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Are allergic multimorbidities and IgE polysensitization associated with the persistence or re-occurrence of foetal type 2 signalling? The MeDALL hypothesis

Bousquet, J., Anto, J. M., Wickman, M., Keil, T., Valenta, R., Haahtela, T., Carlsen, K. L., van Hage, M., Akdis, C., Bachert, C., Akdis, M., Auffray, C., Annesi-Maesano, I., Bindslev-Jensen, C., Cambon-Thomsen, A., Carlsen, K. H., Chatzi, L., Forastiere, F., Garcia-Aymerich, J., Gehrig, U., Guerra, S., Heinrich, J., Koppelman, G. H., Kowalski, M. L., Lambrecht, B., Lupinek, C., Maier, D., Melen, E., Momas, I., Palkonen, S., Pinart, M., Postma, D., Siroux, V., Smit, H. A., Sunyer, J., Wright, J., Zuberbier, T., Arshad, S. H., Nadif, R., Thijs, C., Andersson, N., Asarnoj, A., Ballardini, N., Ballereau, S., Bedbrook, A., Benet, M., Bergstrom, A., Brunekreef, B., Burte, E., Calderon, M., De Carlo, G., Demoly, P., Eller, E., Fantini, M. P., Hammad, H., Hohman, C., Just, J., Kerkhof, M., Kogevinas, M., Kull, I., Lau, S., Lemonnier, N., Mommers, M., Nawijn, M., Neubauer, A., Oddie, S., Pellet, J., Pin, I., Porta, D., Saes, Y., Skrindo, I., Tischer, C. G., Torrent, M. & von Hertzen, L., Sep-2015, In : Allergy. 70, 9, p. 1062-1078 17 p.

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  • Are allergic multimorbidities and IgE polysensitization associated with the persistence

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DOI

  • J. Bousquet
  • J. M. Anto
  • M. Wickman
  • T. Keil
  • R. Valenta
  • T. Haahtela
  • K. Lodrup Carlsen
  • M. van Hage
  • C. Akdis
  • C. Bachert
  • M. Akdis
  • C. Auffray
  • I. Annesi-Maesano
  • C. Bindslev-Jensen
  • A. Cambon-Thomsen
  • K. H. Carlsen
  • L. Chatzi
  • F. Forastiere
  • J. Garcia-Aymerich
  • U. Gehrig
  • S. Guerra
  • J. Heinrich
  • G. H. Koppelman
  • M. L. Kowalski
  • B. Lambrecht
  • C. Lupinek
  • D. Maier
  • E. Melen
  • I. Momas
  • S. Palkonen
  • M. Pinart
  • D. Postma
  • V. Siroux
  • H. A. Smit
  • J. Sunyer
  • J. Wright
  • T. Zuberbier
  • S. H. Arshad
  • R. Nadif
  • C. Thijs
  • N. Andersson
  • A. Asarnoj
  • N. Ballardini
  • S. Ballereau
  • A. Bedbrook
  • M. Benet
  • A. Bergstrom
  • B. Brunekreef
  • E. Burte
  • M. Calderon
  • G. De Carlo
  • P. Demoly
  • E. Eller
  • M. P. Fantini
  • H. Hammad
  • C. Hohman
  • J. Just
  • M. Kerkhof
  • M. Kogevinas
  • I. Kull
  • S. Lau
  • N. Lemonnier
  • M. Mommers
  • M. Nawijn
  • A. Neubauer
  • S. Oddie
  • J. Pellet
  • I. Pin
  • D. Porta
  • Y. Saes
  • I. Skrindo
  • C. G. Tischer
  • M. Torrent
  • L. von Hertzen

Allergic diseases [asthma, rhinitis and atopic dermatitis (AD)] are complex. They are associated with allergen-specific IgE and nonallergic mechanisms that may coexist in the same patient. In addition, these diseases tend to cluster and patients present concomitant or consecutive diseases (multimorbidity). IgE sensitization should be considered as a quantitative trait. Important clinical and immunological differences exist between mono- and polysensitized subjects. Multimorbidities of allergic diseases share common causal mechanisms that are only partly IgE-mediated. Persistence of allergic diseases over time is associated with multimorbidity and/or IgE polysensitization. The importance of the family history of allergy may decrease with age. This review puts forward the hypothesis that allergic multimorbidities and IgE polysensitization are associated and related to the persistence or re-occurrence of foetal type 2 signalling. Asthma, rhinitis and AD are manifestations of a common systemic immune imbalance (mesodermal origin) with specific patterns of remodelling (ectodermal or endodermal origin). This study proposes a new classification of IgE-mediated allergic diseases that allows the definition of novel phenotypes to (i) better understand genetic and epigenetic mechanisms, (ii) better stratify allergic preschool children for prognosis and (iii) propose novel strategies of treatment and prevention.

Original languageEnglish
Pages (from-to)1062-1078
Number of pages17
JournalAllergy
Volume70
Issue number9
Publication statusPublished - Sep-2015

    Keywords

  • asthma, atopic dermatitis, IgE, polysensitization, rhinitis, SKIN PRICK TEST, GENOME-WIDE ASSOCIATION, SERUM IMMUNOGLOBULIN-E, ACTIVE EOSINOPHILIC ESOPHAGITIS, EPITHELIAL BARRIER FUNCTION, GENERAL-POPULATION SAMPLE, SEVERE ATOPIC-DERMATITIS, SOYBEAN EPIDEMIC ASTHMA, ORAL FOOD CHALLENGES, HEALTH-SURVEY-I

ID: 24182532