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Yang Y, Li W, Zhu R. Allergen immunotherapy in China. FRONTIERS IN ALLERGY 2024; 4:1324844. [PMID: 38260178 PMCID: PMC10801290 DOI: 10.3389/falgy.2023.1324844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Allergen immunotherapy (AIT) is an etiological treatment strategy that involves administering escalating doses of clinically relevant allergens to desensitize the immune system. It has shown encouraging results in reducing allergy symptoms and enhancing patients' quality of life. In this review, we offer a thorough overview of AIT in China, examining its efficacy, safety, current practices, and prospects. We further underscore the progress made in AIT research and clinical applications, as well as the distinct challenges and opportunities that China faces in this area.
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Affiliation(s)
- Yaqi Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Wenjing Li
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Institute of Allergy and Clinical Immunology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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Calderon MA, Waserman S, Bernstein DI, Demoly P, Douglass J, Gagnon R, Katelaris CH, Kim H, Nelson HS, Okamoto Y, Okubo K, Virchow JC, DuBuske L, Casale TB, Canonica GW, Nolte H. Clinical Practice of Allergen Immunotherapy for Allergic Rhinoconjunctivitis and Asthma: An Expert Panel Report. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2920-2936.e1. [PMID: 32422372 DOI: 10.1016/j.jaip.2020.04.071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/13/2020] [Accepted: 04/20/2020] [Indexed: 12/18/2022]
Abstract
Allergen immunotherapy (AIT) reduces symptoms and medication use associated with allergic rhinitis with or without conjunctivitis and allergic asthma. Although several AIT guidelines exist, there remain unanswered questions about AIT that are relevant to everyday practice. Our objective was to prepare an evidence-based overview addressing the practical aspects of AIT in clinical practice based on published evidence and the experience of international experts in the field. Topics covered include interpretation and translation of clinical trial data into everyday clinical practice (eg, allergen doses and treatment duration), assessment of risk and treatment of local and systemic allergic reactions, recommendations for improvement of AIT guidelines, and identification of appropriate data for seeking regulatory approval, to name a few. Many informational gaps in AIT practice need further evaluation as products and practices evolve.
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Affiliation(s)
- Moisés A Calderon
- Section of Allergy and Clinical Immunology, Imperial College London-NHLI, London, United Kingdom.
| | - Susan Waserman
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - David I Bernstein
- Division of Allergy, Rheumatology and Immunology, Department of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Pascal Demoly
- Department of Pulmonology, University Hospital of Montpellier, & IPLESP, Sorbonne Université - Inserm, Paris, France
| | - Jo Douglass
- The Royal Melbourne Hospital & The University of Melbourne, Melbourne, VIC, Australia
| | - Remi Gagnon
- Clinique Spécialisée en Allergie de la Capitale, Québec, QC, Canada
| | - Constance H Katelaris
- Campbelltown Hospital and the School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Harold Kim
- Division of Clinical Immunology and Allergy, Western University, London, ON, Canada; Division of Clinical Immunology & Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Harold S Nelson
- Department of Medicine, National Jewish Health, Denver, Colo
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - Kimihiro Okubo
- Department of Otolaryngology, Nippon Medical School, Nippon, Japan
| | - J Christian Virchow
- Department of Pneumology/Intensive Care Medicine, University of Rostock, Rostock, Germany
| | - Lawrence DuBuske
- Department of Medicine, Division of Allergy and Immunology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Thomas B Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, Fla
| | - G Walter Canonica
- Personalized Medicine Clinic Asthma & Allergy, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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Shen Z, Tan G, Zhong Z, Ding S, Wang F. Interactive Network Platform Improves Compliance and Efficacy of Subcutaneous Immunotherapy for Patients with Allergic Rhinitis. Patient Prefer Adherence 2019; 13:2101-2110. [PMID: 31997878 PMCID: PMC6917540 DOI: 10.2147/ppa.s235711] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 12/09/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Allergic rhinitis (AR) is a common chronic inflammatory disease of nasal mucosa worldwide, and its symptoms seriously affect the lives of patients. Subcutaneous immunotherapy (SCIT) is an effective treatment for AR, but it is also associated with low patient compliance and difficulties in fully achieving therapeutic effects. OBJECTIVE In this prospective randomized controlled study, we verified the effects of an interactive network platform named "U breath" in improving patient compliance and the efficacy of SCIT in patients with AR. METHODS A total of 148 patients who received SCIT were recruited as participants and randomly assigned to either the standardized management (SM) or the interactive network platform management (INP) group. The SM group experienced the standard management SCIT process. The INP group experienced a new management approach based on an interactive network platform called "U breath". The compliance rate, combined symptom and medication score (CSMS), visual analogue scale score and the rhinoconjunctivitis quality of life questionnaire (RQLQ) results were evaluated at baseline and 1-year postintervention for the two groups. RESULTS Within the first year of treatment, the INP group had a higher compliance rate than did the SM group, with a statistically significant difference (P<0.05). The INP group showed better clinical improvement than the SM group did in terms of the VAS score, and the RQLQ score except the sleep problems (P< 0.05). CONCLUSION This study confirmed that the application of an interactive network platform is of great significance for improving patient compliance and the treatment effects of SCIT in patients with AR.
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Affiliation(s)
- Zhiying Shen
- Nursing Department, Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Guolin Tan
- Department of Otolaryngology Head Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Zhuqing Zhong
- Nursing Department, Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Siqing Ding
- Nursing Department, Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
| | - Fang Wang
- Department of Otolaryngology Head Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, People’s Republic of China
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Fujisawa T, Shimoda T, Masuyama K, Okubo K, Honda K, Okano M, Katsunuma T, Urisu A, Kondo Y, Odajima H, Kurihara K, Nagata M, Taniguchi M, Taniuchi S, Doi S, Matsumoto T, Hashimoto S, Tanaka A, Natsui K, Abe N, Ozaki H. Long-term safety of subcutaneous immunotherapy with TO-204 in Japanese patients with house dust mite-induced allergic rhinitis and allergic bronchial asthma: Multicenter, open label clinical trial. Allergol Int 2018; 67:347-356. [PMID: 29233461 DOI: 10.1016/j.alit.2017.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/21/2017] [Accepted: 10/24/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND To evaluate the long-term safety of subcutaneous immunotherapy with TO-204, a standardized house dust mite (HDM) allergen extracts, we conducted a multicenter, open label clinical trial. METHODS Japanese patients aged 5-65 years were eligible for the study, if they had HDM-induced allergic rhinitis (AR), allergic bronchial asthma (BA), or both. TO-204 was administered in a dose titration scheme, and the maintenance dose was determined according to the predefined criteria. The treatment period was 52 weeks, and patients who were willing to continue the treatment received TO-204 beyond 52 weeks. This clinical trial is registered at the Japan Pharmaceutical Information Center (Japic CTI-121900). RESULTS Between July 2012 and May 2015, 44 patients (28 with AR and 16 with allergic BA) were enrolled into the study. All patients were included in the analysis. The duration of treatment ranged from 23 to 142 weeks and the median maintenance dose was 200 Japanese allergy units (JAU). Adverse events occurred in 22 patients (50%). The most common adverse event was local reactions related to the injection sites. Four patients experienced anaphylactic reactions when they were treated with the dose of 500 JAU. Two patients experienced anaphylactic shock with the doses of 1000 JAU at onset. These 6 patients could continue the study with dose reduction. CONCLUSIONS Safety profile of TO-204 was acceptable in Japanese patients with HDM-induced AR or allergic BA. Higher doses should be administered carefully, because the risk of anaphylaxis increased at doses of 500 or 1000 JAU.
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Affiliation(s)
| | - Terufumi Shimoda
- Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan
| | - Keisuke Masuyama
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Yamanashi, Yamanashi, Japan
| | - Kimihiro Okubo
- Department of Otorhinolaryngology, Nippon Medical School, Tokyo, Japan
| | - Kohei Honda
- Department of Otorhinolaryngology, Head and Neck Surgery, Akita Graduate School of Medicine, Akita, Japan
| | - Mitsuhiro Okano
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshio Katsunuma
- Department of Pediatrics, Jikei University Daisan Hospital, Tokyo, Japan
| | - Atsuo Urisu
- Department of Pediatrics, Fujita Health University, The Second Teaching Hospital, Nagoya, Japan
| | - Yasuto Kondo
- Department of Pediatrics, Fujita Health University, The Second Teaching Hospital, Nagoya, Japan
| | - Hiroshi Odajima
- Department of Pediatrics, Fukuoka National Hospital, Fukuoka, Japan
| | - Kazuyuki Kurihara
- Department of Allergy, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Makoto Nagata
- Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan
| | - Masami Taniguchi
- Department of Allergy, Sagamihara National Hospital, Kanagawa, Japan
| | - Shoichiro Taniuchi
- Department of Pediatrics, Kansai Medical University Takii Hospital, Osaka, Japan
| | - Satoru Doi
- Department of Pediatrics, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Tomoshige Matsumoto
- Department of Allergy and Internal Medicine, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Shoji Hashimoto
- Department of Allergy and Internal Medicine, Osaka Prefectural Hospital Organization Osaka Habikino Medical Center, Osaka, Japan
| | - Akihiko Tanaka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University, School of Medicine, Tokyo, Japan
| | - Kensuke Natsui
- Department of Clinical Development, Torii Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Nahoko Abe
- Department of Clinical Development, Torii Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Hideki Ozaki
- Department of Clinical Development, Torii Pharmaceutical Co., Ltd., Tokyo, Japan
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Larenas-Linnemann DES, Antolín-Amérigo D, Parisi C, Nakonechna A, Luna-Pech JA, Wedi B, Davila I, Gómez M, Levin M, Ortega Martell JA, Klimek L, Rosario N, Muraro AM, Agache I, Bousquet J, Sheikh A, Pfaar O. National clinical practice guidelines for allergen immunotherapy: An international assessment applying AGREE-II. Allergy 2018; 73:664-672. [PMID: 28940450 DOI: 10.1111/all.13316] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Since 1988, numerous allergen immunotherapy guidelines (AIT-GLs) have been developed by national and international organizations to guide physicians in AIT. Even so, AIT is still severely underused. OBJECTIVE To evaluate AIT-GLs with AGREE-II, developed in 2010 by McMaster University methodologists to comprehensively evaluate GL quality. METHODS Allergist, from different continents, knowledgeable in AIT and AGREE-II trained were selected into the project team. The project received methodologists' guidance. AIT-GLs in any language were sought from 1980 to 2016; AIT-GLs were AGREE II-evaluated by at least 2 team members, independently; discrepancies were resolved in a second round, by team discussion or methodologists' consulting. RESULTS We found 31 AIT-GLs (15 post-2010), ranging from local consensus reports to international position papers (EAACI, AAAAI-ACAAI, WAO). Pre-2010 GLs scored 1.6-4.6 (23%-67%) and post-2010 GLs scored 2.1-6 (30%-86%), on a 7-point Likert scale. The highest scores went to: German-Austrian-Swiss (6.0), Mexican (5.1), and the AAAAI/ACAAI AIT-GL (4.7). These were also the only 3 GLs that received "yes" of both evaluators to the item: "I would recommend this GL for use." The domains of "Stakeholder involvement" and "Rigor of Development" only scored 3/7, and "Applicability" scored the lowest. Strikingly, newer GLs only scored clearly better in "Editorial independence" and "Global evaluation." CONCLUSIONS In AIT-GLs, there is still a lot of room for improvement, especially in domains crucial for the dissemination. For some GLs, the "Scientific rigor" domain flawed. When resources are limited, transculturizing a high-quality GL might be preferable over developing a GL from zero. Our study and AGREE-II could help to select the best candidate. CLINICAL IMPLICATIONS We here evaluate allergen immunotherapy guideline (AIT-GL) quality. Only high-quality AIT-GLs should be consulted for AIT management decisions. In low-resource settings, transculturization of these is preferred over developing low-quality guidelines.
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Affiliation(s)
| | - D. Antolín-Amérigo
- Servicio de Enfermedades del Sistema Inmune-Alergia; Hospital Universitario Príncipe de Asturias; Alcalá de Henares Spain
- Departamento de Medicina y Especialidades Médicas; Universidad de Alcalá; Madrid Spain
| | - C. Parisi
- Hospital Italiano de Buenos Aires; Buenos Aires Argentina
| | - A. Nakonechna
- Royal Liverpool University Hospital and Liverpool Hope University; Liverpool United Kingdom
| | | | - B. Wedi
- Hannover Medical School; Hannover Germany
| | - I. Davila
- University Hospital of Salamanca; Salamanca Spain
| | - M. Gómez
- Fundación Ayre (Education & Research); Salta Argentina
| | - M. Levin
- Red Cross Children's Hospital and School of Adolescent and Child Health; University of Cape Town; Cape Town South Africa
| | | | - L. Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - N. Rosario
- Universidade Federal do Paraná; Curitiba Brazil
| | | | - I. Agache
- Department of Allergy & Clinical Immunology; Transylvania University; Brasov Romania
| | - J. Bousquet
- MACVIA-France; Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site; Montpellier France
| | - A. Sheikh
- Asthma UK Centre for Applied Research; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh; Scotland UK
| | - 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
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Murakami D, Sawatsubashi M, Omori H, Saito A, Kato A, Komune S, Nakagawa T. Safety and efficacy of short-term oral immunotherapy with Cry j 1-galactomannan conjugate for Japanese cedar pollinosis: a randomized controlled trial. Sci Rep 2017; 7:46142. [PMID: 28397833 PMCID: PMC5387405 DOI: 10.1038/srep46142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 03/13/2017] [Indexed: 11/29/2022] Open
Abstract
Current allergen-specific immunotherapy (AIT) for pollinosis requires long-term treatment with potentially severe side effects. Therefore, development of an AIT that is safe and more convenient with a shorter regimen is needed. This prospective, double-blind, placebo-controlled trial randomized 55 participants with Japanese cedar pollinosis (JCP) to active or placebo groups to test the safety and efficacy of short-term oral immunotherapy (OIT) with Cry j 1-galactomannan conjugate for JCP. Mean symptom-medication score as the primary outcome in the active group improved 27.8% relative to the placebo group during the entire pollen season. As the secondary outcomes, mean medication score in active group improved significantly, by 56.2%, compared with placebo during the entire pollen season. Mean total symptom score was similar between active and placebo groups during the entire pollen season. There were no severe treatment-emergent adverse events in the active and placebo groups. Therefore short-term OIT with Cry j 1-galactomannan conjugate is safe, and effective for reducing the amount of medication use for JCP.
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Affiliation(s)
- Daisuke Murakami
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Otorhinolaryngology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Motohiro Sawatsubashi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirofumi Omori
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Saito
- Bio &Healthcare Business Group, Bio &Healthcare Business Division, Wako Filter Technology Co., Ltd., Ibaraki, Japan
| | - Akio Kato
- Department of Biological Chemistry, Yamaguchi University, Yamaguchi, Japan
| | - Shizuo Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Masuyama K, Goto M, Takeno S, Ohta N, Okano M, Kamijo A, Suzuki M, Terada T, Sakurai D, Horiguchi S, Honda K, Matsune S, Yamada T, Sakashita M, Yuta A, Fuchiwaki T, Miyanohara I, Nakayama T, Okamoto Y, Fujieda S. Guiding principles of sublingual immunotherapy for allergic rhinitis in Japanese patients. Auris Nasus Larynx 2015; 43:1-9. [PMID: 26615715 DOI: 10.1016/j.anl.2015.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/03/2015] [Accepted: 08/26/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Sublingual immunotherapy (SLIT) appears to offer practical advantages for the treatment of allergic rhinitis (AR). Based on a review of the scientific literature, we present recommendations as guiding principles to administer SLIT safely. METHODS Clinical questions concerning SLIT were prepared. Literature published between January 2003 and December 2012 was searched from PubMed, the Cochrane Library, and Japana Centra Revuo Medicina. Qualified studies were analyzed and the results were evaluated, consolidated, and codified. We answered 17 clinical questions and, based on this, presented evidence-based recommendations. RESULTS Sublingual immunotherapy improved symptoms (e.g., quality of life [QOL]) and reduced medication scores in seasonal AR and perennial AR. Most SLIT-induced adverse effects were local oral reactions, although systemic adverse effects such as gastrointestinal symptoms, urticaria, and asthma are occasionally reported. There have been no reports of lethal anaphylactic reactions by SLIT. When SLIT is continued for 3-4 years, its effect persists long after discontinuation. CONCLUSION A correct diagnosis of AR and sufficient informed consent from patients are required before initiating SLIT. Sublingual immunotherapy should be continued for 3 years or longer. The initial administration of SLIT during the uptitration of an allergen vaccine and the general condition of patients are critical for the safe performance of SLIT.
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Affiliation(s)
- Keisuke Masuyama
- Department of Otorhinolaryngology, University of Yamanashi, Japan
| | - Minoru Goto
- Department of Otorhinolaryngology - Head and Neck Surgery, Nippon Medical School, Japan
| | - Sachio Takeno
- Department of Otolaryngology - Head and Neck Surgery, Hiroshima University, Japan
| | - Nobuo Ohta
- Department of Otolaryngology - Head and Neck Surgery, Yamagata University, Japan
| | - Mitsuhiro Okano
- Department of Otolaryngology - Head and Neck Surgery, Okayama University, Okayama, Japan
| | - Atsushi Kamijo
- Otorhinolaryngology/Allergy Center, Saitama Medical University, Japan
| | - Motohiko Suzuki
- Department of Otolaryngology - Head and Neck Surgery, Nagoya City University, Japan
| | - Tetsuya Terada
- Department of Otorhinolaryngology, Osaka Medical University, Japan
| | - Daiju Sakurai
- Department of Otolaryngology - Head and Neck Surgery, Chiba University, Japan
| | | | - Kohei Honda
- Department of Otorhinolaryngology - Head and Neck Surgery, Akita University, Japan
| | - Shoji Matsune
- Department of Otolaryngology Nippon Medical School, Musashikosugi Hospital, Japan
| | - Takechiyo Yamada
- Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan
| | - Masafumi Sakashita
- Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan
| | | | | | - Ikuyo Miyanohara
- Department of Otolaryngology - Head and Neck Surgery, Kagoshima University, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Japan
| | - Yoshitaka Okamoto
- Department of Otolaryngology - Head and Neck Surgery, Chiba University, Japan
| | - Shigeharu Fujieda
- Department of Otolaryngology - Head and Neck Surgery, University of Fukui, Japan.
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8
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International consensus on allergy immunotherapy. J Allergy Clin Immunol 2015; 136:556-68. [DOI: 10.1016/j.jaci.2015.04.047] [Citation(s) in RCA: 367] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 04/20/2015] [Accepted: 04/29/2015] [Indexed: 12/11/2022]
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Murakami D, Sawatsubashi M, Kikkawa S, Ejima M, Saito A, Kato A, Komune S. Safety and efficacy of a new regimen of short-term oral immunotherapy with Cry j 1-galactomannan conjugate for Japanese cedar pollinosis: a prospective, randomized, open-label study. Allergol Int 2015; 64:161-8. [PMID: 25838092 DOI: 10.1016/j.alit.2014.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/04/2014] [Accepted: 10/30/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Short-term oral immunotherapy (OIT) using the Cry j1-galactomannan conjugate for Japanese cedar pollinosis may be effective and relatively safe. However, a treatment regimen has not been established. In the present study, we examined a new OIT regimen with a build-up phase and extended the maintenance phase of OIT to the peak period of the pollen season to enhance the therapeutic effect and safety of OIT. METHODS A prospective, randomized, open-label trial was conducted over a period of 4 months. Participants were randomly divided into two groups. The OIT group comprised 23 subjects. The build-up phase was initiated 1 month before the expected pollen season. The maintenance phase was continued for 51 days during the peak pollen season. The control group comprised 24 subjects. The symptoms and medication score, levels of allergen-specific serum antibodies throughout the pollen season, and adverse effects with OIT were evaluated. RESULTS Participants receiving OIT showed significant improvements in total symptom scores, medication score, and total symptom-medication scores throughout the pollen season compared with the control group. The levels of allergen-specific serum IgG4 were significantly increased in the OIT group but not in the control group throughout the cedar pollen season. Importantly, no severe adverse effects were observed with OIT. CONCLUSIONS The new regimen of short-term OIT using the Cry j1-galactomannan conjugate for Japanese cedar pollinosis is effective, relatively safe and induces immune tolerance. Thus, OIT using allergen-galactomannan conjugates may provide a rapid, effective, and thus convenient immunotherapy for pollinosis instead of SLIT or SCIT.
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Affiliation(s)
- Daisuke Murakami
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Otorhinolaryngology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan.
| | - Motohiro Sawatsubashi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Sayaka Kikkawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Otorhinolaryngology, Saitama Medical University Hospital, Saitama, Japan
| | - Masayoshi Ejima
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Otorhinolaryngology, Kitakyushu Municipal Medical Center, Fukuoka, Japan
| | - Akira Saito
- Biobusiness Propulsion Group, Biobusiness Propulsion Division, Wako Filter Technology Co., Ltd., Ibaraki, Japan
| | - Akio Kato
- Department of Biological Chemistry, Yamaguchi University, Yamaguchi, Japan
| | - Shizuo Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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10
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Takai T, Okamoto Y, Okubo K, Nagata M, Sakaguchi M, Fukutomi Y, Saito A, Yasueda H, Masuyama K. Japanese Society of Allergology task force report on standardization of house dust mite allergen vaccines - secondary publication. Allergol Int 2015; 64:181-6. [PMID: 25838095 DOI: 10.1016/j.alit.2015.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/21/2014] [Accepted: 01/06/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In the 1990s, the Japanese Society of Allergology (JSA) standardized Japanese cedar pollen allergen vaccines. In the present study, the task force for house dust mite (HDM) allergen standardization of the Committee for Allergens and Immunotherapy of JSA reports the standardization of HDM allergen vaccines in Japan. METHODS In vivo allergenic potency was determined by intradermal testing of 51 Japanese adults with positive serum specific IgE to HDM allergens. In vitro total IgE binding potency was analyzed by competition ELISA using a pooled serum, with sera obtained from 10 allergic patients. The amounts of HDM group 1 (Der 1) and group 2 major allergens in eight HDM allergen extracts were measured by sandwich ELISAs. Correlation between the in vitro total IgE binding potency and major allergen levels was analyzed. RESULTS We selected a JSA reference HDM extract and determined its in vivo allergenic potency. The in vitro total IgE binding potency significantly correlated with Der 1 content, group 2 allergen content, and their combined amount, indicating that measurement of major allergen contents can be used as a surrogate in vitro assay. CONCLUSIONS The task force determined the in vivo allergenic potency (100,000 JAU/ml) and Der 1 content (38.5 μg/ml) of the JSA reference HDM extract, selected the measurement of Der 1 content as the surrogate in vitro assay, and decided that manufacturers can label a HDM allergen extract as having a titer of 100,000 JAU/ml if it contains 22.2-66.7 μg/ml of Der 1.
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Affiliation(s)
- Toshiro Takai
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshitaka Okamoto
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kimihiro Okubo
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Department of Head and Neck Sensory Organ Science (Otolaryngology), Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Makoto Nagata
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan; Allergy Center, Saitama Medical University, Saitama, Japan
| | - Masahiro Sakaguchi
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Laboratory of Microbiology I, School of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Yuma Fukutomi
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Akemi Saito
- Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Hiroshi Yasueda
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Keisuke Masuyama
- Task Force for House Dust Mite Allergen Standardization of the Committee for Allergens and Immunotherapy of the Japanese Society of Allergology, Tokyo, Japan; Department of Otorhinolaryngology-Head and Neck Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.
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