Allergen Sensitization and Diagnostic Approaches in Respiratory Allergies

Respiratory allergies arise when inhaled proteins from pollen, animal dander, mites or moulds trigger an aberrant immune response. Sensitization begins as antigen-presenting cells capture allergenic proteins and present them to T helper 2 cells, which in turn drive B-cell class switching to produce allergen-specific immunoglobulin E (IgE). Bound IgE on mast cells and basophils sensitises these effector cells, so that subsequent exposures lead to cross-linking of IgE receptors and rapid release of histamine and other mediators. The clinical spectrum ranges from seasonal rhinitis to persistent asthma, reflecting both the nature of the allergen and host predisposition. Modern diagnostics aim to dissect individual sensitization profiles through skin prick testing, serum assays and functional cellular readouts. Component-resolved diagnosis employs purified or recombinant allergen molecules to distinguish genuine sensitization from cross-reactivity, thereby guiding precision immunotherapy. Emerging approaches include microfluidic basophil activation tests for rapid functional assessment and high-throughput immunoassays to quantify low-abundance sensitizers. An improved understanding of allergen structure, including oligomeric states, has revealed how molecular stability and aggregation influence immunogenicity. Together, these insights underpin global efforts to refine risk stratification, optimise targeted therapies and mitigate the burden of allergic respiratory disease.

Research from Nature Portfolio

Structural analysis of major inhalant allergens has highlighted the importance of transient oligomer formation in eliciting robust IgE cross-linking. Detailed crystallographic and mass-spectrometric studies revealed that lipocalin allergens, such as those from bovine dander, form reversible dimers under physiological conditions. These transient dimers present repetitive epitopes that enhance mast cell activation at lower allergen concentrations. Mapping of monomer–monomer interfaces has provided a blueprint for engineering monomeric variants with reduced allergenicity, offering a promising route to safer, molecule-based immunotherapies.

Allergen Sensitization and Diagnostic Approaches in Respiratory Allergies publication trend

The graph below shows the total number of articles in allergen sensitization and diagnostic approaches in respiratory allergies across all publications each year (not limited to Nature Index journals).

Technical terms

Allergen sensitization: The process by which the immune system becomes primed to recognise and respond to an otherwise innocuous protein, leading to IgE production.

Component-resolved diagnosis: An approach that uses purified or recombinant allergen molecules to determine specific IgE sensitization profiles and distinguish genuine sensitization from cross-reactivity.

Lipocalin: A family of small, β-barrel proteins that carry hydrophobic ligands; many mammalian lipocalins are inhalant allergens.

Basophil activation test: A functional assay measuring up-regulation of activation markers or mediator release from basophils upon allergen challenge.

Immunoglobulin E (IgE): An antibody isotype involved in allergic responses; binds high-affinity receptors on mast cells and basophils.

References

1. Albumins represent highly cross-reactive animal allergens. Frontiers in Immunology (2023).
2. Allergenic Activity of Individual Cat Allergen Molecules. International Journal of Molecular Sciences (2023).
3. Dimerization of lipocalin allergens. Scientific Reports (2015).