{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:23:02Z","timestamp":1785424982556,"version":"3.56.0"},"reference-count":47,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004242","name":"Princess Nourah bint Abdulrahman University","doi-asserted-by":"crossref","award":["PNURSP2026R879"],"award-info":[{"award-number":["PNURSP2026R879"]}],"id":[{"id":"10.13039\/501100004242","id-type":"DOI","asserted-by":"crossref"}]},{"award":["PNURSP2026R879"],"award-info":[{"award-number":["PNURSP2026R879"]}],"id":[{"id":"https:\/\/ror.org\/05b0cyh02","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Background: Sublingual immunotherapy (SLIT) is an effective treatment for house dust mite (HDM)-induced allergic rhinitis (AR); however, the significance of qualitative changes in specific IgE (sIgE) remains unclear. This study evaluated post-treatment changes in sIgE reactivity and compared the performance of three immunoassays. Methods: In this prospective study, monosensitized patients with HDM-induced AR were identified using skin prick testing and followed for 12 months after SLIT. Serum sIgE levels were assessed at baseline and after treatment using immunoblot, chemiluminescent immunoassay (CLIA), and ImmunoCAP as the reference method. Qualitative changes in sIgE reactivity were analyzed. Clinical response was assessed using the total nasal symptom score (TNSS), and total IgE (tIgE) levels were measured. Results: At baseline, HDM-sIgE reactivity was detected in 85.7%, 82.1%, and 92.9% of patients by immunoblot, CLIA, and ImmunoCAP, respectively. Following SLIT, a significant qualitative conversion to non-reactive status was observed across all assays (p &lt; 0.001). Conversion rates were 94.0% for immunoblot, 83.3% for CLIA, and 100.0% for ImmunoCAP. Significant improvements in TNSS and reductions in tIgE were also observed. Conclusions: SLIT induces a marked qualitative reduction in HDM-sIgE reactivity, with complete serological conversion detected by ImmunoCAP. Although the immunoassays showed comparable rates of HDM-sIgE detection, their agreement in classifying individual patients differed, indicating variability in assay performance. Qualitative assessment of sIgE may provide a clinically meaningful approach for monitoring immunotherapy response.<\/jats:p>","DOI":"10.3390\/biom16060905","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:25:34Z","timestamp":1781778334000},"page":"905","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of sIgE Qualitative Conversion and Clinical Response to HDMs Sublingual Immunotherapy: Insights from Three Immunoassays"],"prefix":"10.3390","volume":"16","author":[{"given":"Tarek","family":"Gheith","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherihan M.","family":"Rohayem","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Portsaid University, Portsaid 42511, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atef Taha","family":"El Bahrawy","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2646-4722","authenticated-orcid":false,"given":"Amira E.","family":"Mesbah","sequence":"additional","affiliation":[{"name":"Department of Acarology, Plant Protection Research Institute, Agricultural Research Center, Giza 12611, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safaa Gaber Aly","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Maternity, Obst & Gyn Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9400-7822","authenticated-orcid":false,"given":"Noha M.","family":"Hammad","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt"},{"name":"Al Jouf Regional Laboratory, Shared Services, Ministry of Health, Sakaka 73244, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2147\/JAA.S281439","article-title":"Diagnosis and Management of Allergic Rhinitis in Asthmatic Children","volume":"16","author":"Tenero","year":"2023","journal-title":"J. Asthma Allergy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.coi.2006.09.016","article-title":"Allergy and hypersensitivity: Mechanisms of allergic disease","volume":"18","author":"Akdis","year":"2006","journal-title":"Curr. Opin. Immunol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Reithofer, M., and Jahn-Schmid, B. (2017). Allergens with Protease Activity from House Dust Mites. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18071368"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Keshavarz, B., Erickson, L.D., Platts-Mills, T.A.E., and Wilson, J.M. (2021). Lessons in Innate and Allergic Immunity from Dust Mite Feces and Tick Bites. Front. Allergy, 2.","DOI":"10.3389\/falgy.2021.692643"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1159\/000524108","article-title":"Clinical Efficacy and Safety of Artesimia annua-Sublingual Immunotherapy in Seasonal Allergic Rhinitis Patients Based on Different Intervention Time","volume":"183","author":"Yang","year":"2022","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1007\/s00405-025-09664-7","article-title":"Efficacy and Safety of Sublingual Immunotherapy for Allergic Rhinitis: An Overview of Systematic Reviews and Meta Analyses","volume":"283","author":"Wang","year":"2026","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Sahiner, U.M., Giovannini, M., Escribese, M.M., Paoletti, G., Heffler, E., Alvaro Lozano, M., Barber, D., Canonica, G.W., and Pfaar, O. (2023). Mechanisms of Allergen Immunotherapy and Potential Biomarkers for Clinical Evaluation. J. Pers. Med., 13.","DOI":"10.3390\/jpm13050845"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s12016-018-8678-z","article-title":"The Use of Biomarkers to Predict Aero-Allergen and Food Immunotherapy Responses","volume":"55","author":"Sindher","year":"2018","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2147\/JAA.S267522","article-title":"Allergen Immunotherapy: Biomarkers and Clinical Outcome Measures","volume":"14","author":"Pitsios","year":"2021","journal-title":"J. Asthma Allergy"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"6327","DOI":"10.19082\/6327","article-title":"Accuracy of immunoblotting assay for detection of specific IgE compared with ImmunoCAP in allergic patients","volume":"10","author":"Shoormasti","year":"2018","journal-title":"Electron. Physician"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6927","DOI":"10.1021\/acs.chemrev.7b00649","article-title":"Chemi- and Bioluminescence of Cyclic Peroxides","volume":"118","author":"Vacher","year":"2018","journal-title":"Chem. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.aller.2019.06.013","article-title":"Phadiatop, Phadiatop Infant and total IgE evaluated in allergic Brazilian children and adolescents","volume":"48","author":"Pierotti","year":"2020","journal-title":"Allergol. Immunopathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jaci.2019.06.049","article-title":"Next-generation Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines for allergic rhinitis based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) and real-world evidence","volume":"145","author":"Bousquet","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1002\/jcla.21741","article-title":"Allergen Component Specific IgE Measurement With the Immulite\u2122 2000 System: Diagnostic Accuracy and Intermethod Comparison","volume":"29","author":"Villalta","year":"2015","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_15","first-page":"5554461","article-title":"Role of MicroRNA-155 as a Potential Biomarker for Allergic Rhinitis in Children","volume":"2021","author":"Hammad","year":"2021","journal-title":"Can. Respir. J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Mokhtar, G.A., Gebriel, M.G., Hammad, N.M., Roman, S.W., Attia, O., Behiry, A., Ismail, N.A., Sayed, M.S.A.E.A.E., Hadhoud, A.N., and Osama, Y.A. (2023). Fungal Aeroallergen Sensitization Patterns among Airway-Allergic Patients in Zagazig, Egypt. J. Fungi, 9.","DOI":"10.3390\/jof9020185"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"100080","DOI":"10.1016\/j.waojou.2019.100080","article-title":"IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper","volume":"13","author":"Ansotegui","year":"2020","journal-title":"World Allergy Organ. J."},{"key":"ref_18","unstructured":"Akhouri, S., and House, S.A. (2025, December 18). Allergic Rhinitis, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK538186\/."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s43168-021-00082-x","article-title":"Association between house dust mites sensitization and level of asthma control and severity in children attending Mansoura University Children\u2019s Hospital","volume":"15","author":"Okasha","year":"2021","journal-title":"Egypt. J. Bronchol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1111\/all.13138","article-title":"Biomarkers for monitoring clinical efficacy of allergen immunotherapy for allergic rhinoconjunctivitis and allergic asthma: An EAACI Position Paper","volume":"72","author":"Shamji","year":"2017","journal-title":"Allergy"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1111\/all.13809","article-title":"Immunological methods for diagnosis and monitoring of IgE-mediated allergy caused by industrial sensitizing agents (IMExAllergy)","volume":"74","author":"Baur","year":"2019","journal-title":"Allergy"},{"key":"ref_22","first-page":"420","article-title":"Detection of allergen specific IgE by AdvanSure Allergy Screen test","volume":"30","author":"Oh","year":"2010","journal-title":"Korean J. Lab. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"68","DOI":"10.23822\/EurAnnACI.1764-1489.241","article-title":"Qualitative and quantitative comparison of allergen component-specific to birch and grass analyzed by ImmunoCAP assay and Euroline immunoblot test","volume":"55","author":"Berge","year":"2023","journal-title":"Eur. Ann. Allergy Clin. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"340513","DOI":"10.1155\/2013\/340513","article-title":"Comparison of Three Multiple Allergen Simultaneous Tests: RIDA Allergy Screen, MAST Optigen, and Polycheck Allergy","volume":"2013","author":"Han","year":"2013","journal-title":"BioMed Res. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"135","DOI":"10.2147\/JAA.S292710","article-title":"The Role of Phadiatop Tests and Total Immunoglobulin E Levels in Screening Aeroallergens: A Hospital-Based Cohort Study","volume":"14","author":"Chang","year":"2021","journal-title":"J. Asthma Allergy"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/sinusitis6010001","article-title":"Atopic Status in Children with Asthma and Respiratory Allergies\u2014Comparative Analysis of Total IgE, ImmunoCAP Phadiatop\/fx5 and Euroimmun Pediatric Immunoblot","volume":"6","author":"Lazova","year":"2022","journal-title":"Sinusitis"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.jaci.2007.12.1150","article-title":"Correlation of serum allergy (IgE) tests performed by different assay systems","volume":"121","author":"Wang","year":"2008","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S1081-1206(10)60618-7","article-title":"Accuracy of IgE antibody laboratory results","volume":"99","author":"Wood","year":"2007","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.5114\/ada.2022.117978","article-title":"Nasal cytology can predict clinical efficacy of subcutaneous immunotherapy in intermittent allergic rhinitis","volume":"39","author":"Gawlik","year":"2022","journal-title":"Postep. Dermatol. Alergol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/1939-4551-7-6","article-title":"Sublingual immunotherapy: World Allergy Organization position paper 2013 update","volume":"7","author":"Canonica","year":"2014","journal-title":"World Allergy Organ. J."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Liu, B., Hu, S., and Xiao, M. (2026). Improvement in nasal signs and eosinophils following 3 years of sublingual immunotherapy for allergic rhinitis. Front. Immunol., 17.","DOI":"10.3389\/fimmu.2026.1828695"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"271","DOI":"10.2500\/ajra.2010.24.3501","article-title":"Clinical and immunologic effects of sublingual immunotherapy on patients with allergic rhinitis to house-dust mites: 1-year follow-up results","volume":"24","author":"Kim","year":"2010","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/j.1365-2222.2009.03448.x","article-title":"Clinical efficacy and immunological mechanisms of sublingual and subcutaneous immunotherapy in asthmatic\/rhinitis children sensitized to house dust mite: An open randomized controlled trial","volume":"40","author":"Eifan","year":"2010","journal-title":"Clin. Exp. Allergy"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4775","DOI":"10.21608\/ejhm.2022.260603","article-title":"Assessment of Efficacy of Sublingual Immunotherapy Compared to the Standard Treatment in Children with Bronchial Asthma in Zagazig University Hospitals","volume":"89","author":"Elsayed","year":"2022","journal-title":"Egypt. J. Hosp. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100206","DOI":"10.1016\/j.jacig.2024.100206","article-title":"Long-term efficacy of house dust mite sublingual immunotherapy on clinical and pulmonary function in patients with asthma and allergic rhinitis","volume":"3","author":"Hoshino","year":"2024","journal-title":"J. Allergy Clin. Immunol. Glob."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1016\/j.jaip.2020.11.046","article-title":"Serum Periostin as a Biomarker for Predicting Clinical Response to House Dust Mite Sublingual Immunotherapy in Allergic Rhinitis","volume":"9","author":"Hoshino","year":"2021","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1016\/j.jaci.2012.03.040","article-title":"High titers of IgE antibody to dust mite allergen and risk for wheezing among asthmatic children infected with rhinovirus","volume":"129","author":"Avila","year":"2012","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.jaci.2015.03.024","article-title":"Different IgE recognition of mite allergen components in asthmatic and nonasthmatic children","volume":"136","author":"Resch","year":"2015","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1159\/000327566","article-title":"Effect of one-year subcutaneous and sublingual immunotherapy on clinical and laboratory parameters in children with rhinitis and asthma: A randomized, placebo-controlled, double-blind, double-dummy study","volume":"157","author":"Yukselen","year":"2012","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/j.1399-3038.2005.00301.x","article-title":"Three-year follow-up of clinical and inflammation parameters in children monosensitized to mites undergoing sub-lingual immunotherapy","volume":"16","author":"Marcucci","year":"2005","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/j.1365-2222.2006.02429.x","article-title":"Sublingual immunotherapy with Dermatophagoides monomeric allergoid down-regulates allergen-specific immunoglobulin E and increases both interferon-gamma- and interleukin-10-production","volume":"36","author":"Cosmi","year":"2006","journal-title":"Clin. Exp. Allergy"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Gupta, N., and Nagarajan, S.A. (Clin. Exp. Allergy, 2026). When a Positive IgE Test Is Not an Allergy: Distinguishing Sensitisation, Cross-Reactivity and Irritant Responses in Clinical Practice, Clin. Exp. Allergy, in press.","DOI":"10.1111\/cea.70315"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1016\/j.jaip.2023.05.022","article-title":"History and Utility of Specific IgE Cutoff Levels: What is the Relevance for Allergy Diagnosis?","volume":"11","author":"Thorpe","year":"2023","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.jaci.2013.12.1088","article-title":"Mechanisms of allergen-specific immunotherapy: Multiple suppressor factors at work in immune tolerance to allergens","volume":"133","author":"Akdis","year":"2014","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1007\/s00405-023-08220-5","article-title":"Does skin prick test response intensity predict symptom severity and efficacy of subcutaneous immunotherapy in allergic rhinitis?","volume":"281","author":"Yuan","year":"2024","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s12948-021-00151-y","article-title":"Distinct differences in analytical performance of two commercially available assays for specific IgE to egg white and house dust mite allergens","volume":"19","author":"Ito","year":"2021","journal-title":"Clin. Mol. Allergy"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Tempels-Pavlica, \u017d., Aarts, M.C.J., Welsing, P.M.J., van der Meer, A.N., van der Zwan, L.P., Uss, E., and Knulst, A.C. (2024). House dust mite sublingual allergen immunotherapy tablet is safe and well-tolerated in Dutch clinical practice. Front. Allergy, 5.","DOI":"10.3389\/falgy.2024.1355324"}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/6\/905\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T04:21:00Z","timestamp":1781929260000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/6\/905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":47,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["biom16060905"],"URL":"https:\/\/doi.org\/10.3390\/biom16060905","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]}}}