title: Evolution and predictive value of IgE responses toward a comprehensive panel of house dust mite allergens during the first 2 decades of life.
abstract: The evolution of the IgE response to the numerous allergen molecules of Dermatophagoides pteronyssinus is still unknown.
  
  
  
  We sought to characterize the evolutionary patterns of the IgE response to 12 molecules of D pteronyssinus from birth to adulthood and to investigate their determinants and clinical relevance.
  
  
  
  We investigated the clinical data and sera of 722 participants in the German Multicenter Allergy Study, a birth cohort started in 1990. Diagnoses of current allergic rhinitis (AR) related to mite allergy and asthma were based on yearly interviews at the ages of 1 to 13 years and 20 years. IgE to the extract and 12 molecules of D pteronyssinus were tested by means of ImmunoCAP and microarray technology, respectively, in sera collected at ages 1, 2, 3, 5, 6, 7, 10, 13, and 20 years. Exposure to mites at age 6 and 18 months was assessed by measuring Der p 1 weight/weight concentration in house dust.
  
  
  
  One hundred ninety-one (26.5%) of 722 participants ever had IgE to D pteronyssinus extract (≥0.35 kUA/L). At age 20 years, their IgE recognized most frequently Der p 2, Der p 1, and Der p 23 (group A molecules; prevalence, >40%), followed by Der p 5, Der p 7, Der p 4, and Der p 21 (group B molecules; prevalence, 15% to 30%) and Der p 11, Der p 18, clone 16, Der p 14, and Der p 15 (group C molecules; prevalence, <10%). IgE sensitization started almost invariably with group A molecules and expanded sequentially first to group B and finally to group C molecules. Early IgE sensitization onset, parental hay fever, and higher exposure to mites were associated with a broader polymolecular IgE sensitization pattern. Participants reaching the broadest IgE sensitization stage (ie, ABC) had significantly higher risk of mite-related AR and asthma than unsensitized participants. IgE to Der p 1 or Der p 23 at age 5 years or less predicted asthma at school age.
  
  
  
  Parental hay fever and early exposure to D pteronyssinus allergens promote IgE polysensitization to several D pteronyssinus molecules, which in turn predicts current mite-related AR and current/future asthma. These results might inspire predictive algorithms and prevention strategies against the progression of IgE sensitization to mites toward AR and asthma.
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Daniela
authors: D
authors: Posa
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Serena
authors: S
authors: Perna
authors: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
authors: Yvonne
authors: Y
authors: Resch
authors: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
authors: Christian
authors: C
authors: Lupinek
authors: L'altrastatistica srl, Consultancy & Training, Biostatistics, Rome, Italy.
authors: Valentina
authors: V
authors: Panetta
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Stephanie
authors: S
authors: Hofmaier
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Alexander
authors: A
authors: Rohrbach
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Laura
authors: L
authors: Hatzler
authors: Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Linus
authors: L
authors: Grabenhenrich
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Olympia
authors: O
authors: Tsilochristou
authors: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
authors: Kuan-Wei
authors: KW
authors: Chen
authors: Department of Pediatrics Technical University of Munich, Munich, Germany.
authors: Carl-Peter
authors: CP
authors: Bauer
authors: Department of Pediatrics Technical University of Munich, Munich, Germany.
authors: Ute
authors: U
authors: Hoffman
authors: Department of Pediatrics St Hedwig, St Josefs Hospital, Freiburg, Germany.
authors: Johannes
authors: J
authors: Forster
authors: Department of Pediatrics and Adolescent Medicine, University Medicine Mainz, Mainz, Germany.
authors: Fred
authors: F
authors: Zepp
authors: Department of Pediatrics, Heinrich-Heine-University, Düsseldorf, Germany.
authors: Antje
authors: A
authors: Schuster
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Ulrich
authors: U
authors: Wahn
authors: Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
authors: Thomas
authors: T
authors: Keil
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors: Susanne
authors: S
authors: Lau
authors: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for the Development of Allergen Chips, Medical University of Vienna, Vienna, Austria.
authors: Susanne
authors: S
authors: Vrtala
authors: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
authors: Rudolf
authors: R
authors: Valenta
authors: Department of Paediatric Pneumology & Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany. Electronic address: paolo.matricardi@charite.de.
authors: Paolo Maria
authors: PM
authors: Matricardi
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology*; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003429:Cross Reactions; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007073:Immunoglobulin E / Q000378:metabolism*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D039981:Pyroglyphidae / Q000276:immunology; D065631:Rhinitis, Allergic / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors; D055815:Young Adult
chemical_list: D039741:Antigens, Dermatophagoides; D007073:Immunoglobulin E
keywords: Dermatophagoides pteronyssinus; House dust mite allergy; IgE; allergic rhinitis; asthma; birth cohort; children; component-resolved diagnostics; microarray; prediction; recombinant allergens