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