Allergologia Molecolare!

Filippo Fassio
Dept. of Biomedicine – ImmunoallergologyUnit (Director Prof. E Maggi)
UniversityofFlorence

AllergyTests: history…

AllergyTests: a very long road…
1880: ProvocationTesting
1967: CharacterizationofIgE
’70s: RAST

…somesortofevolution…
Allergy!
(allergytesting)
No allergies
(no allergytesting)

…somesortofevolution…
?

first crossroad: in vitro vs in vivo…

Prick test…
High sensibility and specificity
Immediate response
Low cost (?)
Influencedbytherapies and skinconditions
Needofallergist or experiencedphysician
Contra-indications
Time-consuming

In vitro IgEtests…
High sensibility and specificity
Notinfluencedbytherapies and skinconditions
No contra-indicationsofin vivo tests
Needof a lab and equipment
Expensive
Not immediate response

’70s: RAST
1995: RecombinantAllergens
2001: AllergenMicroarray

…not just a single crossroad…

…fromextractstomolecules…

…fromextractstomolecules…
=

…a bit ofcomplexity!

…canwe do better?
Let’s put allthese “lights” in anordinatedarray…
Allergenmicroarray: 103“lights” and growing…

…allergymicroarray

…dowereallyneed CRD?
vs

Case 1: pollens…
47-yo man whitrhinitis…
Grass +++
Birch ++
Olive tree ++
…ishe a candidate for vaccine therapy?

Case 1: pollens…
…cross-reaction or co-sensitization?

Case 1: pollens…
Co-sensitization!
(Grass, Birch, Olive tree))

Case 1: pollens…
Cross-reaction!
(Just grass + Phl p 12: Profilin)

Case 2: latex…

Case 3: foods…
A youngpatientwithhazelnutallergy…
…shetoleratesotherkindofnutsevenifdiscouragedtoeatthem…

Case 3: foods…
Thisisherprick test forfoodallergens:
Hazelnut+++
Walnut(+/-)

Case 3: foods…
Total IgE (RIST): 37 kU/l
SpecificIgEforrespiratoryallergens: < 0.10 kUI/l
SpecificIgEforfoodallergens:
Hazelnut 3,07 kUI/l
Walnut 0,12 kUI/l

Case 3: foods…
Cor a 1: Bet v 1-homologue (PR-10)
Cor a 2: profilin (homologuetoBet v 2)
Cor a 8: LTP
Cor a 9: 11S globulin (homologueto Ara h 3)

Case 3: foods…
Hazelnutallergy in Europe:
Cor a 1: 75% (100% northeurope, 17% southeurope)
Cor a 2: 42% (profilin)
Cor a 8: 28% (5-15% northeurope, 71% southeurope)
Cor a 1 + Cor a 8 = 96%

Case 3: foods…
None!
What’s the patientallergicto?
Cor a 2
Cor a 1
Cor a 8
Cor a 9

Case 3: foods…
…because103molecularallergens are a lot…
…but nature hasmanymore…
=
westillneed “traditional” testingwithallergenextractstoo…

…CRD: a newperspective…

…doweknowhowto drive the newcar?

…whatkindofresearchisneeded?

…what’s the roleforyoungallergists?
Molecularallergology and CRD are highlyactive “Works in Progress” fields
No needtochangeperspective:
learn CRD at the sametimeof “traditionaldiagnostics” toget the most out ofthem

…ahead!
’70s: RAST
1995: RecombinantAllergens
2001: AllergenMicroarray

Lombardia:
Marco Caminati
Piemonte – Val d’Aosta:
Stefano Pizzimenti
Emilia Romagna:
Silvia Peveri
Liguria:
Valentina Garelli
Lazio - Abruzzo:
Maria Costanza Turi
Campania:
Francesca Rossi
Sardegna:
Gianni Pala
Puglia:
Laura Losappio
Sicilia:
SeleneImbesi
Calabria:
Mariella Patafi
Webmaster:
Felice Rivellese
Silvia Peveri, 2010

Thankyou!
fil.fassio@tin.it

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Allergologia Molecolare!

by filfassio on Nov 30, 2010

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Allergologia Molecolare! — Presentation Transcript