Exploring molecular allergology as the future of allergy testing and immunotherapy

Content sponsored by Nextmune

At the VMX 2023 in Orlando, Florida, Thierry Olivry, DrVet, PhD, DACVD, DECVD and head of research and development at Nextmune, discussed how the advent of molecular allergology promises radical changes in the speed, accuracy, and effectiveness of allergy testing and treatment.¹

“Predicting clinical evaluations in dogs and cats is inaccurate. And chemically, the base diagnostic procedure is a full trial plus oral provocation—the elimination diet simply allows you to do the provocation; an elimination diet alone is not worth anything,” Olivry said.

Further, food allergy is not a diagnosis, like a bacterial infection. “If I tell you [that] you have a bacterial infection, you don't know where it is, you don't know what form,” he pointed out. “It is the same with food allergies, and the food extracts are too insensitive.”

By definition, a food allergy is an immunologic reaction that can go to specific IgE, lymphocytes, or both. It's a complex syndrome. And in animals, it’s the same situation with different manifestations—some are IgE-mediated, some are cell-mediated.

What is molecular biology?

Molecular biology is a new concept in veterinary medicine. It diagnoses immunoglobulin E (IgE) sensitization. Traditionally, in veterinarian clinics, allergen testing uses an allergen extract with ELISA whereas molecular biology uses individual molecular proteins in the allergen extract shown to be relevant. The challenge is allergen extracts have an inherent variability in composition and lack of standardization. Often extracts may not contain enough of the relevant allergenic protein molecules to detect a reaction.

Molecular allergology

In humans, molecular allergology is advantageous for understanding where in the allergic disease a patient is currently located. Molecular allergology inherently increases test sensitivity, and it can help define and identify the primary sensitizing allergens and allow us to avoid treatment for those that are cross-reactive. Because allergy is a progressive disease, it is important to understand which specific proteins a patient is sensitized to, in order to help impede the progression of the disease.

“Cross-reactivity is a phenomenon that is not limited to a laboratory,” Olivry said. “It’s an issue when you have an immune reaction to one protein antigen or allergen, and because of that, you have a reaction to proteins that have the same structure.”

In humans, you can predict the clinical evolution and the severity of allergic disease, which is important to help identify better allergens to include in immunotherapy. These advantages are the same for pets, and because the results are more accurate and sensitive, there is more relief for clients’ companion pets.

Moreover, pilot tests in Europe using molecular allergology show a reduction in the number of allergens in formulation by more than 50%, Olivry said.

A streamlined treatment set avoids overstimulation and allows the patient to be exposed more effectively to the necessary allergenic compounds during hypo-sensitization.

Reference

1. Olivry T. Molecular Allergology: The Future of Allergy Testing and Immunotherapy. Presented at: Veterinary Meeting and Expo. January 14-18, 2023; Orlando, FL.