Biomarkers in immune monitoring of allergen-specific immunotherapy
Allergen immunotherapy (AIT) is the only therapy that can alter the natural course of immune responses to specific allergens, directing it towards desensitization and perhaps, towards tolerance. Routes of AIT include subcutaneous (SCIT), sublingual (SLIT), oral (OIT), or epicutaneous (EPIT).218 219 Licensed products are available for therapy of AR, allergic asthma, stinging insect hypersensitivity, AD.220-225 AIT for food allergy is currently investigational, however, phase 3 trials are promising.226 Current evidence indicates that immunological changes associated with AIT differ from permanent tolerance as in healthy non-allergic individuals. AIT-acquired desensitization is often temporary, waning with time, but can be maintained with regular exposure to the allergen.219
Biomarkers that can identify responders, monitor treatment, predict durability of desensitization, and determine adverse event risk would aid clinical decisions and delivery of targeted and effective treatment. With the advent of data-driven “-omic” technologies, more potential biomarkers have been identified.227 Here, we briefly review the more promising candidates that are being evaluated for immune monitoring with an expanded number in Figure 8.228