - Grosch, Johannes
AU - Ollert, Markus
AU - Bilò, Maria Beatrice
N1 - Funding Information:
This work was supported by the Helmholtz Association, Future Topic “Immunology and Inflammation” (ZT-0027) to SB, by the Personalized Medicine Consortium (PMC) of Luxembourg (SYS-T-ACT) to MO and the FNR PRIDE Doctoral Training Unit program (PRIDE/11012546/NEXTIMMUNE) to MO. The publication of this article was supported by Bencard Allergy
Publisher Copyright:
© Copyright © 2020 Blank, Grosch, Ollert and Bilò.
PY - 2020/10/22
Y1 - 2020/10/22
N2 - Allergic reactions to stings of Hymenoptera species may be severe and are potentially fatal deviations of the immunological response observed in healthy individuals. However, venom-specific immunotherapy (VIT) is an immunomodulatory approach able to cure venom allergy in the majority of affected patients. An appropriate therapeutic intervention and the efficacy of VIT not only depend on a conclusive diagnosis, but might also be influenced by the patient-specific manifestation of the disease. As with other diseases, it should be borne in mind that there are different endotypes and phenotypes of venom allergy, each of which require a patient-tailored disease management and treatment scheme. Reviewed here are different endotypes of sting reactions such as IgE-mediated allergy, asymptomatic sensitization or a simultaneous presence of venom allergy and mast cell disorders including particular considerations for diagnosis and therapy. Additionally, phenotypical manifestations of venom allergy, as e.g. differences in age of onset and disease severity, multiple sensitization or patients unsusceptible to therapy, are described. Moreover, biomarkers and diagnostic strategies that might reflect the immunological status of the patient and their value for therapeutic guidance are discussed. Taken together, the increasing knowledge of different disease manifestations in venom hypersensitivity and the growing availability of diagnostic tools open new options for the classification of venom allergy and, hence, for personalized medical approaches and precision medicine in Hymenoptera venom allergy.
AB - Allergic reactions to stings of Hymenoptera species may be severe and are potentially fatal deviations of the immunological response observed in healthy individuals. However, venom-specific immunotherapy (VIT) is an immunomodulatory approach able to cure venom allergy in the majority of affected patients. An appropriate therapeutic intervention and the efficacy of VIT not only depend on a conclusive diagnosis, but might also be influenced by the patient-specific manifestation of the disease. As with other diseases, it should be borne in mind that there are different endotypes and phenotypes of venom allergy, each of which require a patient-tailored disease management and treatment scheme. Reviewed here are different endotypes of sting reactions such as IgE-mediated allergy, asymptomatic sensitization or a simultaneous presence of venom allergy and mast cell disorders including particular considerations for diagnosis and therapy. Additionally, phenotypical manifestations of venom allergy, as e.g. differences in age of onset and disease severity, multiple sensitization or patients unsusceptible to therapy, are described. Moreover, biomarkers and diagnostic strategies that might reflect the immunological status of the patient and their value for therapeutic guidance are discussed. Taken together, the increasing knowledge of different disease manifestations in venom hypersensitivity and the growing availability of diagnostic tools open new options for the classification of venom allergy and, hence, for personalized medical approaches and precision medicine in Hymenoptera venom allergy.
KW - Hymenoptera venom allergy
KW - allergy diagnosis
KW - biomarkers
KW - immune tolerance
KW - molecular allergology
KW - precision medicine
KW - venom allergen
KW - venom-specific immunotherapy
UR - http://www.scopus.com/inward/record.url?scp=85095689467&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/33193378
U2 - 10.3389/fimmu.2020.579409
DO - 10.3389/fimmu.2020.579409
M3 - Review article
C2 - 33193378
AN - SCOPUS:85095689467
SN - 1664-3224
VL - 11
JO - Frontiers in Immunology
JF - Frontiers in Immunology
M1 - 579409
ER -