Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Sep;70(9):1062-78.
doi: 10.1111/all.12637. Epub 2015 Jul 14.

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

J Bousquet  1   2   3   4 , J M Anto  5   6   7   8 , M Wickman  9   10 , T Keil  11   12 , R Valenta  13 , T Haahtela  14 , K Lodrup Carlsen  15   16 , M van Hage  17 , C Akdis  18 , C Bachert  19 , M Akdis  18 , C Auffray  20 , I Annesi-Maesano  21   22 , C Bindslev-Jensen  23 , A Cambon-Thomsen  24 , K H Carlsen  15   25 , L Chatzi  26 , F Forastiere  27 , J Garcia-Aymerich  5   6   7   8 , U Gehrig  28 , S Guerra  5 , J Heinrich  29 , G H Koppelman  30 , M L Kowalski  31 , B Lambrecht  32 , C Lupinek  13 , D Maier  33 , E Melén  10 , I Momas  34   35 , S Palkonen  36 , M Pinart  5 , D Postma  37 , V Siroux  38 , H A Smit  28 , J Sunyer  5   6   7   8 , J Wright  39 , T Zuberbier  40   41 , S H Arshad  42 , R Nadif  3   4 , C Thijs  43 , N Andersson  9   10 , A Asarnoj  9   10 , N Ballardini  9   10 , S Ballereau  20 , A Bedbrook  2 , M Benet  5 , A Bergstrom  9   10 , B Brunekreef  28 , E Burte  3   4 , M Calderon  44 , G De Carlo  36 , P Demoly  45 , E Eller  23 , M P Fantini  46 , H Hammad  32 , C Hohman  11 , J Just  47   48 , M Kerkhof  37 , M Kogevinas  5   6   7   8 , I Kull  9   10 , S Lau  49 , N Lemonnier  20 , M Mommers  43 , M Nawijn  30 , A Neubauer  33 , S Oddie  39 , J Pellet  20 , I Pin  50 , D Porta  27 , Y Saes  32 , I Skrindo  15   16 , C G Tischer  29 , M Torrent  5   51 , L von Hertzen  14
Affiliations
Review

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

J Bousquet et al. Allergy. 2015 Sep.

Abstract

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.

Keywords: IgE; asthma; atopic dermatitis; polysensitization; rhinitis.

PubMed Disclaimer

LinkOut - more resources