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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.

Allergy 70, 1062-1078 (2015)
Postprint DOI
Open Access Green
as soon as is submitted to ZB.
Allergic diseases (asthma, rhinitis and atopic dermatitis) are complex. They are associated with allergen-specific IgE and non-allergic 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 or 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 atopic dermatitis are manifestations of a common systemic immune imbalance (mesodermal origin) with specific patterns of remodelling (ectodermal or endodermal origin). This paper proposes a new classification of IgE-mediated allergic diseases that allows the definition of novel phenotypes in order 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.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Ige ; Allergy ; Asthma ; Atopic Dermatitis ; 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
Reviewing status