1101
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Yukselen A. Allergen-specific immunotherapy in pediatric allergic asthma. Asia Pac Allergy 2016; 6:139-48. [PMID: 27489785 PMCID: PMC4967613 DOI: 10.5415/apallergy.2016.6.3.139] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/10/2016] [Indexed: 12/12/2022] Open
Abstract
Allergen-specific immunotherapy (AIT) is the only curative way that can change the immunologic response to allergens and thus can modify the natural progression of allergic diseases. There are some important criteria which contributes significantly on efficacy of AIT, such as the allergen extract used for treatment, the dose and protocol, patient selection in addition to the severity and control of asthma. The initiation of AIT in allergic asthma should be considered in intermittent, mild and moderate cases which coexisting with other allergic diseases such as allergic rhinitis, and in case of unacceptable adverse effects of medications. Two important impact of AIT; steroid sparing effect and preventing from progression to asthma should be taken into account in pediatric asthma when making a decision on starting of AIT. Uncontrolled asthma remains a significant risk factor for adverse events and asthma should be controlled both before and during administration of AIT. The evidence concerning the efficacy of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) for treatment of pediatric asthma suggested that SCIT decreases asthma symptoms and medication scores, whereas SLIT can ameliorate asthma symptoms. Although the effectiveness of SCIT has been shown for both seasonal and perennial allergens, the data for SLIT is less convincing for perennial allergies in pediatric asthma.
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Affiliation(s)
- Ayfer Yukselen
- Division of Pediatric Allergy & Immunology, Department of Pediatrics, Baskent University Istanbul Hospital, Istanbul 34662, Turkey
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1102
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Ansotegui IJ, Sánchez-Borges M, Cardona V. Current Trends in Prevalence and Mortality of Anaphylaxis. CURRENT TREATMENT OPTIONS IN ALLERGY 2016. [DOI: 10.1007/s40521-016-0094-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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1103
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A Pragmatic Approach to Patch Testing Atopic Dermatitis Patients: Clinical Recommendations Based on Expert Consensus Opinion. Dermatitis 2016; 27:186-92. [DOI: 10.1097/der.0000000000000208] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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1104
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Agache I, Akdis CA. Endotypes of allergic diseases and asthma: An important step in building blocks for the future of precision medicine. Allergol Int 2016; 65:243-52. [PMID: 27282212 DOI: 10.1016/j.alit.2016.04.011] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 04/25/2016] [Indexed: 02/07/2023] Open
Abstract
Discoveries from basic science research in the last decade have brought significant progress in knowledge of pathophysiologic processes of allergic diseases, with a compelling impact on understanding of the natural history, risk prediction, treatment selection or mechanism-specific prevention strategies. The view of the pathophysiology of allergic diseases developed from a mechanistic approach, with a focus on symptoms and organ function, to the recognition of a complex network of immunological pathways. Several subtypes of inflammation and complex immune-regulatory networks and the reasons for their failure are now described, that open the way for the development of new diagnostic tools and innovative targeted-treatments. An endotype is a subtype of a disease condition, which is defined by a distinct pathophysiological mechanism, whereas a disease phenotype defines any observable characteristic of a disease without any implication of a mechanism. Another key word linked to disease endotyping is biomarker that is measured and evaluated to examine any biological or pathogenic processes, including response to a therapeutic intervention. These three keywords will be discussed more and more in the future with the upcoming efforts to revolutionize patient care in the direction of precision medicine and precision health. The understanding of disease endotypes based on pathophysiological principles and their validation across clinically meaningful outcomes in asthma, allergic rhinitis, chronic rhinosinusitis, atopic dermatitis and food allergy will be crucial for the success of precision medicine as a new approach to patient management.
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1105
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Pfaar O, Nell MJ, Boot JD, Versteeg SA, van Ree R, Roger A, Riechelmann H, Sperl A, Oude Elberink JNG, Diamant Z, Bachert C. A randomized, 5-arm dose finding study with a mite allergoid SCIT in allergic rhinoconjunctivitis patients. Allergy 2016; 71:967-76. [PMID: 26864207 DOI: 10.1111/all.12860] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND The safety and tolerability of a mite allergoid subcutaneous allergen immunotherapy (SCIT) product was previously established. The aim of this study (EudraCT number: 2011-000393-61) was to find the optimally safe and effective allergoid dose by evaluating several dosages in patients with house dust mite (HDM)-induced allergic rhinoconjunctivitis (ARC) using a titrated nasal provocation test (TNPT). METHODS In total, 290 adult ARC patients (148 females; 142 males) with established HDM allergy and with a positive TNPT were randomized to receive placebo or mite allergoid SCIT 6667, 20 000, 50 000 or 100 000 AUeq/ml for 12 months. Patients were updosed weekly, followed by monthly maintenance dosing. The primary study endpoint comprised the clinical response to TNPT after 12 months of treatment. Secondary endpoints included response to TNPT after 6 months, PNIF measurements, symptom and medication scores during the last 8 weeks of treatment, serum immunoglobulins and safety assessments. RESULTS After 12 months, a dose-response was observed showing statistically significant improvements in the TNPT with SCIT concentrations of ≥20 000 AUeq/ml, while no significantly different outcomes were reached after 6 months. Specific serum IgG and IgG4 levels were dose dependently increased. In the highest dose group, more treatment-emergent adverse events were observed compared with the lower dose groups. CONCLUSION In this mite allergoid SCIT dose finding study in HDM-induced ARC, concentrations of ≥20 000 AUeq/ml showed both immunological effects and clinical efficacy in the TNPT compared with placebo. The risk-benefit ratio favours 20 000 AUeq/ml and 50 000 AUeq/ml strengths for further clinical development.
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Affiliation(s)
- O. Pfaar
- Center for Rhinology and Allergology; Wiesbaden Germany
- Department of Otorhinolaryngology; Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | | | | | - S. A. Versteeg
- Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
| | - R. van Ree
- Experimental Immunology; Academic Medical Center; Amsterdam The Netherlands
- Department of Otorhino-laryngology; Academic Medical Center; Amsterdam The Netherlands
| | - A. Roger
- Unitat d'Allèrgia; Hospital Universitari Germans Trias i Pujol; Badalona Spain
| | - H. Riechelmann
- Department of Otorhinolaryngology - Head & Neck Surgery; Medical University of Innsbruck; Innsbruck Austria
| | - A. Sperl
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - J. N. G. Oude Elberink
- Department of Allergology; University Medical Center Groningen; University of Groningen; Groningen The Netherlands
| | - Z. Diamant
- Department of Respiratory Medicine & Allergology; Institute for Clinical Science; Skane University Hospital; Lund Sweden
- Department of Clinical Pharmacy & Pharmacology and Department of Gen Practice; University Medical Center Groningen; University Groningen; Groningen The Netherlands
| | - C. Bachert
- Upper Airways Research Laboratory; Ghent University; Ghent Belgium
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1106
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Lanier BQ, Tierce M. Considerations in difficult-to-control asthma. Int Forum Allergy Rhinol 2016; 5 Suppl 1:S57-60. [PMID: 26335837 DOI: 10.1002/alr.21593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Revised: 05/12/2015] [Accepted: 06/09/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Difficult-to-control asthma includes those patients who require treatment with high-dose inhaled glucocorticosteroid (ICS) plus a second controller and/or systemic glucocorticosteroids to manage. The exact percentage of "difficult to treat," "refractory," "severe," or "brittle" asthma is 3% to 10% of all asthmatic patients, but this group of asthmatics use the majority of resources for the entire asthmatic population. METHODS Medline searches for the terms "difficult to control," "severe," "refractory," "brittle," and asthma were done and the results were reviewed. RESULTS Patterns for difficult-to-control asthma emerge from concepts of compliance, comorbidity, and endotypes, which give the practitioner pathways for analyzing this subset of asthma patients. CONCLUSION The ear, nose, and throat (ENT) physician can be of significant help to other asthma specialists in the recognition of the difficult-to-control asthmatic, as well as providing specific specialized diagnostic skills and the reinforcement of adherence to medical regimens.
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Affiliation(s)
- Bob Q Lanier
- Immunology and Respiratory Consultants, Ft. Worth, TX
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1107
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Trendelenburg V, Blümchen K. [Allergen-specific immunotherapy for food allergies in childhood. Current options and future perspectives]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:855-64. [PMID: 27324376 DOI: 10.1007/s00103-016-2372-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
During recent years increasing research has been conducted on casual treatment options for food allergy, with focus on oral immunotherapy (OIT) for hen's egg, cow's milk and peanut allergy. Several studies could show that OIT leads to desensitization or an increase of threshold. However, severe adverse events during this treatment are not uncommon. Whether OIT leads to a sustained, 'robust' development of tolerance in patients has not yet been thoroughly investigated. Besides OIT, some studies on sublingual (SLIT) and epicutaneous immunotherapy (EPIT) were performed, aiming to improve the safety profile. Furthermore, there are some pilot studies investigating a combined treatment of SLIT and OIT or a combined use of anti-IgE treatment or probiotic supplementation with OIT. Further placebo-controlled trials with larger sample size are needed in order to develop standardized protocols before immunotherapy may be used as a therapeutic option for food allergy outside of clinical trials.
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Affiliation(s)
- Valérie Trendelenburg
- Klinik für Pädiatrie mit Schwerpunkt Pneumologie/Immunologie, Universitätsmedizin Charité, Berlin, Deutschland
| | - Katharina Blümchen
- Klinik für Kinder- und Jugendmedizin, Pädiatrische Allergologie, Pneumologie und Mukoviszidose, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
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1108
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1109
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Bano N, Najam R, Qazi F, Mateen A. Clinical Features of Oxaliplatin Induced Hypersensitivity Reactions and Therapeutic Approaches. Asian Pac J Cancer Prev 2016; 17:1637-41. [DOI: 10.7314/apjcp.2016.17.4.1637] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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1110
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Laser-facilitated epicutaneous immunotherapy to IgE-mediated allergy. J Control Release 2016; 235:82-90. [PMID: 27235977 DOI: 10.1016/j.jconrel.2016.05.057] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/25/2016] [Accepted: 05/25/2016] [Indexed: 01/21/2023]
Abstract
Allergen specific immunotherapy has been shown to be the only effective treatment for long-lasting clinical benefit to IgE-mediated allergic diseases, but a fewer than 5% of patients choose the treatment because of inconvenience and a high risk of anaphylaxis. Recently, epicutaneous allergen-specific immunotherapy (EPIT) has proven effective, yet with limitations owing to strong skin reactions. We demonstrate here safer and faster EPIT, named μEPIT, by delivering powdered allergen and adjuvants into many micropores in the epidermis. We fabricated a microarray patch fractionally coated with a powder mixture of ovalbumin (OVA) model allergen, CpG, and 1,25-dihydroxyvitamin D3 (VD3). Topical application of the patch onto laser-microperforated skin resulted in a high level of epidermal delivery while greatly minimizing allergen leakage into circulation system as compared to current subcutaneous immunotherapy (SCIT). Moreover, only three times of μEPIT over two weeks could sufficiently inhibit allergen-specific IgE responses in mice suffering OVA-induced airway hyperresponsivness (AHR), which was unattainable by eight times of SCIT over three weeks. Mechanistically, μEPIT preferably enhanced IgG2a production suggesting TH1-biased immune responses and induced a high level of T-regulatory (Treg) cells against repeated allergen sensitization. The immune tolerance was confirmed by marked reduction in airway wall thickness as well as eosinophil and neutrophil infiltration into the respiratory airway. The μEPIT represents a novel and painless technology to treat IgE-mediated allergic diseases with little local skin reaction and a minimal risk of anaphylaxis.
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1111
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Pohlit H, Frey H, Saloga J. Could allergen-specific immunotherapy benefit from the use of nanocarriers? Nanomedicine (Lond) 2016; 11:1329-31. [PMID: 27221075 DOI: 10.2217/nnm-2016-0111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Hannah Pohlit
- Department of Dermatology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.,Institute of Organic Chemistry, Johannes Gutenberg University Mainz, Duesbergweg 10-14, 55128 Mainz, Germany.,Graduate School Materials Science in Mainz, Staudinger Weg 9, 55128 Mainz, Germany
| | - Holger Frey
- Institute of Organic Chemistry, Johannes Gutenberg University Mainz, Duesbergweg 10-14, 55128 Mainz, Germany
| | - Joachim Saloga
- Department of Dermatology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
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1112
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Lucendo AJ. Meta-Analysis-Based Guidance for Dietary Management in Eosinophilic Esophagitis. Curr Gastroenterol Rep 2016; 17:464. [PMID: 26292666 DOI: 10.1007/s11894-015-0464-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Eosinophilic esophagitis (EoE) is a prevalent chronic esophageal disorder, triggered and maintained by immunologically mediated responses against dietary antigens. EoE represents the most recent form of food allergy, and its control by avoiding offending foods has increasingly appeared as a therapeutic alternative to achieve and maintain remission. Dietary therapies have proved equally effective in pediatric and adult EoE patients, among whom various types of interventions to eliminate or reduce food antigens exposure have been evaluated. A recent meta-analysis showed elemental diet as the most effective option to induce disease remission, but with a limited application in clinical practice. Inconsistency and wide variability in results from skin allergy testing-directed food restriction contributed to dissatisfaction with implementation of this option, which subsequently was displaced by empiric elimination of common food allergens. Such empiric elimination of common food allergens is now recognized as the best alternative for dietary treatment, with moderate-to-high efficiency and reproducible results. This review provides evidence-based insights into the dietary management of EoE.
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Affiliation(s)
- Alfredo J Lucendo
- Department of Gastroenterology, Hospital General de Tomelloso, Vereda de Socuéllamos, s/n., 13700, Tomelloso, Ciudad Real, Spain,
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1113
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Cao T, Zhang Z, Liu ZG, Dou X, Zhang J, Zhang W, Wu B, Yu ZD, Wei Z, Yu B. High-level expression and purification of the major house dust mite allergen Der p 2 in Escherichia coli. Protein Expr Purif 2016; 121:97-102. [PMID: 26812600 DOI: 10.1016/j.pep.2016.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 02/05/2023]
Abstract
Der p 2, a major allergen derived from the house dust mite Dermatophagoides pteronyssinus, is one of the most clinically relevant allergens worldwide. Recombinant Der p 2 (rDer p 2) is useful in clinical diagnosis and disease-specific immunotherapy. However, previous studies showed that Der p 2 can only be expressed in Escherichia coli (E. coli) cells as inclusion bodies, thus protein refolding is required to obtain functional products. Here we report a new method to produce biologically active Der p 2 protein in E. coli. N-terminal hexahistidine- and trigger factor (TF)-tagged Der p 2 was expressed in soluble form in E. coli and purified using a combination of chromatography processes. This procedure produced milligram-level high purity Der p 2 per liter of bacterial culture. Moreover, far-UV region circular dichroism (CD) analysis and serum specific IgE reactivity test demonstrated that the secondary structure and IgE reactivity properties of rDer p 2 produced in our study were almost identical to those of natural Der p 2 (nDer p 2). In conclusion, the method developed in this work provides a useful tool for the production of immunologically active recombinant Der p 2 for clinical applications.
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Affiliation(s)
- Tuo Cao
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China; Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China; Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zhang Zhang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China; Shenzhen Key Lab for Translational Medicine of Dermatology, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China
| | - Zhi-Gao Liu
- Biomedical Research Institute, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China
| | - Xia Dou
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China; Shenzhen Key Lab for Translational Medicine of Dermatology, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China
| | - Jie Zhang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China; Shenzhen Key Lab for Translational Medicine of Dermatology, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China
| | - Wei Zhang
- Biomedical Research Institute, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China; Shenzhen Key Lab for Translational Medicine of Dermatology, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China
| | - Bo Wu
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China; Shenzhen Key Lab for Translational Medicine of Dermatology, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China
| | - Zhen-Dong Yu
- Central Laboratory, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China
| | - Zhun Wei
- Biomedical Research Institute, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China; Shenzhen Key Lab for Translational Medicine of Dermatology, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China.
| | - Bo Yu
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China; Shenzhen Key Lab for Translational Medicine of Dermatology, Shenzhen Peking University - the Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, Guangdong, China.
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1114
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Matricardi PM, Kleine-Tebbe J, Hoffmann HJ, Valenta R, Hilger C, Hofmaier S, Aalberse RC, Agache I, Asero R, Ballmer-Weber B, Barber D, Beyer K, Biedermann T, Bilò MB, Blank S, Bohle B, Bosshard PP, Breiteneder H, Brough HA, Caraballo L, Caubet JC, Crameri R, Davies JM, Douladiris N, Ebisawa M, EIgenmann PA, Fernandez-Rivas M, Ferreira F, Gadermaier G, Glatz M, Hamilton RG, Hawranek T, Hellings P, Hoffmann-Sommergruber K, Jakob T, Jappe U, Jutel M, Kamath SD, Knol EF, Korosec P, Kuehn A, Lack G, Lopata AL, Mäkelä M, Morisset M, Niederberger V, Nowak-Węgrzyn AH, Papadopoulos NG, Pastorello EA, Pauli G, Platts-Mills T, Posa D, Poulsen LK, Raulf M, Sastre J, Scala E, Schmid JM, Schmid-Grendelmeier P, van Hage M, van Ree R, Vieths S, Weber R, Wickman M, Muraro A, Ollert M. EAACI Molecular Allergology User's Guide. Pediatr Allergy Immunol 2016; 27 Suppl 23:1-250. [PMID: 27288833 DOI: 10.1111/pai.12563] [Citation(s) in RCA: 512] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.
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Affiliation(s)
- P M Matricardi
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - J Kleine-Tebbe
- Allergy & Asthma Center Westend, Outpatient Clinic Ackermann, Hanf, & Kleine-Tebbe, Berlin, Germany
| | - H J Hoffmann
- Department of Respiratory Diseases and Allergy, Institute of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - C Hilger
- Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - S Hofmaier
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - R C Aalberse
- Sanquin Research, Department of Immunopathology, Amsterdam, The Netherlands
- Landsteiner Laboratory, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - I Agache
- Department of Allergy and Clinical Immunology, Faculty of Medicine, Transylvania University of Brasov, Brasov, Romania
| | - R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - B Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - D Barber
- IMMA-School of Medicine, University CEU San Pablo, Madrid, Spain
| | - K Beyer
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - T Biedermann
- Department of Dermatology and Allergology, Technical University Munich, Munich, Germany
| | - M B Bilò
- Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy
| | - S Blank
- Center of Allergy and Environment (ZAUM), Helmholtz Center Munich, Technical University of Munich, Munich, Germany
| | - B Bohle
- Division of Experimental Allergology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology & Immunology, Medical University of Vienna, Vienna, Austria
| | - P P Bosshard
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - H Breiteneder
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - H A Brough
- Paediatric Allergy, Department of Asthma, Allergy and Respiratory Science, King's College London, Guys' Hospital, London, UK
| | - L Caraballo
- Institute for Immunological Research, The University of Cartagena, Cartagena de Indias, Colombia
| | - J C Caubet
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - R Crameri
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Davos, Switzerland
| | - J M Davies
- School of Biomedical Sciences, Institute of Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - N Douladiris
- Allergy Unit, 2nd Paediatric Clinic, National & Kapodistrian University, Athens, Greece
| | - M Ebisawa
- Department of Allergy, Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - P A EIgenmann
- Pediatric Allergy Unit, Department of Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - M Fernandez-Rivas
- Allergy Department, Hospital Clinico San Carlos IdISSC, Madrid, Spain
| | - F Ferreira
- Division of Allergy and Immunology, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - G Gadermaier
- Division of Allergy and Immunology, Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | - M Glatz
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - R G Hamilton
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - T Hawranek
- Department of Dermatology, Paracelsus Private Medical University, Salzburg, Austria
| | - P Hellings
- Department of Otorhinolaryngology, Academic Medical Center (AMC), Amsterdam, The Netherlands
- Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium
| | - K Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - T Jakob
- Department of Dermatology and Allergology, University Medical Center Giessen and Marburg, Justus Liebig University Giessen, Giessen, Germany
| | - U Jappe
- Division of Clinical and Molecular Allergology, Research Centre Borstel, Airway Research Centre North (ARCN), Member of the German Centre for Lung Research (DZL), Borstel, Germany
- Interdisciplinary Allergy Division, Department of Pneumology, University of Lübeck, Lübeck, Germany
| | - M Jutel
- Department of Clinical Immunology, 'ALL-MED' Medical Research Institute, Wrocław Medical University, Wrocław, Poland
| | - S D Kamath
- Molecular Allergy Research Laboratory, Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville City, Qld, Australia
| | - E F Knol
- Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Korosec
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - A Kuehn
- Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - G Lack
- King's College London, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
- Division of Asthma, Allergy and Lung Biology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A L Lopata
- Department of Clinical Immunology, 'ALL-MED' Medical Research Institute, Wrocław Medical University, Wrocław, Poland
| | - M Mäkelä
- Skin and Allergy Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - M Morisset
- National Service of Immuno-Allergology, Centre Hospitalier Luxembourg (CHL), Luxembourg, UK
| | - V Niederberger
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - A H Nowak-Węgrzyn
- Pediatric Allergy and Immunology, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - N G Papadopoulos
- Centre for Paediatrics and Child Health, Institute of Human Development, University of Manchester, Manchester, UK
| | - E A Pastorello
- Unit of Allergology and Immunology, Niguarda Ca' Granda Hospital, Milan, Italy
| | - G Pauli
- Service de Pneumologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - T Platts-Mills
- Department of Microbiology & Immunology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - D Posa
- Paediatric Pneumology and Immunology, Charitè Medical University, Berlin, Germany
| | - L K Poulsen
- Allergy Clinic, Copenhagen University Hospital, Copenhagen, Denmark
| | - M Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Ruhr-University Bochum (IPA), Bochum, Germany
| | - J Sastre
- Allergy Division, Fundación Jimenez Díaz, Madrid, Spain
| | - E Scala
- Experimental Allergy Unit, IDI-IRCCS, Rome, Italy
| | - J M Schmid
- Department of Respiratory Diseases and Allergy, Institute of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - M van Hage
- Department of Medicine Solna, Clinical Immunology and Allergy Unit, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - R van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - S Vieths
- Department of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - R Weber
- School of Medicine, University of Colorado, Denver, CO, USA
- Department of Medicine, National Jewish Health Service, Denver, CO, USA
| | - M Wickman
- Sachs' Children's Hospital, Karolinska Institutet, Stockholm, Sweden
| | - A Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - M Ollert
- Department of Infection & Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark
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1115
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Peng Z, Xu WW, Sham Y, Lam H, Sun D, Cheng L, Rasic NF, Guan Q, James AA, Simons FER. Mosquito salivary allergen Aed a 3: cloning, comprehensive molecular analysis, and clinical evaluation. Allergy 2016; 71:621-8. [PMID: 26608594 DOI: 10.1111/all.12812] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allergic reactions to mosquito bites are an increasing clinical concern. Due to the lack of availability of mosquito salivary allergens, they are underdiagnosed. Here, we reported a newly cloned mosquito Aedes (Ae.) aegypti salivary allergen. METHODS A cDNA encoding a 30-kDa Ae. aegypti salivary protein, designated Aed a 3, was isolated from an expression library. The full-length cDNA was cloned into a baculovirus expression vector, and recombinant Aed a 3 (rAed a 3) was expressed, purified, and characterized. Skin prick tests with purified rAed a 3 and Ae. aegypti bite tests were performed in 43 volunteers. Serum rAed a 3-specific IgE levels were measured in 28 volunteers. RESULTS The primary nucleotide sequence, deduced amino acid sequence, and IgE-binding sites of Aed a 3 were identified. rAed a 3-selected antibodies recognized a 30-kDa Ae. aegypti saliva protein. rAed a 3 bound IgE in mosquito-allergic volunteers and the binding could be inhibited by the addition of natural mosquito extract dose dependently. Immediate skin test reactions to rAed a 3 correlated significantly with mosquito bite-induced reactions. Of the bite test-positive volunteers, 32% had a positive rAed a 3 skin test and 46% had specific IgE. No bite test-negative volunteers reacted to rAed a 3 in either the skin tests or the IgE assays, confirming the specificity of the assay. CONCLUSIONS Aed a 3 that corresponds to the Aegyptin protein is a major mosquito salivary allergen. Its recombinant form has biological activity and is suitable for use in skin tests and specific IgE assays in mosquito-allergic individuals.
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Affiliation(s)
- Z. Peng
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Immunology; University of Manitoba; Winnipeg MB Canada
| | - W. W. Xu
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Biochemistry and Medical Genetics; University of Manitoba; Winnipeg MB Canada
| | - Y. Sham
- Center for Drug Design; Academic Health Center; University of Minnesota; Minneapolis MN USA
| | - H. Lam
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - D. Sun
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - L. Cheng
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - N. F. Rasic
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
| | - Q. Guan
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Immunology; University of Manitoba; Winnipeg MB Canada
| | - A. A. James
- Departments of Microbiology & Molecular Genetics and Molecular Biology & Biochemistry; University of California; Irvine CA USA
| | - F. E. R. Simons
- Department of Pediatrics and Child Health; University of Manitoba; Winnipeg MB Canada
- Department of Immunology; University of Manitoba; Winnipeg MB Canada
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1116
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Pei H, Linden J. Adenosine influences myeloid cells to inhibit aeroallergen sensitization. Am J Physiol Lung Cell Mol Physiol 2016; 310:L985-92. [PMID: 27016586 DOI: 10.1152/ajplung.00330.2015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 03/21/2016] [Indexed: 12/13/2022] Open
Abstract
Agonists of adenosine A2A receptors (A2ARs) suppress the activation of most immune cells and reduce acute inflammatory responses. Asthma is characterized by sensitization in response to initial allergen exposure and by airway hyperreactivity in response to allergen rechallenge. We sought to determine if A2AR activation with CGS-21680 (CGS) is more effective when CGS is administered during sensitization or rechallenge. C57BL/6 wild-type mice and Adora2a(f/f)LysMCre(+/-) mice, which lack A2ARs on myeloid cells, were sensitized with intranasal ovalbumin (OVA) and LPS. Airway sensitization was characterized by a rapid increase in numbers of IL-6(+) and IL-12(+) macrophages and dendritic cells in lungs. A2AR activation with CGS (0.1 μg·kg(-1)·min(-1) sc) only during sensitization reduced numbers of IL-6(+) and IL-12(+) myeloid cells in the lungs and reversed the effects of OVA rechallenge to increase airway hyperresponsiveness to methacholine. CGS treatment during sensitization also reduced the expansion of lung T helper (Th1 and Th17) cells and increased expansion of regulatory T cells in response to OVA rechallenge. Most of the effects of CGS administered during sensitization were eliminated by myeloid-selective A2AR deletion. Administration of CGS only during OVA rechallenge failed to reduce airway hyperresponsiveness. We conclude that myeloid cells are key targets of adenosine during sensitization and indirectly modify T cell polarization. The results suggest that a clinically useful strategy might be to use A2AR agonists to inhibit sensitization to new aeroallergens. We speculate that adenosine production by macrophages engulfing bacteria contributes to the curious suppression of sensitization in response to early-life infections.
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Affiliation(s)
- Hong Pei
- Division of Developmental Immunology, La Jolla Institute for Allergy and Immunology, La Jolla, California
| | - Joel Linden
- Division of Developmental Immunology, La Jolla Institute for Allergy and Immunology, La Jolla, California
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1117
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Smoldovskaya O, Feyzkhanova G, Arefieva A, Voloshin S, Ivashkina O, Reznikov Y, Rubina A. Allergen extracts and recombinant proteins: comparison of efficiency of in vitro allergy diagnostics using multiplex assay on a biological microchip. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2016. [PMID: 26973700 DOI: 10.1186/s13223-016-0117-1.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Immunological test systems for diagnostics of type I hypersensitivity involve the following types of antigens: whole allergen extracts, individual highly purified proteins and their recombinant analogues. The goal of this study was to compare the results obtained with whole allergen extracts (birch pollen, cat dander, and timothy grass pollen) and their respective recombinant proteins in biochip-based immunoassay. METHODS Multiplex fluorescent immunoassay of 139 patients' blood serum samples was carried out using biological microchips (biochips). sIgE concentrations for the chosen allergens and their recombinant components were measured. ROC analysis was used for comparison of the results and determination of diagnostic accuracy. RESULTS The results for the birch pollen extract and its recombinant allergens have shown that the diagnostic accuracy of the methods utilizing the whole allergen extract, its major component Bet v 1 and the combination of major and minor components (Bet v 1 and Bet v 2) was the same. Values for diagnostic accuracy for the cat dander extract and its major recombinant component Fel d 1 were equal. In contrast with birch pollen and cat dander allergens, using of recombinant components of timothy grass pollen (Phl p 1, Phl p 5, Phl p 7 and Phl p 12) did not allow reaching the diagnostic accuracy of using natural extract. CONCLUSIONS Multiplex analysis of samples obtained from patients with allergy to birch pollen and cat dander using biological microchips has shown that comparable accuracy was observed for the assay with natural extracts and recombinant allergens. In the case of timothy grass allergen, using the recombinant components may be insufficient.
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Affiliation(s)
- Olga Smoldovskaya
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Guzel Feyzkhanova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Alla Arefieva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Sergei Voloshin
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Olga Ivashkina
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Yuriy Reznikov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Alla Rubina
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
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1118
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Smoldovskaya O, Feyzkhanova G, Arefieva A, Voloshin S, Ivashkina O, Reznikov Y, Rubina A. Allergen extracts and recombinant proteins: comparison of efficiency of in vitro allergy diagnostics using multiplex assay on a biological microchip. Allergy Asthma Clin Immunol 2016; 12:9. [PMID: 26973700 PMCID: PMC4789275 DOI: 10.1186/s13223-016-0117-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/03/2016] [Indexed: 11/10/2022] Open
Abstract
Background Immunological test systems for diagnostics of type I hypersensitivity involve the following types of antigens: whole allergen extracts, individual highly purified proteins and their recombinant analogues. The goal of this study was to compare the results obtained with whole allergen extracts (birch pollen, cat dander, and timothy grass pollen) and their respective recombinant proteins in biochip-based immunoassay. Methods Multiplex fluorescent immunoassay of 139 patients’ blood serum samples was carried out using biological microchips (biochips). sIgE concentrations for the chosen allergens and their recombinant components were measured. ROC analysis was used for comparison of the results and determination of diagnostic accuracy. Results The results for the birch pollen extract and its recombinant allergens have shown that the diagnostic accuracy of the methods utilizing the whole allergen extract, its major component Bet v 1 and the combination of major and minor components (Bet v 1 and Bet v 2) was the same. Values for diagnostic accuracy for the cat dander extract and its major recombinant component Fel d 1 were equal. In contrast with birch pollen and cat dander allergens, using of recombinant components of timothy grass pollen (Phl p 1, Phl p 5, Phl p 7 and Phl p 12) did not allow reaching the diagnostic accuracy of using natural extract. Conclusions Multiplex analysis of samples obtained from patients with allergy to birch pollen and cat dander using biological microchips has shown that comparable accuracy was observed for the assay with natural extracts and recombinant allergens. In the case of timothy grass allergen, using the recombinant components may be insufficient.
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Affiliation(s)
- Olga Smoldovskaya
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Guzel Feyzkhanova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Alla Arefieva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Sergei Voloshin
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Olga Ivashkina
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Yuriy Reznikov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
| | - Alla Rubina
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences (EIMB RAS), 119991 Vavilova str.,32, Moscow, Russia
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1119
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Incorvaia C, Montagni M, Ridolo E. The efficiency of peptide immunotherapy for respiratory allergy. Expert Rev Clin Pharmacol 2016; 9:831-7. [PMID: 26901667 DOI: 10.1586/17512433.2016.1157017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Allergen immunotherapy (AIT) was introduced more than a century ago and is yet the only disease-modifying treatment for allergy. AIT is currently conducted with whole allergen extracts and several studies clearly support its efficacy in the treatment of respiratory allergies, however the need for a long treatment - that affects costs and patients compliance - and possible IgE-mediated adverse events are still unresolved issues. Peptide immunotherapy is based on the use of short synthetic peptides which represent major T-cell epitopes of the allergen with markedly reduced ability to cross-link IgE and activate mast cells and basophils. Data from clinical trials confirmed the efficacy and tolerability of peptide immunotherapy in patients with cat allergy, with a sustained clinical effect after a short course treatment. Peptide therapy is a promising safe and effective new specific treatment for allergy to be developed for the most important allergens causing rhinitis or asthma.
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Affiliation(s)
- Cristoforo Incorvaia
- a Allergy/Pulmonary Rehabilitation , Istituti Clinici di Perfezionamento , Milan , Italy
| | - Marcello Montagni
- b Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
| | - Erminia Ridolo
- b Department of Clinical and Experimental Medicine , University of Parma , Parma , Italy
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1120
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1121
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Vazquez-Ortiz M, Turner PJ. Improving the safety of oral immunotherapy for food allergy. Pediatr Allergy Immunol 2016; 27:117-25. [PMID: 26593873 PMCID: PMC4950028 DOI: 10.1111/pai.12510] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2015] [Indexed: 12/11/2022]
Abstract
Food allergy is a major public health problem in children, impacting upon the affected individual, their families and others charged with their care, for example educational establishments, and the food industry. In contrast to most other paediatric diseases, there is no established cure: current management is based upon dietary avoidance and the provision of rescue medication in the event of accidental reactions, which are common. This strategy has significant limitations and impacts adversely on health-related quality of life. In the last decade, research into disease-modifying treatments for food allergy has emerged, predominantly for peanut, egg and cow's milk. Most studies have used the oral route (oral immunotherapy, OIT), in which increasing amounts of allergen are given over weeks-months. OIT has proven effective to induce immune modulation and 'desensitization' - that is, an increase in the amount of food allergen that can be consumed, so long as regular (typically daily) doses are continued. However, its ability to induce permanent tolerance once ongoing exposure has stopped seems limited. Additionally, the short- and long-term safety of OIT is often poorly reported, raising concerns about its implementation in routine practice. Most patients experience allergic reactions and, although generally mild, severe reactions have occurred. Long-term adherence is unclear, which rises concerns given the low rates of long-term tolerance induction. Current research focuses on improving current limitations, especially safety. Strategies include alternative routes (sublingual, epicutaneous), modified hypoallergenic products and adjuvants (anti-IgE, pre-/probiotics). Biomarkers of safe/successful OIT are also under investigation.
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Affiliation(s)
| | - Paul J Turner
- Section of Paediatrics, Imperial College London, London, UK.,Discipline of Paediatrics and Child Health, School of Medicine, University of Sydney, Sydney, NSW, Australia
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1122
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Zhao X, Birchall JC, Coulman SA, Tatovic D, Singh RK, Wen L, Wong FS, Dayan CM, Hanna SJ. Microneedle delivery of autoantigen for immunotherapy in type 1 diabetes. J Control Release 2016; 223:178-187. [DOI: 10.1016/j.jconrel.2015.12.040] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 12/23/2015] [Indexed: 11/24/2022]
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1123
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Sheldon E, Schwickart M, Li J, Kim K, Crouch S, Parveen S, Kell C, Birrell C. Pharmacokinetics, Pharmacodynamics, and Safety of MEDI4212, an Anti-IgE Monoclonal Antibody, in Subjects with Atopy: A Phase I Study. Adv Ther 2016; 33:225-51. [PMID: 26843086 DOI: 10.1007/s12325-016-0287-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The anti-IgE therapy omalizumab is currently licensed for the treatment of moderate to severe allergic asthma and chronic idiopathic urticaria. Owing to limitations in the use of omalizumab, a need exists for optimized anti-IgE therapies to broaden clinical indications and patient populations, and to improve dosing schedules. The objective of this phase I, randomized, placebo/omalizumab-controlled, first-in-human, dose-escalation study was to evaluate the pharmacokinetics, pharmacodynamics, and safety of the high-affinity, anti-IgE therapy MEDI4212 in non-Japanese and Japanese subjects with atopy and/or diagnostic IgE ≥ 30 IU/mL. METHODS Subjects with atopy and/or baseline IgE ≥ 30 IU/mL were randomized to a single dose of subcutaneous (5, 15, 60, 150, or 300 mg) or intravenous (300 mg) MEDI4212, subcutaneous omalizumab, or placebo. Following administration, pharmacokinetic, pharmacodynamic [IgE (free and total), and cellular FcεRI expression], and safety assessments were made. RESULTS MEDI4212 rapidly suppressed free serum IgE to a greater extent than omalizumab; however, recovery of free IgE to baseline in MEDI4212-dosed subjects was rapid when compared with the slow and gradual recovery seen in omalizumab-dosed individuals. The loss of IgE suppression corresponded with a rapid decrease of serum MEDI4212. FcεRI expression on dendritic cells and basophils was reduced following MEDI4212 dosing. MEDI4212 was well tolerated by subjects; adverse events were generally of low severity and no subjects discontinued due to adverse events. CONCLUSIONS The increased potency of MEDI4212 may be of clinical interest for individuals with high-diagnostic IgE levels where more extensive IgE suppression is required for clinical response. However, the modest duration of free IgE suppression below the target concentration noted with MEDI4212 in this study suggests limited potential for dosing schedule advantages over omalizumab. FUNDING MedImmune. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT01544348.
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Affiliation(s)
| | | | - Jing Li
- MedImmune, Mountain View, CA, USA
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1124
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Potter P, Mitha E, Barkai L, Mezei G, Santamaría E, Izquierdo I, Maurer M. Rupatadine is effective in the treatment of chronic spontaneous urticaria in children aged 2-11 years. Pediatr Allergy Immunol 2016; 27:55-61. [PMID: 26267219 DOI: 10.1111/pai.12460] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recommendations in current guidelines for the treatment of chronic spontaneous urticaria (CSU) in infants and children are mostly based on extrapolation of data obtained in adults. This study reports the efficacy and safety of rupatadine, a modern H1 and PAF antagonist recently authorized in Europe for children with allergic rhinitis and CSU. METHODS A double-blind, randomized, parallel-group, multicentre, placebo-controlled compared study to desloratadine was carried out in children aged 2-11 years with CSU, with or without angio-oedema. Patients received either rupatadine (1 mg/ml), or desloratadine (0.5 mg/ml) or placebo once daily over 6 weeks. A modified 7-day cumulative Urticaria Activity Score (UAS7) was employed as the primary end-point. RESULTS The absolute change of UAS7 at 42 days showed statistically significant differences between active treatments vs. placebo (-5.5 ± 7.5 placebo, -11.8 ± 8.7 rupatadine and -10.6 ± 9.6 desloratadine; p < 0.001) and without differences between antihistamines compounds. There was a 55.8% decrease for rupatadine followed by desloratadine (-48.4%) and placebo (-30.3%). Rupatadine but not desloratadine was statistically superior to placebo in reduction of pruritus (-57%). Active treatments also showed a statistically better improvement in children's quality of life compared to placebo. Adverse events were uncommon and non-serious in both active groups. CONCLUSION Rupatadine is effective and well tolerated in the relief of urticaria symptoms, improving quality of life over 6 weeks in children with CSU. This is the first study using a modified UAS to assess severity and efficacy outcome in CSU in children.
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Affiliation(s)
- Paul Potter
- Allergy Diagnostic and Clinical Research Unit, Department of Medicine, University of Cape Town Lung Institute, Cape Town, South Africa
| | - Essack Mitha
- Newtown clinical Research, Johannerburg, South Africa
| | - László Barkai
- BAZ Megyei Kórház Gyermekegészségügyi Központ, Miskolc, Hungary
| | - Györgyi Mezei
- Allergy Unit, First Department of Pediatrics, Faculty of Medicine, Semmelweis U, Budapest Hungary
| | | | | | - Marcus Maurer
- Department of Dermatology and Allergy, Allergie-Centrum Charité/ECARF, Charité-Universitätsmedizin Berlin, Berlin, Germany
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1125
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Batard T, Baron-Bodo V, Martelet A, Le Mignon M, Lemoine P, Jain K, Mariano S, Horiot S, Chabre H, Harwanegg C, Marquette CA, Corgier BP, Soh WT, Satitsuksanoa P, Jacquet A, Chew FT, Nony E, Moingeon P. Patterns of IgE sensitization in house dust mite-allergic patients: implications for allergen immunotherapy. Allergy 2016; 71:220-9. [PMID: 26485347 DOI: 10.1111/all.12796] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Understanding patterns of IgE sensitization in Dermatophagoides-allergic patients living in various geographical areas is necessary to design a product suitable for worldwide allergen immunotherapy (AIT). METHODS Using a HIFI Allergy customized microarray assay, IgEs specific for 12 purified allergens from Dermatophagoides pteronyssinus or D. farinae were assessed in sera from 1302 house dust mite (HDM)-allergic patients living in various areas. Comprehensive mass spectrometric (MS) analyses were conducted to characterize HDM extracts, as well as purified bodies and feces. RESULTS Patterns of IgE reactivity to HDM allergens are comparable in all cohorts of patients analyzed, encompassing adults and 5- to 17-year-old children, as well as American, Canadian, European, and Japanese patients. Overall, >70% and >80% of HDM-allergic patients are sensitized to group 1 and group 2 allergens, respectively, from D. pteronyssinus and/or D. farinae species. Furthermore, 20-47% of patients also have IgEs to allergens from groups 4, 5, 7, 13, 15, 21, and 23. All patients have IgEs to allergens present in mite bodies and feces. MS-based analyses confirmed the presence of mite allergens recorded by IUIS in D. pteronyssinus and D. farinae extracts, with groups 2, 8, 10, 11, 14, and 20 prominent in bodies and groups 1, 6, 18, and 23 well represented in feces. CONCLUSIONS Mite-specific AIT should rely upon a mixture of D. pteronyssinus and D. farinae extracts, manufactured from both feces and bodies. Such a combination is appropriate to treat children and adult Dermatophagoides-allergic patients from Asia, Europe, and North America.
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Affiliation(s)
- T. Batard
- Research and Development; Stallergenes; Antony France
| | - V. Baron-Bodo
- Research and Development; Stallergenes; Antony France
| | - A. Martelet
- Research and Development; Stallergenes; Antony France
| | - M. Le Mignon
- Research and Development; Stallergenes; Antony France
| | - P. Lemoine
- Research and Development; Stallergenes; Antony France
| | - K. Jain
- Research and Development; Stallergenes; Antony France
| | - S. Mariano
- Research and Development; Stallergenes; Antony France
| | - S. Horiot
- Research and Development; Stallergenes; Antony France
| | - H. Chabre
- Research and Development; Stallergenes; Antony France
| | - C. Harwanegg
- Thermo Fisher Scientific ImmunoDiagnostics/Phadia Austria GmbH; Vienna Austria
| | | | | | - W. T. Soh
- Chulalongkorn University; Bangkok Thailand
| | | | - A. Jacquet
- Chulalongkorn University; Bangkok Thailand
| | - F. T. Chew
- National University of Singapore; Singapore City Singapore
| | - E. Nony
- Research and Development; Stallergenes; Antony France
| | - P. Moingeon
- Research and Development; Stallergenes; Antony France
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1126
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Torres MJ, Montañez MI, Ariza A, Salas M, Fernandez TD, Barbero N, Mayorga C, Blanca M. The role of IgE recognition in allergic reactions to amoxicillin and clavulanic acid. Clin Exp Allergy 2016; 46:264-74. [DOI: 10.1111/cea.12689] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- M. J. Torres
- Allergy Unit; IBIMA-Regional University Hospital of Malaga; Malaga Spain
| | - M. I. Montañez
- Research Laboratory; IBIMA-Regional University Hospital of Malaga; Malaga Spain
- BIONAND-Andalusian Centre for Nanomedicine and Biotechnology; Malaga Spain
| | - A. Ariza
- Research Laboratory; IBIMA-Regional University Hospital of Malaga; Malaga Spain
| | - M. Salas
- Allergy Unit; IBIMA-Regional University Hospital of Malaga; Malaga Spain
| | - T. D. Fernandez
- Research Laboratory; IBIMA-Regional University Hospital of Malaga; Malaga Spain
| | - N. Barbero
- BIONAND-Andalusian Centre for Nanomedicine and Biotechnology; Malaga Spain
- Department of Organic Chemistry; IBIMA; University of Malaga; Malaga Spain
| | - C. Mayorga
- Allergy Unit; IBIMA-Regional University Hospital of Malaga; Malaga Spain
- Research Laboratory; IBIMA-Regional University Hospital of Malaga; Malaga Spain
| | - M. Blanca
- Allergy Unit; IBIMA-Regional University Hospital of Malaga; Malaga Spain
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1127
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Stanic-Vucinic D, Stojadinovic M, Mirkov I, Apostolovic D, Burazer L, Atanaskovic-Markovic M, Kataranovski M, Cirkovic Velickovic T. Hypoallergenic acid-sensitive modification preserves major mugwort allergen fold and delivers full repertoire of MHC class II-binding peptides during endolysosomal degradation. RSC Adv 2016. [DOI: 10.1039/c6ra17261j] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Hypoallergenic acid-sensitive modification preserves major mugwort pollen allergen fold and delivers a full repertoire of MHC class II-binding peptides during endolysosomal degradation.
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Affiliation(s)
- Dragana Stanic-Vucinic
- University of Belgrade
- Faculty of Chemistry
- Center of Excellence for Molecular Food Sciences
- Department of Biochemistry
- 11000 Belgrade
| | - Marija Stojadinovic
- University of Belgrade
- Faculty of Chemistry
- Center of Excellence for Molecular Food Sciences
- Department of Biochemistry
- 11000 Belgrade
| | - Ivana Mirkov
- Institute for Biological Research “Sinisa Stankovic”
- University of Belgrade
- Belgrade
- Serbia
| | | | - Lidija Burazer
- Institute of Virology
- Vaccines and Sera – Torlak
- Belgrade
- Serbia
| | - Marina Atanaskovic-Markovic
- University Children's Hospital “Tirsova”
- Department of Allergology and Pulmology
- University of Belgrade
- Belgrade
- Serbia
| | - Milena Kataranovski
- Institute for Biological Research “Sinisa Stankovic”
- University of Belgrade
- Belgrade
- Serbia
- University of Belgrade
| | - Tanja Cirkovic Velickovic
- University of Belgrade
- Faculty of Chemistry
- Center of Excellence for Molecular Food Sciences
- Department of Biochemistry
- 11000 Belgrade
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1128
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Akdis CA, Akdis M. Advances in allergen immunotherapy: aiming for complete tolerance to allergens. Sci Transl Med 2015; 7:280ps6. [PMID: 25810310 DOI: 10.1126/scitranslmed.aaa7390] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Allergen-specific immunotherapy (AIT) has been used for more than 100 years as a tolerance-inducing therapy for allergic diseases and represents a potentially curative method of treatment. AIT functions through multiple mechanisms, including regulating T and B cell responses, changing antibody isotypes, and decreasing mediator release and migration of eosinophils, basophils, and mast cells to affected tissues. Despite the relative success of AIT, attempts are being made to improve this therapy in order to overcome problems in standardization, efficacy, safety, long duration of treatment, and costs. These have led to the development of biotechnological products with successful clinical results.
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Affiliation(s)
- Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Obere Strasse 22, CH-7270 Davos Platz, Switzerland. Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Obere Strasse 22, CH-7270 Davos Platz, Switzerland. Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.
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1129
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Allergen-specific Immunotherapy--Turning the Tables on the Immune System. Immunol Allergy Clin North Am 2015; 36:xv-xxi. [PMID: 26617238 DOI: 10.1016/j.iac.2015.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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1130
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Mondoulet L, Dioszeghy V, Thébault C, Benhamou PH, Dupont C. Epicutaneous immunotherapy for food allergy as a novel pathway for oral tolerance induction. Immunotherapy 2015; 7:1293-305. [PMID: 26584421 DOI: 10.2217/imt.15.86] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Epicutaneous immunotherapy is a developing technique, aiming at desensitizing patients with food allergy with less risks that oral ingestion or injection could generate. Several clinical trials have been performed and are currently running, in milk and peanut allergy, assessing the safety of the technique and its efficacy. Preclinical models indicate a major role in the mechanisms of desensitization, for example, Tregs and epigenetic modifications.
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Affiliation(s)
- Lucie Mondoulet
- DBV Technologies, Green Square, 80/84 rue des Meuniers, Bagneux, France
| | - Vincent Dioszeghy
- DBV Technologies, Green Square, 80/84 rue des Meuniers, Bagneux, France
| | - Claude Thébault
- DBV Technologies, Green Square, 80/84 rue des Meuniers, Bagneux, France
| | | | - Christophe Dupont
- Université Paris Descartes - Hôpital Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France
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1131
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Ras L, de Groot H, Stengs CHM, van Weissenbruch R. Persistence of treatment with 5-grass pollen tablets in patients with allergic rhinitis: a real-life study. Ann Allergy Asthma Immunol 2015; 116:52-58.e2. [PMID: 26596408 DOI: 10.1016/j.anai.2015.10.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/09/2015] [Accepted: 10/11/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND In patients with allergic rhinitis, treatment adherence to allergen immunotherapy varies greatly in randomized and real-life studies. OBJECTIVE To evaluate the use of a 5-grass pollen tablet as sublingual immunotherapy, its treatment persistence, and the reasons for discontinuation in a real-life clinical setting. METHODS This multicenter, prospective, open-label, noncontrolled observational study evaluated the use of sublingual immunotherapy with a 5-grass pollen tablet in a cross-sectional population of patients (≥5 years old) with grass pollen-induced allergic rhinitis with or without asthma. The primary objective was to determine the percentage of patients persisting with treatment across 1 season in a pre-co-seasonal scheme. Secondary objectives included evaluation of reasons for treatment discontinuation, safety and adverse events; effectiveness (based on physician and patient assessments), and treatment compliance. RESULTS The study included 196 patients (49.2% male, mean age 27.5 years, range 5.3-65.7 years), with treatment provided by 47 participating physicians. Sixty-seven percent of patients had polysensitivity and 32% had coexistent asthma. On average, patients were treated for 7 months with the 5-grass pollen tablet. After 1 month, 85% of all patients persisted with treatment, and 70% persisted after 7 months. Treatment discontinuation was due chiefly to known side effects (mild to moderate local allergic reactions). Most patients reported symptom improvement; 80% of all patients intended to continue treatment next season. CONCLUSION Most patients with allergic rhinitis treated pre-co-seasonally with a 5-grass pollen tablet persisted with treatment after the first pollen season. Patients were willing to continue their treatment in the following season owing to improvement of symptoms.
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Affiliation(s)
| | - Hans de Groot
- Department of Allergology, Reinier de Graaf Gasthuis lokatie Diakonessenhuis, Voorburg, The Netherlands
| | - Cornelis H M Stengs
- Department of Otorhinolaryngology, Rijnstate Ziekenhuis, Arnhem, The Netherlands
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1132
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So JK, Hamstra A, Calame A, Hamann CR, Jacob SE. Another Great Imitator: Allergic Contact Dermatitis Differential Diagnosis, Clues to Diagnosis, Histopathology, and Treatment. CURRENT TREATMENT OPTIONS IN ALLERGY 2015. [DOI: 10.1007/s40521-015-0064-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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1133
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Carnés J, Iraola V, Gallego M, Leonor JR. Control Process for Manufacturing and Standardization of Allergenic Molecules. Curr Allergy Asthma Rep 2015; 15:37. [PMID: 26143393 DOI: 10.1007/s11882-015-0541-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
It is widely accepted that the success of the allergen immunotherapy (AIT), beyond clinical parameters such as dose, dosage regimen, or compliance, depends on the quality and composition of the final products used in the vaccines. Allergenic vaccines are pharmaceutical preparations derived from the natural sources which contain the allergenic components responsible for allergic sensitization. The selection of the appropriate allergenic sources must be a requirement. They suffer a dramatic transformation during the manufacturing process which renders a biologically standardized final product. The inclusion of the appropriate control analyses in the manufacturing process has demonstrated to be an efficient method to guarantee the quality and homogeneity of the final product as well as being a very useful tool for saving time and money. In this context, in the last years, the Regulatory Agencies have released specific guidelines to guarantee the manufacturing of the most appropriate products for the treatment of patients.
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Affiliation(s)
- Jerónimo Carnés
- R&D Department, Laboratorios LETI SLu, C/ Sol n° 5, Tres Cantos, Madrid, Spain,
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1134
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Vale S, Smith J, Said M, Mullins RJ, Loh R. ASCIA guidelines for prevention of anaphylaxis in schools, pre-schools and childcare: 2015 update. J Paediatr Child Health 2015; 51:949-54. [PMID: 26428419 DOI: 10.1111/jpc.12962] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 11/30/2022]
Abstract
The aim of these guidelines is to assist staff in school and childcare settings to plan and implement appropriate risk minimisation strategies, taking into consideration the needs of the allergic child, the likely effectiveness of measures and the practicality of implementation. Although these guidelines include risk minimisation strategies for allergic reactions to insect stings or bites, latex and medication, the major focus relates to food allergy. This is due to the higher relative prevalence of food allergy in childhood (compared with other allergic triggers) and the higher likelihood of accidental exposure in these settings. Care of the allergic child in the school, pre-school or childcare settings requires accurate information obtained from parents and carers, staff training in the recognition and management of acute allergic reactions, planning for unexpected reactions (including in those not previously identified as being at risk), age appropriate education of children with severe allergies and their peers, and implementation of practical strategies to reduce the risk of accidental exposure to known allergic triggers. Strategy development also needs to take into account local or regional established legislative or procedural guidelines and the possibility that the first episode of anaphylaxis may occur outside the home. Food bans are not recommended as the primary risk minimisation strategy due to difficulties in implementation and lack of proven effectiveness.
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Affiliation(s)
- Sandra Vale
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney, New South Wales, Australia
| | - Jill Smith
- Australasian Society of Clinical Immunology and Allergy (ASCIA), Sydney, New South Wales, Australia
| | - Maria Said
- ASCIA Anaphylaxis Working Party, Sydney, New South Wales, Australia.,Allergy & Anaphylaxis Australia, Sydney, New South Wales, Australia
| | - Raymond James Mullins
- ASCIA Anaphylaxis Working Party, Sydney, New South Wales, Australia.,Health Sciences, University of Canberra, Canberra, Australian Capital Territory, Australia.,Australian National University, Medical School Canberra, Canberra, Australian Capital Territory, Australia
| | - Richard Loh
- ASCIA Anaphylaxis Working Party, Sydney, New South Wales, Australia.,Department of Immunology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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1135
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Mahapatra S, Albrecht M, Baru AM, Sparwasser T, Herrick C, Dittrich AM. Superior Suppressive Capacity of Skin Tregs Compared with Lung Tregs in a Model of Epicutaneous Priming. J Invest Dermatol 2015; 135:2418-26. [DOI: 10.1038/jid.2015.191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 04/09/2015] [Accepted: 04/30/2015] [Indexed: 12/13/2022]
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1136
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Qin R, Lampel HP. Review of Occupational Contact Dermatitis—Top Allergens, Best Avoidance Measures. CURRENT TREATMENT OPTIONS IN ALLERGY 2015. [DOI: 10.1007/s40521-015-0063-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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1137
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Abstract
BACKGROUND Asthma is a common long-term respiratory disease affecting approximately 300 million people worldwide. Approximately half of people with asthma have an important allergic component to their disease, which may provide an opportunity for targeted treatment. Sublingual immunotherapy (SLIT) aims to reduce asthma symptoms by delivering increasing doses of an allergen (e.g. house dust mite, pollen extract) under the tongue to induce immune tolerance. However, it is not clear whether the sublingual delivery route is safe and effective in asthma. OBJECTIVES To assess the efficacy and safety of sublingual immunotherapy compared with placebo or standard care for adults and children with asthma. SEARCH METHODS We identified trials from the Cochrane Airways Group Specialised Register (CAGR), ClinicalTrials.gov (www.ClinicalTrials.gov), the World Health Organization (WHO) trials portal (www.who.int/ictrp/en/) and reference lists of all primary studies and review articles. The search is up to date as of 25 March 2015. SELECTION CRITERIA We included parallel randomised controlled trials (RCTs), irrespective of blinding or duration, that evaluated sublingual immunotherapy versus placebo or as an add-on to standard asthma management. We included both adults and children with asthma of any severity and with any allergen-sensitisation pattern. We included studies that recruited participants with asthma, rhinitis, or both, providing at least 80% of trial participants had a diagnosis of asthma. DATA COLLECTION AND ANALYSIS Two review authors independently screened the search results for included trials, extracted numerical data and assessed risk of bias, all of which were cross-checked for accuracy. We resolved disagreements by discussion.We analysed dichotomous data as odds ratios (ORs) or risk differences (RDs) using study participants as the unit of analysis; we analysed continuous data as mean differences (MDs) or standardised mean differences (SMDs) using random-effects models. We rated all outcomes using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) and presented results in the 'Summary of findings' table. MAIN RESULTS Fifty-two studies met our inclusion criteria, randomly assigning 5077 participants to comparisons of interest. Most studies were double-blind and placebo-controlled, but studies varied in duration from one day to three years. Most participants had mild or intermittent asthma, often with co-morbid allergic rhinitis. Eighteen studies recruited only adults, 25 recruited only children and several recruited both or did not specify (n = 9).With the exception of adverse events, reporting of outcomes of interest to this review was infrequent, and selective reporting may have had a serious effect on the completeness of the evidence. Allocation procedures generally were not well described, about a quarter of the studies were at high risk of bias for performance or detection bias or both and participant attrition was high or unknown in around half of the studies.One short study reported exacerbations requiring a hospital visit and observed no adverse events. Five studies reported quality of life, but the data were not suitable for meta-analysis. Serious adverse events were infrequent, and analysis using risk differences suggests that no more than 1 in 100 are likely to suffer a serious adverse event as a result of treatment with SLIT (RD 0.0012, 95% confidence interval (CI) -0.0077 to 0.0102; participants = 2560; studies = 22; moderate-quality evidence).Within secondary outcomes, wide but varied reporting of largely unvalidated asthma symptom and medication scores precluded meaningful meta-analysis; a general trend suggested SLIT benefit over placebo, but variation in scales meant that results were difficult to interpret.Changes in inhaled corticosteroid use in micrograms per day (MD 35.10 mcg/d, 95% CI -50.21 to 120.42; low-quality evidence), exacerbations requiring oral steroids (studies = 2; no events) and bronchial provocation (SMD 0.69, 95% CI -0.04 to 1.43; very low-quality evidence) were not often reported. This led to many imprecise estimates with wide confidence intervals that included the possibility of both benefit and harm from SLIT.More people taking SLIT had adverse events of any kind compared with control (OR 1.70, 95% CI 1.21 to 2.38; low-quality evidence; participants = 1755; studies = 19), but events were usually reported to be transient and mild.Lack of data prevented most of the planned subgroup and sensitivity analyses. AUTHORS' CONCLUSIONS Lack of data for important outcomes such as exacerbations and quality of life and use of different unvalidated symptom and medication scores have limited our ability to draw a clinically useful conclusion. Further research using validated scales and important outcomes for patients and decision makers is needed so that SLIT can be properly assessed as clinical treatment for asthma. Very few serious adverse events have been reported, but most studies have included patients with intermittent or mild asthma, so we cannot comment on the safety of SLIT for those with moderate or severe asthma. SLIT is associated with increased risk of all adverse events.
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Affiliation(s)
- Rebecca Normansell
- St George's, University of LondonPopulation Health Research InstituteLondonUKSW17 0RE
| | - Kayleigh M Kew
- St George's, University of LondonPopulation Health Research InstituteLondonUKSW17 0RE
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1138
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Anagnostou K. Recent advances in immunotherapy and vaccine development for peanut allergy. THERAPEUTIC ADVANCES IN VACCINES 2015; 3:55-65. [PMID: 26288733 DOI: 10.1177/2051013615591739] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Peanut allergy is a common problem and can be the cause of severe, life-threatening allergic reactions. It rarely resolves, with the majority of patients carrying the disease onto adulthood. Peanut allergy poses a significant burden on the quality of life of sufferers and their families, which results mainly from the fear of accidental peanut ingestion, but is also due to dietary and social restrictions. Current standard management involves avoidance, patient education and provision of emergency medication, for use in allergic reactions, when they occur. Efforts have been made to develop a vaccine for peanut allergy. Recent developments have also highlighted the use of immunotherapy, which has shown promise as an active form of treatment and may present a disease-modifying therapy for peanut allergy. So far, results, especially from oral immunotherapy studies, have shown good efficacy in achieving desensitization to peanut with a good safety profile. However, the capacity to induce long-term tolerance has not been demonstrated conclusively yet and larger, phase III studies are required to further investigate safety and efficacy of this intervention. Peanut immunotherapy is not currently recommended for routine clinical use or outside specialist allergy units.
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Affiliation(s)
- Katherine Anagnostou
- Department of Paediatric Allergy, Guy's and St Thomas' Hospitals NHS Foundation Trust, Westminster Bridge Road, London-SE1 7EH, UK
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1139
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1140
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Nandy A, Häfner D, Klysner S. Rekombinante Allergene in der spezifischen Immuntherapie. ALLERGO JOURNAL 2015. [DOI: 10.1007/s15007-015-0882-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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1141
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Chhiba KD, Singh AM, Bryce PJ. New developments in immunotherapies for food allergy. Immunotherapy 2015; 7:913-22. [DOI: 10.2217/imt.15.55] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Food allergy affects around 10% of the population. As the prevalence of food allergy continues to increase, disproportionately in children, new therapies for food allergy are being investigated. While there are no approved treatments for food allergy, immunotherapy facilitates significant desensitization and protection from accidental exposure. Nevertheless, current immunotherapies do not entirely nor permanently eliminate sensitivity to the food allergen. Since the rates of sustained unresponsiveness are significantly lower than desensitization, future therapies that enhance the rates of long-term tolerance in patients will catalyze progress in this field over the next 5–10 years.
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Affiliation(s)
- Krishan Dilip Chhiba
- Division of Allergy-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Anne Marie Singh
- Division of Allergy-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Paul J Bryce
- Division of Allergy-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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1142
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Hsu YJ, Hsu JH, Lin KC. Yam storage protein dioscorins modulate cytokine gene expression in BALB/c and C57BL/6 lymphocytes. FOOD AGR IMMUNOL 2015. [DOI: 10.1080/09540105.2015.1048787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Yu-Jhen Hsu
- Department of Life Science and Institute of Biotechnology, National Dong Hwa University, Hualien County 974, Taiwan
| | - Jung-Hsin Hsu
- Department of Life Science and Institute of Biotechnology, National Dong Hwa University, Hualien County 974, Taiwan
| | - Kuo-Chih Lin
- Department of Life Science and Institute of Biotechnology, National Dong Hwa University, Hualien County 974, Taiwan
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1143
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Goldberg MR, Nachshon L, Appel MY, Elizur A, Levy MB, Eisenberg E, Sampson HA, Katz Y. Efficacy of baked milk oral immunotherapy in baked milk-reactive allergic patients. J Allergy Clin Immunol 2015; 136:1601-1606. [PMID: 26194541 DOI: 10.1016/j.jaci.2015.05.040] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 05/19/2015] [Accepted: 05/19/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with IgE-mediated cow's milk allergy who are nonreactive to baked milk (BM) can be desensitized with BM to promote tolerance to unheated milk (UM). OBJECTIVE We sought to test whether patients who are BM reactive can progress in BM oral immunotherapy (OIT) and become desensitized to UM as well. METHODS Fifteen patients (>4 years) who previously failed to complete our milk OIT program were enrolled into the BM OIT protocol. A dose of BM (180 °C for 30 minutes) which was less than the eliciting dose was increased 50% monthly while under medical supervision until the primary outcome dose of 1.3 g/d BM protein was achieved. Basophil reactivity and milk protein-specific IgE binding were analyzed at the first round of BM OIT therapy (T0) and at 12 months of BM treatment. RESULTS In terms of the primary outcome, only 3 (21%) of 14 patients tolerated the 1.3 g/d BM dose. Although some patients initially progressed in BM OIT, 8 of 11 failed because of IgE-mediated reactions. Three did not complete the program because of non-IgE-mediated factors. An increase in challenge threshold to UM was noted in patients continuing until 12 months (P = .003), including those among whom reactions precluded continuation in the program. Patients (n = 3) who successfully reached maintenance had decreased milk-specific IgE reactivity. Furthermore, the mean difference at T0 between induced HM and UM percentages of CD203c expression was significantly lower in patients who successfully completed BM OIT than in those who did not (-11% vs 4.4%, P = .0002), which is consistent with their decreased clinical reactivity to BM. CONCLUSIONS Although use of hypoallergenic BM in OIT is a promising therapy, care must be taken before its administration in BM-reactive patients because of the risk for anaphylaxis and only limited increase in challenge threshold attained.
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Affiliation(s)
- Michael R Goldberg
- Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel.
| | - Liat Nachshon
- Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Michael Y Appel
- Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Arnon Elizur
- Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler Faculty of Medicine, New York, NY
| | - Michael B Levy
- Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Eli Eisenberg
- Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv, Israel
| | - Hugh A Sampson
- Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yitzhak Katz
- Allergy and Immunology Institute, Assaf Harofeh Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler Faculty of Medicine, New York, NY
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1144
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Passalacqua G, Rogkakou A, Mincarini M, Canonica GW. Allergen immunotherapy in asthma; what is new? Asthma Res Pract 2015; 1:6. [PMID: 27965760 PMCID: PMC4970380 DOI: 10.1186/s40733-015-0006-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 05/27/2015] [Indexed: 12/29/2022] Open
Abstract
The use and role of allergen immunotherapy (AIT) in asthma is still a matter of debate, and no definite recommendation about this is made in guidelines, both for the subcutaneous and sublingual routes. This is essentially due to the fact that most controlled randomised trials were not specifically designed for asthma, and that objective measures of pulmonary function were only occasionally considered. Nonetheless, in many trials, favourable results in asthma (symptoms, medication usage, bronchial reactivity) were consistently reported. There are also several meta analyses in favour of AIT, although their validity is limited by a relevant methodological heterogeneity. In addition to the crude clinical effect, a disease modifying action of AIT (prevention of asthma onset and long-lasting effects) have been reported. The safety is an important aspect to consider in asthma. Fatalities were rare: in Europe no fatality was reported in the last three decades, as in the United States in the last 4 years. Based on previous surveys, and common sense, uncontrolled asthma is still recognized as the most important risk factor for severe adverse events. On the contrary, there is no evidence that AIT can worsen or induce asthma. According to the available evidence, AIT can be safely used as add-on treatment when asthma is associated with rhinitis (a frequent condition), provided that asthma is adequately controlled by pharmacotherapy. AIT cannot be recommended or suggested as single therapy. When asthma is the unique manifestation of respiratory allergy, its use should be evaluated case by case.
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Affiliation(s)
- Giovanni Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino Hospital-IST-University of Genoa, Padiglione Maragliano, L.go R.Benzi 10, Genoa, 16133 Italy
| | - Anthi Rogkakou
- Allergy and Respiratory Diseases, IRCCS San Martino Hospital-IST-University of Genoa, Padiglione Maragliano, L.go R.Benzi 10, Genoa, 16133 Italy
| | - Marcello Mincarini
- Allergy and Respiratory Diseases, IRCCS San Martino Hospital-IST-University of Genoa, Padiglione Maragliano, L.go R.Benzi 10, Genoa, 16133 Italy
| | - Giorgio Walter Canonica
- Allergy and Respiratory Diseases, IRCCS San Martino Hospital-IST-University of Genoa, Padiglione Maragliano, L.go R.Benzi 10, Genoa, 16133 Italy
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1145
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Perez-Riverol A, Justo-Jacomini DL, Zollner RDL, Brochetto-Braga MR. Facing Hymenoptera Venom Allergy: From Natural to Recombinant Allergens. Toxins (Basel) 2015; 7:2551-70. [PMID: 26184309 PMCID: PMC4516928 DOI: 10.3390/toxins7072551] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 05/16/2015] [Accepted: 06/23/2015] [Indexed: 12/30/2022] Open
Abstract
Along with food and drug allergic reactions, a Hymenoptera insect Sting (Apoidea, Vespidae, Formicidae) is one of the most common causes of anaphylaxis worldwide. Diagnoses of Hymenoptera venom allergy (HVA) and specific immunotherapy (SIT) have been based on the use of crude venom extracts. However, the incidence of cross-reactivity and low levels of sensibility during diagnosis, as well as the occurrence of nonspecific sensitization and undesired side effects during SIT, encourage the search for novel allergenic materials. Recombinant allergens are an interesting approach to improve allergy diagnosis and SIT because they circumvent major problems associated with the use of crude venom. Production of recombinant allergens depends on the profound molecular characterization of the natural counterpart by combining some “omics” approaches with high-throughput screening techniques and the selection of an appropriate system for heterologous expression. To date, several clinically relevant allergens and novel venom toxins have been identified, cloned and characterized, enabling a better understanding of the whole allergenic and envenoming processes. Here, we review recent findings on identification, molecular characterization and recombinant expression of Hymenoptera venom allergens and on the evaluation of these heterologous proteins as valuable tools for tackling remaining pitfalls on HVA diagnosis and immunotherapy.
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Affiliation(s)
- Amilcar Perez-Riverol
- Laboratório de Biologia Molecular de Artrópodes-LBMA-IB-RC-UNESP (Univ Estadual Paulista), Av. 24-A, n_ 1515, Bela Vista, Rio Claro 13506-900, SP, Brazil.
| | - Débora Lais Justo-Jacomini
- Laboratório de Biologia Molecular de Artrópodes-LBMA-IB-RC-UNESP (Univ Estadual Paulista), Av. 24-A, n_ 1515, Bela Vista, Rio Claro 13506-900, SP, Brazil.
| | - Ricardo de Lima Zollner
- Laboratório de Imunologia e Alergia Experimental-LIAE, Departamento de Clínica Médica, Faculdade de Ciências Médicas, FCM, Universidade Estadual de Campinas-UNICAMP, Rua Tessália Vieira de Camargo n_ 126, Cidade Universitária "Zeferino Vaz", Campinas 13083-887, SP, Brazil.
| | - Márcia Regina Brochetto-Braga
- Laboratório de Biologia Molecular de Artrópodes-LBMA-IB-RC-UNESP (Univ Estadual Paulista), Av. 24-A, n_ 1515, Bela Vista, Rio Claro 13506-900, SP, Brazil.
- Centro de Estudos de Venenos e Animais Peçonhentos-CEVAP (Univ Estadual Paulista), Rua José Barbosa de Barros, 1780, Fazenda Experimental Lageado, Botucatu 18610-307, SP, Brazil.
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1146
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Nony E, Bouley J, Le Mignon M, Lemoine P, Jain K, Horiot S, Mascarell L, Pallardy M, Vincentelli R, Leone P, Roussel A, Batard T, Abiteboul K, Robin B, de Beaumont O, Arvidsson M, Rak S, Moingeon P. Development and evaluation of a sublingual tablet based on recombinant Bet v 1 in birch pollen-allergic patients. Allergy 2015; 70:795-804. [PMID: 25846209 DOI: 10.1111/all.12622] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) applied to type I respiratory allergies is commonly performed with natural allergen extracts. Herein, we developed a sublingual tablet made of pharmaceutical-grade recombinant Bet v 1.0101 (rBet v 1) and investigated its clinical safety and efficacy in birch pollen (BP)-allergic patients. METHODS Following expression in Escherichia coli and purification, rBet v 1 was characterized using chromatography, capillary electrophoresis, circular dichroism, mass spectrometry and crystallography. Safety and efficacy of rBet v 1 formulated as a sublingual tablet were assessed in a multicentre, double-blind, placebo-controlled study conducted in 483 patients with BP-induced rhinoconjunctivitis. RESULTS In-depth characterization confirmed the intact product structure and high purity of GMP-grade rBet v 1. The crystal structure resolved at 1.2 Å documented the natural conformation of the molecule. Native or oxidized forms of rBet v 1 did not induce the production of any proinflammatory cytokine by blood dendritic cells or mononuclear cells. Bet v 1 tablets were well tolerated by patients, consistent with the known safety profile of SLIT. The average adjusted symptom scores were significantly decreased relative to placebo in patients receiving once daily for 5 months rBet v 1 tablets, with a mean difference of 17.0-17.7% relative to the group treated with placebo (P < 0.025), without any influence of the dose in the range (12.5-50 μg) tested. CONCLUSION Recombinant Bet v 1 has been produced as a well-characterized pharmaceutical-grade biological drug. Sublingual administration of rBet v 1 tablets is safe and efficacious in patients with BP allergic rhinoconjunctivitis.
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Affiliation(s)
| | | | | | | | | | | | | | - M. Pallardy
- UFR Pharmacie Paris 11; Châtenay-Malabry France
| | | | - P. Leone
- Structural Immunology; AFMB-UMR7257; Marseille France
| | - A. Roussel
- Structural Immunology; AFMB-UMR7257; Marseille France
| | | | | | | | | | - M. Arvidsson
- Department of Respiratory Medicine and Allergology; Sahlgrenska University Hospital; Goteborg Sweden
| | - S. Rak
- Department of Respiratory Medicine and Allergology; Sahlgrenska University Hospital; Goteborg Sweden
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1147
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Sandrini A, Rolland JM, O'Hehir RE. Current developments for improving efficacy of allergy vaccines. Expert Rev Vaccines 2015; 14:1073-87. [PMID: 26013124 DOI: 10.1586/14760584.2015.1050385] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Allergic diseases are prevalent worldwide. Allergen immunotherapy (AIT) is a current treatment for allergy, leading to modification of the natural course of disease. Mechanisms of efficacy include Treg through release of IL-10 and TGF-β and specific IgG4 blocking antibodies. Subcutaneous and sublingual routes are popular, but uptake is limited by inconvenience and safety concerns. Inclusion criteria limit application to a small proportion of allergic patients. New forms of immunotherapy are being investigated for more efficacious, convenient and safer options with promising advances in recent years. The rationale of reducing vaccine allergenicity to increase safety while improving immunogenicity led to investigation of T-cell epitope-based peptides and recombinant allergen derivatives. Additionally, different routes of administration and adjuvants and adjunct therapies are being explored. This review discusses the current status of AIT and recent advances to improve clinical efficacy, safety and long-term immune tolerance.
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Affiliation(s)
- Alessandra Sandrini
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
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1148
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1149
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Galliher-Beckley A, Pappan LK, Madera R, Burakova Y, Waters A, Nickles M, Li X, Nietfeld J, Schlup JR, Zhong Q, McVey S, Dritz SS, Shi J. Characterization of a novel oil-in-water emulsion adjuvant for swine influenza virus and Mycoplasma hyopneumoniae vaccines. Vaccine 2015; 33:2903-8. [PMID: 25936722 DOI: 10.1016/j.vaccine.2015.04.065] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 04/14/2015] [Accepted: 04/16/2015] [Indexed: 11/16/2022]
Abstract
Vaccines consisting of subunit or inactivated bacteria/virus and potent adjuvants are widely used to control and prevent infectious diseases. Because inactivated and subunit antigens are often less antigenic than live microbes, a growing need exists for the development of new and improved vaccine adjuvants that can elicit rapid and long-lasting immunity. Here we describe the development and characterization of a novel oil-in-water emulsion, OW-14. OW-14 contains low-cost plant-based emulsifiers and was added to antigen at a ratio of 1:3 with simple hand mixing. OW-14 was stable for prolonged periods of time at temperatures ranging from 4 to 40°C and could be sterilized by autoclaving. Our results showed that OW-14 adjuvanted inactivated swine influenza viruses (SIV; H3N2 and H1N1) and Mycoplasma hyopneumoniae (M. hyo) vaccines could be safely administered to piglets in two doses, three weeks apart. Injection sites were monitored and no adverse reactions were observed. Vaccinated pigs developed high and prolonged antibody titers to both SIV and M. hyo. Interestingly, antibody titers were either comparable or greater than those produced by commercially available FluSure (SIV) or RespiSure (M. hyo) vaccines. We also found that OW-14 can induce high antibody responses in pigs that were vaccinated with a decreased antigen dose. This study provides direct evidence that we have developed an easy-to-use and low-cost emulsion that can act as a powerful adjuvant in two common types of swine vaccines.
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Affiliation(s)
- A Galliher-Beckley
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - L K Pappan
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - Rachel Madera
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - Y Burakova
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA; Department of Chemical Engineering, College of Engineering, Kansas State University, Manhattan, KS 66506, USA
| | - A Waters
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - M Nickles
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - X Li
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - J Nietfeld
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Manhattan, KS 66506, USA
| | - J R Schlup
- Department of Chemical Engineering, College of Engineering, Kansas State University, Manhattan, KS 66506, USA
| | - Q Zhong
- Department of Food Science and Technology, University of Tennessee, Knoxville, TN 37996, USA
| | - S McVey
- United States Department of Agriculture, Agricultural Research Service, Arthropod Borne Animal Disease Research Unit, Manhattan, KS 66502, USA
| | - S S Dritz
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Manhattan, KS 66506, USA
| | - J Shi
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
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1150
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Mokarizadeh A, Hassanzadeh K, Abdi M, Soraya H, Faryabi MR, Mohammadi E, Ahmadi A. Transdermal delivery of bovine milk vesicles in patients with multiple sclerosis: A novel strategy to induce MOG-specific tolerance. Med Hypotheses 2015; 85:141-4. [PMID: 25986518 DOI: 10.1016/j.mehy.2015.04.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/30/2015] [Accepted: 04/19/2015] [Indexed: 12/18/2022]
Abstract
Recently, butyrophilin (BTN) - a protein which shares cross-reactive epitopes with myelin oligodendrocyte glycoprotein (MOG) - has been found in milk. A high amount of milk BTN has been reported in the outer membrane of vesicular structures known as exosome and milk fat globule membrane (MFGM). These vesicles can act as Trojan horses, passing their BTN content through epidermis or other biologic barriers of the body. By altering the dose schedule and route of administration, the BTN-bearing vesicles (exosomes and MFGMs) may acquire enough potential to be used in MOG-specific immunotherapy program. Regarding above evidence and considering immunological characteristics of skin-associated lymphoid tissue (SALT), transdermal delivery of bovine milk vesicles, whether through topical administration of bovine milk or by using epicutaneous administration techniques, could be considered as an intriguing approach to induce MOG-specific tolerance in patients with multiple sclerosis.
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Affiliation(s)
- Aram Mokarizadeh
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Kambiz Hassanzadeh
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Abdi
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Hamid Soraya
- Cellular and Molecular Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Reza Faryabi
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ebrahim Mohammadi
- Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Ahmadi
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; Department of Immunology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
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