Inmunidad Tipo 2 y Enfermedades Alérgicas

RESEARCH INTEREST

Immunological and microbiological changes associated with allergen immunotherapy. The initial phase of immunotherapy can cause adverse reactions that compromise both the safety and adherence to treatment. This phase is characterized by the rapid desensitization of mast cells and basophils, whose mechanisms we recently reviewed (López-Sanz et al. Front Allergy. 2022;16;3:898494) and are currently studying in vitro using a mast cell desensitization protocol (López-Sanz, Sánchez-Martínez & Jiménez-Saiz. STAR Protoc. 2022;16;3(4):101755) to identify therapeutic targets. In this context, our group conducted a two-year placebo-controlled clinical trial investigating the immunological changes induced by grass pollen immunotherapy in respiratory allergy, as part of the doctoral thesis of Dr. Raphaelle Bazire (Barker-Tejeda & Bazire et al. Allergy. 2021;76(4):1199-1212). This research line has been funded by the Spanish Society of Allergy and Clinical Immunology (SEAIC) and by the Agencia Estatal de Investigación (AEI).

In food allergen immunotherapy, adverse reactions are usually mediated by IgE, but a disconnect is often observed between IgE levels and clinical reactivity. We reviewed the role of the microbiota in food sensitivities (Caminero et al. Semin Immunol. 2025 Sep;79:101982) and we have recently shown that the human microbiota metabolize certain antigens, modifying their structure, absorption, and IgE recognition (Sánchez-Martínez et al. Cell Host Microbe. 2026 Apr 8;34(4):600-619.e9). In this regard, we have identified human bacterial strains capable of metabolizing food allergens that could be used in the prevention and immunomodulation of anaphylaxis and serve as biomarkers during immunotherapy. This work has been published in Cell Host & Microbe and featured by Nature, Nature Reviews Microbiology and by several media outlets (El Mundo, Cadena SER, and Diario Médico, among others). This line of research is being carried out in collaboration with Dr. Alberto Caminero (McMaster University, Canada) and has been funded by several programs, including the New Frontiers in Research Fund, the Weston Family Foundation, the Canadian Asthma, Allergy and Immunology Foundation (CAAIF), as well as by The Nutricia Research Foundation (Netherlands), the European Food Safety Authority (EFSA), the Instituto de Salud Carlos III (ISCIII) and the Comunidad de Madrid.

Hypersensitivity reactions to radiodiagnostic contrast media. Drug allergies are also a growing concern, due to both the potentially severe nature of reactions and their significant impact on patients’ quality of life. In recent decades, the use of contrast media for radiological imaging has become a valuable tool to enhance X-ray and MRI studies. A downside of this increased use is the rise in hypersensitivity reactions to both iodinated and gadolinium-based contrast media. In this context, our group studies adverse reactions to contrast media, evaluates tolerance to alternative agents through a rapid full-dose challenge protocol, and investigates the underlying immunological mechanisms (Ruiz de Azcárate et al. Allergy. 2023 (12):3255-3258; Vega et al. Allergy. 2022;77(10):3151-3153; Lopez-Raigada et al. J Investig Allergol Clin Immunol. 2022;32(2):163-164).

Allergic inflammation and its association with cardiovascular risk. Several observational clinical studies suggest that having an allergic disease—particularly asthma, atopic dermatitis, allergic rhinitis, or food allergy—may increase the risk of cardiovascular disease. Cardiovascular disease is the leading cause of global mortality and morbidity, and its prevalence continues to rise. In this line of work, our group has reviewed the clinical association between allergic inflammation and cardiovascular disease, as well as the potentially involved immunological mechanisms, through a collaborative effort with allergists, immunologists, and cardiologists from various institutions (Fernández-Gallego et al. Allergy. 2022;77(11):3249-3266). Moreover, we recently identified that allergic inflammation induces a harmful lipid signature characterized by increased serum triglycerides, which was validated in 59 patients after an allergic reaction (Fernández-Gallego et al. Allergy. 2024;79(10):2680-2699). Both studies were funded by the Spanish State Health Agency, and the latter was selected for the “Editor’s Choice” list (October 2024) and awarded the “Best Scientific Publication by Young Researchers 2024” by the Hospital Universitario de La Princesa.