Immunology, Transplantation and Infectious Diseases
Laboratory of Cellular and Molecular Allergology
The question summarizing the activity of this unit is: how far can we simplify the analysis of Th2 immune reactivity to allergens versus tolerance to those same antigens? This topic applies both to allergic patients and to healthy subjects, since no-allergy does not occur for antigen ignorance, but based on the active maintenance of tolerance. Systemic and local factors (i.e., at the level of the target organ) are correlated to physiological and pathological responses to allergens. Furthermore, the latter can be clinically heterogeneous (by type of pathology and severity) and the validation of predictive markers of clinically relevant phenotypes (e.g., severe asthma, T1- or T2-type asthma, etc.) remains priorities in allergology and thoracic medicine.
In my group, we are studying systemic parameters of adaptive immunity by IgE profiling mainly with molecular allergology tools, which allow pinpointing IgE reactivity to single allergen components within complex allergen sources (e.g., all-in-one analysis of arrays of recombinant proteins including up to hundreds of allergens). In the same time, we are exploring systemic tolerance parameters by evaluating non-IgE reactivity (surrogate markers of tolerance, such as blocking antibodies and IgG4).
Research activity
We are studying cohorts of patients who underwent allergen immunotherapy by receiving standardized preparations of allergens by the subcutaneous or sublingual route. In these subjects, we investigate the progression over time of the immune response towards single relevant allergen sources, including the dissection of specificities within them. This phenomenon occurs within each given allergen source and from one first sensitizing allergen source to further ones according to patters which are the subjects of investigation. In particular, we are studying the role of homologous allergen components in intra- and inter-allergen immunological spreading. This analysis will allow to predict from a defined allergen profile which kind of allergy the patient will suffer and at which level allergy progression is. In this context, we have established a consolidated expertise in collaboration with the Proteomic Unit of our Institute (Dr Massimo Alessio) to characterize patients who are not reactive to any of clinically available allergen components, yet they do react to the raw allergen source and display coherent clinical characteristics.
Moreover, we are performing a project aimed to identify responders versus non-responders to anti-Th2 drugs which have entered the therapeutic armamentarium in these last years, i.e., monoclonal antibodies to IgE, IL5, IL-4 receptors, TSLP and the alike. Proteomic analysis of BAL following segmental allergen challenge and determination of genetic markers associated with T2-immunity are promising approaches to identify predictive markers of the clinical response to these molecules as well as to allergen specific immunotherapy.
