“Extended IgE profile based on an allergen macro-array: a novel tool for precision medicine in allergy diagnosis”: this is the title of the study published in the World Allergy Organization Journal, in which the first author was Professor Enrico Heffler, a specialist at the Centre for Personalized Medicine: Asthma and Allergology at Humanitas and a lecturer at Humanitas University.
As Prof. Heffler explains: “This is the first scientific article published in a new test (called Allergy Explorer – ALEX) of molecular diagnostics in the field of allergy, capable of measuring the degree of allergic sensitization to 282 components simultaneously”.
Other Humanitas specialists also took part in the study: Dr. Francesca Puggioni, specialist at the Centre for Personalized Medicine: Asthma and Allergology, Professor Giovanni Melioli, Head of Molecular Allergological Diagnostics and Professor Giorgio Walter Canonica, Head of the Centre for Personalized Medicine: Asthma and Allergology.
Allergy: the diagnostic path
“The first level tests in the field of allergy are skin tests. These, however, in some cases, are not able to identify which is the main allergen responsible for the allergic reaction; this occurs because of the phenomenon of multi-sensitization: many patients, in fact, have positive allergometric skin tests for many allergens and therefore there is the problem of understanding which are clinically relevant, or related to the onset of symptoms, and which instead are negligible.
In doubtful or complicated cases, second level tests are carried out: they are tests carried out on the patient’s serum, and measure the blood levels of IgE (immunoglobulin E, the class of antibodies involved in allergic reactions) to an entire allergic source, such as pollen or mites. However, if the results are positive, we have identified the allergic source, but not the specific allergenic protein involved. Some proteins (“allergens”) are typical of the allergenic source, while others are shared with other sources. This makes it necessary to understand, for diagnosis purposes, which reactivities are genuine and which are attributable to the phenomenon of so-called cross-reactivity,” said Prof. Heffler.
ALEX: the new test for molecular respiratory and food diagnosis
“The development of a new molecular diagnostic test called Allergy Explorer – ALEX represents a turning point. The test is in fact able to measure 282 components simultaneously, of which 125 are single proteins; with a single blood sample we have the largest possible result to date in terms of allergenic components evaluated.
In the study published in the World Allergy Organization Journal we verified that the test results are repeatable, correlated to those obtained with other serum tests and therefore reliable. From the point of view of precision medicine, this test is perfect in the field of allergology, because it is able to identify the real cause of the allergic reaction and choose the most appropriate therapy, for example in the case of immunotherapy.
This test is also valuable in terms of the relationship between pollen allergy and food, given that certain proteins are contained in different sources in the plant world. In fact, some proteins – if ingested – are responsible for triggering the typical symptoms of food allergies, while others cause the appearance of mild symptoms.
Again, knowing which proteins the patient is allergic to allows us to stratify the risk of the seriousness of the allergy and to provide the patient with more precise indications in terms of food consumption, suggesting which foods he can eat without problems and which he should pay attention to because their ingestion could lead to an allergic reaction”, stressed Professor Heffler.
Experimentation thanks to Artificial Intelligence
“Finally, we are associating an Artificial Intelligence system to this test, which will be able to combine the data collected by the test with the clinical data entered by the physician. Thanks to this union it will be possible to obtain clinically more probable conclusions that adhere to the individual patient’s profile. Artificial intelligence could therefore help the specialist to interpret the test data in the light of the individual clinical case: a further step in the perspective of personalized medicine,” concluded Prof. Heffler.
