Advances in Precision Diagnosis for Animal Allergies – an expert view

New DII publication promotes algorithms to improve animal allergy diagnosis and guide personalized treatments

• Molecular and Translational Allergology
• Department of Infection and Immunity

A new algorithm regarding molecular allergology for the personalized care of patients with allergy to furry animals has been published in the News and Views section of the journal Allergy, the highest-ranking journal in the field of allergy research.

Led by Dr Christiane Hilger, Co-Head of the Molecular & Translational Allergology Group in the Department of Infection & Immunity (DII), a team of international experts present a new clinical and diagnostic algorithm for animal allergies. They show how molecular diagnosis can identify genuine sensitization and polysensitization profiles to furry animals, thereby advising patients on allergy management.

Animal allergies are common and affect approximately 10–14% of adults in Europe and the United States. Symptoms range from mild rhinoconjunctivitis to severe asthma and accurate diagnosis is often challenging because sensitization does not always correlate with symptoms. While traditional testing using dander extracts is limited because of variable allergen content and cross-reactivity between species, the recent availability of single allergen molecules has greatly advanced patient diagnosis and care.

The article details how measuring specific IgE antibodies against individual allergen molecules enables clinicians to distinguish genuine sensitization from cross-reactive responses. For example, the marker Fel d 1 is confirmed as a highly specific marker for cat allergies, while patients allergic to dogs frequently show complex sensitization patterns to several markers, with Can f 5, Can f 1 and Can f 4 being the most frequent. The combination of several dog allergens can predict severity better than dog dander extract on its own. Markers have also been identified for hamster, rabbit and guinea-pig, but unfortunately, they are still lacking for other small furry animals such as mouse, rat, ferret and chinchilla.

The approach proposed in the article begins with extract-based testing and, when indicated, proceeds to targeted molecular analysis to confirm genuine sensitization to a specific animal and assess cross-reactivity.

Molecular allergology allows us to move beyond a one-size-fits-all diagnosis. By identifying specific marker allergens, we can distinguish true allergies from cross-reactivity and enable more precise, individualized treatment decisions,

said Dr Christiane Hilger, lead author and Co-Head of the Molecular and Translational Allergology Group at the LIH.