AllergoOncology: Danger signals in allergology and oncology: A European Academy of Allergy and Clinical Immunology (EAACI) Position Paper

Christoph Bergmann, Aurélie Poli, Ioana Agache, Rodolfo Bianchini, Heather J. Bax, Mariana Castells, Silvia Crescioli, David Dombrowicz, Denisa Ferastraoaru, Edda Fiebiger, Hannah J. Gould, Karin Hartmann, Elena Izquierdo, Galateja Jordakieva, Debra H. Josephs, Marek Jutel, Francesca Levi-Schaffer, Leticia de las Vecillas, Michael T. Lotze, Gabriel OsbornMariona Pascal, Frank Redegeld, David Rosenstreich, Franziska Roth-Walter, Carsten Schmidt-Weber, Mohamed Shamji, Esther H. Steveling, Michelle C. Turner, Eva Untersmayr, Erika Jensen-Jarolim*, Sophia N. Karagiannis*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


The immune system interacts with many nominal ‘danger’ signals, endogenous danger-associated (DAMP), exogenous pathogen (PAMP) and allergen (AAMP)-associated molecular patterns. The immune context under which these are received can promote or prevent immune activating or inflammatory mechanisms and may orchestrate diverse immune responses in allergy and cancer. Each can act either by favouring a respective pathology or by supporting the immune response to confer protective effects, depending on acuity or chronicity. In this Position Paper under the collective term danger signals or DAMPs, PAMPs and AAMPs, we consider their diverse roles in allergy and cancer and the connection between these in AllergoOncology. We focus on their interactions with different immune cells of the innate and adaptive immune system and how these promote immune responses with juxtaposing clinical outcomes in allergy and cancer. While danger signals present potential targets to overcome inflammatory responses in allergy, these may be reconsidered in relation to a history of allergy, chronic inflammation and autoimmunity linked to the risk of developing cancer, and with regard to clinical responses to anti-cancer immune and targeted therapies. Cross-disciplinary insights in AllergoOncology derived from dissecting clinical phenotypes of common danger signal pathways may improve allergy and cancer clinical outcomes.

Original languageAmerican English
Pages (from-to)2594-2617
Number of pages24
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number9
Early online date13 Feb 2022
StatePublished - Sep 2022

Bibliographical note

Funding Information:
All authors have read and approved the Position Paper. Any potential conflicts of interest are listed here: CB: Christoph Bergmann received honoraria for presentations from Allergy Theraypeutics, Bencard, HAL Allergy and SCS. CSW: Carsten Schmidt‐Weber has received speaker honoraria from Bencard and Allergopharma and has a patent a patent on nasal secretions that is pending. EJJ: Erika Jensen‐Jarolim declares inventorship in patents on allergen immunotherapy formulation with Biomedical International R+D, Vienna, Austria, of which she is shareholder. She received honoraria for presentations from Allergy Therapeutics, AllergoPharma, Bencard, Meda, Roxall, ThermoFisher, and consulted previously for MediGene, Germany, Novartis, for Allergy Therapeutics and Dr. Schär. EHS: Esther Steveling has received funds from Bencard and ALK. HJB: Heather J. Bax is employed through a fund provided by Epsilogen Ltd. (formerly IGEM Therapeutics Ltd.) and holds patents on anti‐tumour IgE antibodies. DHJ: Debra H Josephs holds patents on anti‐tumour IgE antibodies. GJ: Galateja Jordakieva has received lecture honoraria by Bencard Allergie GmbH and Thermo Fisher Scientific. KH: Karin Hartmann has received research funding from Thermo Fisher and consultancy or lecture fees from Allergopharma, ALK‐Abello, Blueprint, Deciphera, Leo Pharma, Menarini, Novartis, Pfizer, Takeda and Thermo Fisher. MC: Marianna Castells is Principal Investigator for BluePrint PIONEER and HARBOR clinical trials, Editorial Board Annals Of Allergy Asthma and Immunology, Author UpToDate, Board of Directors ABAI. MTL: Michael Lotze is currently Chief Cell Therapy Officer at Nurix Biotherapeutics and has an invention disclosure with the University of Pittsburgh relating IgE to γδ T cells. FRW: Franziska Roth‐Walter declares main inventorship on patent EP2894478 (applicant Biomedical International R+D GmbH, Vienna, Austria) and received research funding from Biomedical International R+D GmbH, Vienna, Austria and Bencard Allergie GmbH, Munich, Germany. Moreover, she received lecture honoraria by FOMF, VAEM, Bencard Allergie GmbH, Munich, Germany and Vienna, Austria, and Allergy Therapeutics, Worthing, UK. SNK: Sophia N. Karagiannis is founder and shareholder of Epsilogen Ltd. (formerly IGEM Therapeutics Ltd.) and has received funds from IGEM Therapeutics Ltd/Epsilogen Ltd. Sophia N. Karagiannis holds patents on anti‐tumour IgE antibodies. AP, DD, DR, DHJ, DF, EF, EI, EU, FLS, FR, GO, HJG, IA, LV, MJ, MP, MCT, MS, RB and SC declare no conflict of interest.

Funding Information:
The authors would like to thank EAACI for financial support in the development of this position paper. We would like to thank Anna Głobińska for her assistance during figures preparation and adaptation.

Funding Information:
The Working group was supported by the European Academy for Allergy and Clinical Immunology (EAACI). Aurélie Poli is financially supported by the Action Lions Vaincre le Cancer association.

Publisher Copyright:
© 2022 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.


  • AAMP
  • ALR
  • DAMP
  • NLR
  • PAMP
  • RLR
  • TLR
  • allergy
  • cancer
  • danger signals
  • immune response
  • immunotherapy
  • inflammation
  • tolerance


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