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March 2013, Vol. 5, No. 3, Pages 203-206 , DOI 10.2217/imt.13.6
(doi:10.2217/imt.13.6)
Predictive biomarkers of clinical efficacy of allergen-specific immunotherapy: how to proceed
Various mode-of-action studies have been conducted to describe and substantiate the immunologic mechanisms behind the long-lasting effect of allergen-specific immunotherapy (SIT) and how it changes the course of IgE-mediated allergic disease. These randomized, double-blind, placebo-controlled studies have reported both cellular and humoral changes systemically and in the target organ following SIT. However, demonstrating that these immunological changes can be used to monitor the effect of treatment has proven challenging. Although we are able to distinguish between actively and placebo-treated patients, candidate biomarkers of effect or biomarker combinations remain to be determined. The validation of such biomarkers may need to involve unconventional ways to evaluate clinical effect, such as challenge chambers or controlled provocation tests of individual organs, to clearly distinguish between strong and weak or early and late responders, as discussed below.
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