title: An evidence-based appraisal of the surrogate markers of efficacy of allergen immunotherapy.
abstract: OBJECTIVE
  The assessment of clinical efficacy of immunotherapy in patients with respiratory allergy is highly affected by variability and lack of validated outcome measures such as symptom and medication scores. At the same time, there is a need to identify reliable predictive surrogate markers or biomarkers that may correlate with real clinical endpoints and lead to individually tailored immunotherapy treatment.
  
  
  RESULTS
  In-vivo markers, such as early and late skin reaction as well as immunological parameters such as IgE levels, IgG subclasses, mucosal IgA, lymphocyte subsets, cytokines and local and systemic inflammatory markers, have been proposed as potential surrogate markers.
  
  
  CONCLUSIONS
  Given the poor reproducibility and surrogacy to clinical outcomes shown in various clinical trials, the decreased availability in daily practice and anticipated high costs, an ideal surrogate marker is still not available to allergists.
authors.affiliation: Allergy Unit, University of Verona, Verona, Italy. gianenrico.senna@ospedaleuniverona.it
authors.forename: Gianenrico
authors.initials: G
authors.lastname: Senna
authors.forename: Moises
authors.initials: M
authors.lastname: Calderon
authors.forename: Melina
authors.initials: M
authors.lastname: Makatsori
authors.forename: Erminia
authors.initials: E
authors.lastname: Ridolo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
mesh_terms: D000485:Allergens / Q000276:immunology / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis*; D016207:Cytokines / Q000097:blood; D003888:Desensitization, Immunologic; D004804:Eosinophils; D019317:Evidence-Based Medicine; D006801:Humans; D018928:Immunity, Mucosal; D007070:Immunoglobulin A / Q000032:analysis; D007073:Immunoglobulin E / Q000032:analysis; D007074:Immunoglobulin G / Q000097:blood; D018836:Inflammation Mediators / Q000032:analysis; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets; D011788:Quality of Life; D015203:Reproducibility of Results; D012130:Respiratory Hypersensitivity / Q000097:blood / Q000276:immunology / Q000628:therapy*; D012882:Skin Tests; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D015415:Biomarkers; D016207:Cytokines; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D018836:Inflammation Mediators; D007073:Immunoglobulin E