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Zhang Y, Shang M, Tian Y, Liu X, Sun X, Gao L. Allergen sensitization study in Dongying, China: An epidemiological study. Medicine (Baltimore) 2024; 103:e36862. [PMID: 38241586 PMCID: PMC10798692 DOI: 10.1097/md.0000000000036862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/14/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND To explore the relationship between specific immunoglobulin E levels in response to prevalent pollen and food allergens among patients suffering from localized allergic diseases in the Dongying area of China, and to analyze the interconnectivity among these factors. METHODS This research encompassed allergic patients who visited the Allergy Department of Shengli Oilfield Central Hospital from January 2022 to January 2023. We examined the specific immunoglobulin E levels in the blood of 230 patients utilizing the Fobock platform provided by Jiangsu Haoeubo Company. Statistical analysis was conducted with SPSS 25.0 statistical software. The chi-square test evaluated the relevance of differences in gender and age. A value of P < .05 was considered statistically significant. RESULTS In this study, eggs emerged as the allergen with the highest number of sensitized individuals, closely followed by dust mite. Conversely, the least sensitized allergen was the cypress tree, closely followed by mango. Notably, male patients exhibited higher sensitivities to cottonwood (P < .05) and egg (P < .001) compared to female patients. Children aged 0 to 10 years showed increased sensitivity to variety of allergens. A significant correlation was observed among different allergens. The top ten allergen pairs with the highest correlation included Birch Tree and Cottonwood (0.88, P < .001), Cottonwood and Pine Tree (0.86, P < .001), Birch Tree and Pine Tree (0.84, P < .001), Pine Tree and Paulownia (0.81, P < .001), Dust Mite and House Dust Mite (0.76, P < .001), Birch Tree and Paulownia (0.73, P < .001), Cashew and Pistachio (0.71, P < .001), Apple and Hazelnut (0.71, P < .001), Cottonwood and Paulownia (0.71, P < .001), and Pine Tree and Ordinary Ragweed (0.70, P < .001). CONCLUSION This research sheds light on the patterns of allergen sensitization in Dongying, Shandong, highlighting that egg is the most prevalent sensitizing allergen. A notably high correlation was observed between Birch Tree and Cottonwood. This study enhanced the understanding of allergic diseases, explored the causes and mechanisms of allergies, strengthened the management of allergic diseases. Furthermore, it offers valuable insights for the clinical diagnosis and prevention of allergic diseases.
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Affiliation(s)
- Yingying Zhang
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Mei Shang
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Ying Tian
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Xuwei Liu
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Xuhui Sun
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Lianjun Gao
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
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2
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Zimmer J, Schmidt S, Kaul S, Costanzo A, Buchheit K, Brown S, Carnés J, Chapman M, Chen A, De Neergaard M, Döring S, Hindley JP, Holzhauser T, Jorajuria S, Le Tallec D, Lombardero M, Iacovacci P, Reese G, Sander I, Smith B, Strecker D, Ree R, Zebina M, Vieths S. Standardisation of allergen products: 4. Validation of a candidate European Pharmacopoeia standard method for quantification of major grass pollen allergen Phl p 5. Allergy 2022; 77:633-642. [PMID: 34241919 DOI: 10.1111/all.15003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND The aim of the BSP090 project is the establishment of European Pharmacopoeia Chemical Reference Substances (CRSs) in combination with corresponding standard ELISA methods for quantification of major allergens in allergen products. Here, we present data of a Phl p 5-specific sandwich ELISA that proved suitable for the quantification of Phl p 5, one of the major Timothy grass (Phleum pratense) pollen allergens. METHODS A Phl p 5-specific ELISA system was assessed with respect to accuracy, precision, inter-assay (within laboratory) and inter-laboratory variations, in a ring trial including 14 laboratories in Europe and the USA. Model samples containing recombinant Phl p 5a CRS as well as native grass pollen extracts were analysed. Each participant was instructed to perform at least one preliminary assay to familiarise with the protocol, followed by three independent assays. RESULTS The candidate standard ELISA proved suitable to quantify recombinant and native Phl p 5 with satisfactory precision (93% of results within ±30% acceptance range). Inter-assay variation (max. GCV 24%) and especially inter-laboratory variation (max. GCV 13%) showed conclusive results. When assessing accuracy by means of recovery of recombinant spikes from a grass pollen extract matrix, similarly satisfactory spike recovery results were observed for the two spikes with higher concentrations (all within ±30% acceptance range), whereas recovery of the lowest concentration spike was slightly poorer with mean results of six laboratories exceeding acceptance range. CONCLUSIONS Based on the collaborative study results, the assessed Phl p 5-specific immunoassay is appropriate to be proposed as European Pharmacopoeia standard method.
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Affiliation(s)
| | | | | | - Angèle Costanzo
- European Directorate for the Quality of Medicines & HealthCare (EDQM) Strasbourg France
| | - Karl‐Heinz Buchheit
- European Directorate for the Quality of Medicines & HealthCare (EDQM) Strasbourg France
| | | | | | | | - Aaron Chen
- Food and Drug Administration Silver Spring MD USA
| | | | | | | | | | - Sylvie Jorajuria
- European Directorate for the Quality of Medicines & HealthCare (EDQM) Strasbourg France
| | - David Le Tallec
- European Directorate for the Quality of Medicines & HealthCare (EDQM) Strasbourg France
| | | | | | | | - Ingrid Sander
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA) Ruhr‐Universität Bochum Bochum Germany
| | - Bryan Smith
- Indoor Biotechnologies Charlottesville VA USA
| | | | - Ronald Ree
- Departments of Experimental Immunology and of Otorhinolaryngology Amsterdam University Medical Centers Amsterdam The Netherlands
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Ariaee N, Varasteh A, Jabbari Azad F, Sankian M. Preparation allergenic pollen extracts; the points should be considered to make high-quality products. J Immunoassay Immunochem 2018; 40:26-39. [PMID: 30422060 DOI: 10.1080/15321819.2018.1543705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Atopic diseases have an increasing trend worldwide during the last two decades. Determining the main cause of allergic diseases, allergens, is the first step in managing and improving the issue, usually is done by Skin Prick tests (SPTs). Having allergenic extract in high quality is desired to perform a reliable SPT. Several parameters of extracts are considered including composition, stability, potency, preservation conditions, and unit definition. In this review, these factors have been explained pointing to factors might have profitable points or harmful drawback in the quality of allergen extracts.
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Affiliation(s)
- Nazila Ariaee
- a Allergy Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Abdolreza Varasteh
- a Allergy Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
| | | | - Mojtaba Sankian
- b Immunology Research Center , Mashhad University of Medical Sciences , Mashhad , Iran
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4
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Christopher DJ, Ashok N, Ravivarma A, Shankar D, Peterson E, Dinh PT, Vedanthan PK. Low Potency of Indian Dust Mite Allergen Skin Prick Test Extracts Compared to FDA-Approved Extracts: A Double-Blinded Randomized Control Trial. ALLERGY & RHINOLOGY 2018; 9:2152656718796746. [PMID: 30263870 PMCID: PMC6156211 DOI: 10.1177/2152656718796746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Skin prick testing is the most important diagnostic tool to detect immunoglobulin E-mediated allergic diseases. With increase in the number of allergy tests performed in India, it is imperative to know the potency of indigenous extracts in comparison with U.S. Food and Drug Administration (USFDA)-approved extracts. Methods A randomized comparison trial of Indian manufactured and USFDA-approved extracts of Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) was done at Christian Medical College & Hospital, Vellore, India from April 2014 to June 2015, to compare the skin test reactivity of indigenous allergen extracts of dust mites against validated allergen. Study enrollment included 197 patients with allergic disorders that showed sensitivity to dust mite during routine allergy skin testing. Study participants were tested with varying dilutions of DP and DF indigenous extracts along with USFDA-approved allergens in a blinded fashion. Results were recorded, and statistical significance was calculated using the Friedman rank sum test. Results Using the Friedman rank sum test with a Tukey adjustment for multiple comparisons, we found that the extracts in each dilution were significantly different (P < .0001). The full strength indigenous extracts, B-DF (DF allergen standard extract from Bioproducts and Diagnostics, India) and C-DF (DF allergen extract from Creative Diagnostics, India) extracts, had mean wheal sizes of 7.69 (standard deviation [SD] 9.91) and 31.01(SD 51.04), respectively. The full strength S-DF (DF allergen extract from Jubilant Hollister Stier, Spokane, WA, USA) had a mean wheal size of 109.97 (SD 162.73), which was significantly higher (P < .0001) than both the indigenous extracts. For each of the dilutions, the S-DF mean wheal size was significantly greater than that of the corresponding B-DF and C-DF wheal sizes. The full strength indigenous C-DP (DP allergen extract from Creative Diagnostics, India) had mean wheal size of 39.37 (SD 51.74). The full strength standard S-DP (DP allergen extract from Jubilant Hollister Stier, Spokane, WA, USA) extract had a mean wheal size of 167.66 (SD 270.80), which was significantly higher (P < .0001) than the indigenous C-DP extract. Similar differences were seen across all dilutions. Conclusion The indigenous extracts have significantly lower potency compared to USFDA-approved extracts; hence, there is an urgent need for policy makers to institute stringent criteria for standardization of antigens in India.
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Affiliation(s)
| | - Narmada Ashok
- Department of Pediatrics, Nalam Medical Centre & Hospital, Vellore, Tamil Nadu, India
| | - Aruna Ravivarma
- Department of Pulmonary Medicine, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Deepa Shankar
- Department of Pulmonary Medicine, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Erik Peterson
- U.S. Department of Agriculture, Washington, District of Columbia
| | - Phuong T Dinh
- Department of Healthcare Administration, University of Colorado, Denver, Colorado
| | - P K Vedanthan
- Department of Healthcare Administration, University of Colorado, Denver, Colorado
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5
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Zimmer J, Bonertz A, Vieths S. Quality requirements for allergen extracts and allergoids for allergen immunotherapy. Allergol Immunopathol (Madr) 2017; 45 Suppl 1:4-11. [PMID: 29128092 DOI: 10.1016/j.aller.2017.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
All allergen products for allergen immunotherapy currently marketed in the European Union are pharmaceutical preparations derived from allergen-containing source materials like pollens, mites and moulds. Especially this natural origin results in particular demands for the regulatory requirements governing allergen products. Furthermore, the development of regulatory requirements is complicated by the so far missing universal link between certain quality parameters, in particular biological potency, on the one hand and clinical efficacy on the other hand. As a consequence, each allergen product for specific immunotherapy has to be assessed individually for its quality, safety and efficacy. At the same time, biological potency of allergen products is most commonly determined using IgE inhibition assays based on human sera relative to product-specific in house references, ruling out full comparability of products from different manufacturers. This review article aims to summarize the current quality requirements for allergen products including the special requirements implemented for control of chemically modified allergen extracts (allergoids).
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Food allergen extracts to diagnose food-induced allergic diseases: How they are made. Ann Allergy Asthma Immunol 2017; 119:101-107. [PMID: 28801015 DOI: 10.1016/j.anai.2016.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/01/2016] [Accepted: 11/10/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To review the manufacturing procedures of food allergen extracts and applicable regulatory requirements from government agencies, potential approaches to standardization, and clinical application of these products. The effects of thermal processing on allergenicity of common food allergens are also considered. DATA SOURCES A broad literature review was conducted on the natural history of food allergy, the manufacture of allergen extracts, and the allergenicity of heated food. Regulations, guidance documents, and pharmacopoeias related to food allergen extracts from the United States and Europe were also reviewed. STUDY SELECTIONS Authoritative and peer-reviewed research articles relevant to the topic were chosen for review. Selected regulations and guidance documents are current and relevant to food allergen extracts. RESULTS Preparation of a food allergen extract may require careful selection and identification of source materials, grinding, defatting, extraction, clarification, sterilization, and product testing. Although extractions for all products licensed in the United States are performed using raw source materials, many foods are not consumed in their raw form. Heating foods may change their allergenicity, and doing so before extraction may change their allergenicity and the composition of the final product. CONCLUSION The manufacture of food allergen extracts requires many considerations to achieve the maximal quality of the final product. Allergen extracts for a select number of foods may be inconsistent between manufacturers or unreliable in a clinical setting, indicating a potential area for future improvement.
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Fernández-Caldas E, Cases B, El-Qutob D, Cantillo JF. Mammalian raw materials used to produce allergen extracts. Ann Allergy Asthma Immunol 2017; 119:1-8. [PMID: 28668236 DOI: 10.1016/j.anai.2016.08.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/12/2016] [Accepted: 08/22/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To provide information about the complexity of skin-derived mammalian allergen extracts and recent advances made in their characterization and production. DATA SOURCES Original and review articles (involving nonfood allergy to mammals) published in indexed journals were searched in the PubMed database. STUDY SELECTIONS Studies were selected with the following criteria: novelty, species of the study, and date of publication. RESULTS The information provided will help in the understanding and the selection of the appropriate allergen source materials for the preparation of extracts for the diagnosis and treatment of allergic respiratory diseases induced by the inhalation of skin-derived mammalian allergens. The data presented herein suggest the presence of cross-reactive and species-specific allergens in extracts prepared from different mammalian dander. Dander should be strongly considered in the preparation of allergenic extracts not only of cats and dogs but also of other mammalian species. CONCLUSION New methods should be developed to estimate the relative quantities of specific allergens in the extracts. The current knowledge illustrates the complexity of these extracts, and more efforts should be undertaken to fully understand the wide spectrum of mammalian allergens.
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Affiliation(s)
| | | | - David El-Qutob
- Unit of Allergy, University Hospital of La Plana in Vila-Real, Castellon, Spain
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8
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Kaul S, Zimmer J, Dehus O, Costanzo A, Daas A, Buchheit KH, Asturias JA, Barber D, Carnés J, Chapman M, Dayan-Kenigsberg J, Döring S, Führer F, Hanschmann KM, Holzhauser T, Ledesma A, Moingeon P, Nony E, Pini C, Plunkett G, Reese G, Sandberg E, Sander I, Strecker D, Valerio C, van Ree R, Vieths S. Standardization of allergen products: 3. Validation of candidate European Pharmacopoeia standard methods for quantification of major birch allergen Bet v 1. Allergy 2016; 71:1414-24. [PMID: 27018782 DOI: 10.1111/all.12898] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The BSP090 project aims at establishing European Pharmacopoeia Reference Substances in combination with the corresponding ELISA methods for the quantification of major allergens in allergen products. Two sandwich ELISAs proved suitable for quantification of Bet v 1, the major birch pollen allergen, in preceding phases of BSP090. METHODS Two Bet v 1-specific ELISA systems were compared with respect to accuracy and precision in a ring trial including 13 laboratories. Model samples containing recombinant rBet v 1.0101 as well as native birch pollen extracts were measured independently at least three times in each facility. The assessment was completed with a comparative quantification of Bet v 1 in 30 marketed birch allergen products in one laboratory, simulating the future use as reference method. RESULTS In the collaborative study, both candidate ELISAs confirmed their suitability to quantify recombinant and native Bet v 1. ELISA-A showed higher precision and lower interlaboratory variability, yet ELISA-B exhibited slightly higher accuracy. Subsequent parallel measurement of Bet v 1 in a panel of 'real-life' birch allergen products indicated better repeatability of ELISA-B. Both systems detected substantial differences in Bet v 1 content between allergen products, but the effect was more pronounced using ELISA-B due to persistently higher values compared to ELISA-A. CONCLUSIONS In the collaborative study, no deciding differences were observed between the two candidate ELISAs. Further comparison under conditions simulating the intended use combined with the criterion of long-term availability enabled the selection of one Bet v 1-specific ELISA for proposal as European Pharmacopoeia standard method.
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Affiliation(s)
- S. Kaul
- Paul-Ehrlich-Institut; Langen Germany
| | - J. Zimmer
- Paul-Ehrlich-Institut; Langen Germany
| | - O. Dehus
- Paul-Ehrlich-Institut; Langen Germany
| | - A. Costanzo
- European Directorate for the Quality of Medicines & HealthCare (EDQM); Strasbourg France
| | - A. Daas
- European Directorate for the Quality of Medicines & HealthCare (EDQM); Strasbourg France
| | - K. H. Buchheit
- European Directorate for the Quality of Medicines & HealthCare (EDQM); Strasbourg France
| | | | | | - J. Carnés
- Laboratorios Leti S.L.; Tres Cantos Spain
| | - M. Chapman
- Indoor Biotechnologies; Charlottesville VA USA
| | | | - S. Döring
- Paul-Ehrlich-Institut; Langen Germany
| | - F. Führer
- Paul-Ehrlich-Institut; Langen Germany
| | | | | | | | | | - E. Nony
- Stallergenes Greer; Antony Cedex France
| | | | | | - G. Reese
- Allergopharma GmbH & Co. KG; Reinbek Germany
| | - E. Sandberg
- Danish Medicines Agency; Copenhagen S Denmark
| | - I. Sander
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance; Ruhr-Universität Bochum (IPA); Bochum Germany
| | | | - C. Valerio
- Food and Drug Administration; Silver Spring MD USA
| | - R. van Ree
- Academic Medical Centre; Amsterdam The Netherlands
| | - S. Vieths
- Paul-Ehrlich-Institut; Langen Germany
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Zimmer J, Vieths S, Kaul S. Standardization and Regulation of Allergen Products in the European Union. Curr Allergy Asthma Rep 2016; 16:21. [PMID: 26874849 DOI: 10.1007/s11882-016-0599-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Product-specific standardization is of prime importance to ensure persistent quality, safety, and efficacy of allergen products. The regulatory framework in the EU has induced great advancements in the field in the last years although national implementation still remains heterogeneous. Scores of methods for quantification of individual allergen molecules are developed each year and also the challenging characterization of chemically modified allergen products is progressing. However, despite the unquestionable increase in knowledge and the subsequent improvements in control of quality parameters of allergen products, an important aim has not been reached yet, namely cross-product comparability. Still, comparison of allergen product potency, either based on total allergenic activity or individual allergen molecule content, is not possible due to a lack of standard reference preparations in conjunction with validated standard methods. This review aims at presenting the most recent developments in product-specific standardization as well as activities to facilitate cross-product comparability in the EU.
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Affiliation(s)
- Julia Zimmer
- Division of Allergology, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Germany.
| | - Stefan Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Germany.
| | - Susanne Kaul
- Division of Allergology, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Germany.
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10
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Himly M, Nandy A, Kahlert H, Thilker M, Steiner M, Briza P, Neubauer A, Klysner S, van Ree R, Buchheit KH, Vieths S, Ferreira F. Standardization of allergen products: 2. Detailed characterization of GMP-produced recombinant Phl p 5.0109 as European Pharmacopoeia reference standard. Allergy 2016; 71:495-504. [PMID: 26687027 DOI: 10.1111/all.12824] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Biological Standardization Programme of the European Directorate for Quality of Medicines and Healthcare (EDQM) aims at the establishment of well-characterized reference standards based on recombinant allergens and validated assays for the quantification of major allergen content. The objective of this study was to examine the detailed physicochemical and immunological characterization of recombinant Phl p 5.0109, the second available allergen reference standard. METHODS Recombinant Phl p 5.0109 PP5ar06007 was produced under GMP conditions and analyzed by an array of physicochemical and immunological methods for identity, quantity, homogeneity, and folding stability in bulk solution, as well as thermal denaturation, aggregation state, and biological activity when formulated for long-time storage. RESULTS PP5ar06007 revealed as a highly homogeneous, monomeric, well-folded preparation of rPhl p 5.0109, as documented by mass spectrometry, SDS-PAGE, isoelectric focusing, size-exclusion chromatography with light scattering, circular dichroism, and infrared spectroscopy. Upon storage at +4°C, PP5ar06007 retained the monomeric state for at least 2 months. A protein quantity of 1.56 ± 0.03 mg/ml was determined by amino acid analysis in PP5ar06007, and its biological activity was shown to be comparable to natural Phl p 5 in terms of basophil activation and T-cell reactivity. CONCLUSIONS Recombinant Phl p 5.0109 PP5ar06007 was characterized extensively at the physicochemical and immunological level. It revealed to be a highly stable, monomeric, and immunologically equivalent of its natural counterpart. PP5ar06007 is now available as European Pharmacopoeia allergen reference standard for grass pollen products.
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Affiliation(s)
- M. Himly
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
| | - A. Nandy
- Research and Development; Allergopharma GmbH & Co. KG; Reinbek Germany
| | - H. Kahlert
- Research and Development; Allergopharma GmbH & Co. KG; Reinbek Germany
| | - M. Thilker
- Research and Development; Allergopharma GmbH & Co. KG; Reinbek Germany
| | - M. Steiner
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
| | - P. Briza
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
| | | | - S. Klysner
- Research and Development; Allergopharma GmbH & Co. KG; Reinbek Germany
| | - R. van Ree
- Academic Medical Center; Amsterdam The Netherlands
| | - K.-H. Buchheit
- European Directorate for Quality of Medicines and Healthcare; Strasbourg France
| | - S. Vieths
- Department of Allergology; Paul-Ehrlich-Institut; Langen Germany
| | - F. Ferreira
- Department of Molecular Biology; University of Salzburg; Salzburg Austria
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11
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Barber D, Díaz-Perales A, Villalba M, Chivato T. Challenges for allergy diagnosis in regions with complex pollen exposures. Curr Allergy Asthma Rep 2015; 15:496. [PMID: 25504260 DOI: 10.1007/s11882-014-0496-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Over the past few decades, significant scientific progress has influenced clinical allergy practice. The biological standardization of extracts was followed by the massive identification and characterization of new allergens and their progressive use as diagnostic tools including allergen micro arrays that facilitate the simultaneous testing of more than 100 allergen components. Specific diagnosis is the basis of allergy practice and is always aiming to select the best therapeutic or avoidance intervention. As a consequence, redundant or irrelevant information might be adding unnecessary cost and complexity to daily clinical practice. A rational use of the different diagnostic alternatives would allow a significant improvement in the diagnosis and treatment of allergic patients, especially for those residing in complex pollen exposure areas.
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Affiliation(s)
- Domingo Barber
- Institute for Applied Molecular Medicine (IMMA) School of Medicine, Universidad CEU San Pablo, 28668, Madrid, Spain,
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12
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Frati F, Cecchi L, Scala E, Ridolo E, Dell'Albani I, Makrì E, Pajno G, Incorvaia C. New product development with the innovative biomolecular sublingual immunotherapy formulations for the management of allergic rhinitis. Biologics 2014; 8:221-6. [PMID: 25246765 PMCID: PMC4167485 DOI: 10.2147/btt.s50951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The molecular allergy technique, currently defined as component-resolved diagnosis, significantly improved the diagnosis of allergy, allowing for differentiation between molecules actually responsible for clinical symptoms (genuine sensitizers) and those simply cross-reacting or shared by several sources (panallergens), thus influencing the appropriate management of a patient's allergy. This also concerns allergen immunotherapy (AIT), which may be prescribed more precisely based on the component-resolved diagnosis results. However, the advance in diagnosis needs to be mirrored in AIT. According to consensus documents and to expectations of specialists, therapy should be based on standardized extracts containing measured amounts of the clinically relevant molecules, ie, the major allergens. The new generation of extracts for sublingual immunotherapy fulfills these requirements and are thus defined as biomolecular (BM). BM refers to natural extracts with a defined content of major allergens in micrograms. All Staloral BM products are indicated for the treatment of allergic rhinitis with or without asthma. The effectiveness of AIT is related to its ability to modify the immunological response of allergic subjects. The 5-grass and house dust mite extracts were evaluated addressing the T helper 1, T helper 2, and T helper 3 cells by polymerase chain reaction array on mRNA extracted from Waldeyer's ring tissue (adenoids). Sublingual immunotherapy with a defined content of major allergens in micrograms induced a strong downregulation of genes involved in T helper 2 and T helper 1 activation and function, allowing the definition of the immunologic effect as "bio-homeostatic". This clinical and immunological model must be implemented with respect to other allergens, thus expanding the application of a treatment with a unique disease-modifying capacity.
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Affiliation(s)
- Franco Frati
- Medical and Scientific Department, Stallergenes, Milan, Italy
| | - Lorenzo Cecchi
- Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy ; Allergy and Clinical Immunology Section, Azienda Sanitaria di Prato, Prato, Italy
| | - Enrico Scala
- Experimental Allergy Unit, IDI-IRCCS, Rome, Italy
| | - Erminia Ridolo
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Eleni Makrì
- Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy
| | - Giovanni Pajno
- Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy
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13
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Chapman MD, Briza P. Molecular approaches to allergen standardization. Curr Allergy Asthma Rep 2013; 12:478-84. [PMID: 22740009 DOI: 10.1007/s11882-012-0282-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Molecular approaches to allergen standardization include the development of purified natural or recombinant allergen standards whose structural and allergenic properties have been validated, in tandem with certified immunoassays for allergen measurement. Purified allergens can be used individually or incorporated into multiple allergen standards. Multicenter international collaborative studies are required to validate candidate allergen standards and immunoassays, as a prelude to being approved by regulatory agencies. Mass spectrometry is a sophisticated and powerful proteomics tool that is being developed for allergen analysis. Recent results using pollen allergens show that mass spectrometry can identify and measure specific allergens in a complex mixture and can provide precise information of the variability of natural allergen extracts. In future, the combined use of immunoassays and mass spectrometry will provide complete standardization of allergenic products. Molecular standardization will form the basis of new allergy diagnostics and therapeutics, as well as assessment of environmental exposure, and will improve the quality of treatment options for allergic patients.
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Affiliation(s)
- Martin D Chapman
- Indoor Biotechnologies Inc, 1216 Harris Street, Charlottesville, VA 22903, USA.
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Nouri HR, Varasteh A, Vahedi F, Chamani J, Afsharzadeh D, Sankian M. Constructing a hybrid molecule with low capacity of IgE binding from Chenopodium album pollen allergens. Immunol Lett 2012; 144:67-77. [DOI: 10.1016/j.imlet.2012.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 02/28/2012] [Accepted: 03/29/2012] [Indexed: 12/01/2022]
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Filep S, Tsay A, Vailes L, Gadermaier G, Ferreira F, Matsui E, King EM, Chapman MD. A multi-allergen standard for the calibration of immunoassays: CREATE principles applied to eight purified allergens. Allergy 2012; 67:235-41. [PMID: 22092159 PMCID: PMC3257384 DOI: 10.1111/j.1398-9995.2011.02750.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allergen measurements are widely used for environmental exposure assessments and for determining the potency of allergen vaccines, yet few purified allergen standards have been developed. The aim of the study was to develop a single standard containing multiple purified allergens that could be used in enzyme immunoassays and in multiplex arrays for the standardization of allergen measurements. METHODS Eight purified allergens were formulated into a single multi-allergen, or 'universal', standard based on amino acid analysis. Dose-response curves were compared with previous individual ELISA standards and allergen measurements of house dust extracts to obtain correction factors. Measured allergen concentrations were also modeled using linear regression, and the predictive accuracy was determined. RESULTS Parallel dose-response curves were obtained between the universal allergen standard and the individual ELISA standards, with close agreement between curves for 5/8 allergens. Quantitative differences of greater than twofold were observed for Fel d 1, Can f 1, and Der f 1, which were confirmed by the analysis of house dust extracts. Correction factors were developed that allowed ELISA data to be expressed in terms of the universal standard. Linear regression data confirmed the predictive accuracy of the universal standard. CONCLUSION This study shows that a single standard of eight purified allergens can be used to compare allergen measurements by immunoassay. This approach will improve the continuity of environmental exposure assessments and provide improved standardization of allergy diagnostics and vaccines used for immunotherapy.
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Affiliation(s)
- S Filep
- INDOOR Biotechnologies Inc., Charlottesville, VA 22903, USA
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A practical test system for sensitive, rapid screening and authentication of peanut allergens in imported and exported food products in Chinese Customs. Food Control 2012. [DOI: 10.1016/j.foodcont.2011.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Calderón MA, Larenas D, Kleine-Tebbe J, Jacobsen L, Passalacqua G, Eng PA, Varga EM, Valovirta E, Moreno C, Malling HJ, Alvarez-Cuesta E, Durham S, Demoly P. European Academy of Allergy and Clinical Immunology task force report on 'dose-response relationship in allergen-specific immunotherapy'. Allergy 2011; 66:1345-59. [PMID: 21707645 DOI: 10.1111/j.1398-9995.2011.02669.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND For a century, allergen-specific immunotherapy (SIT) has proven to be an effective treatment for allergic rhinitis, asthma, and insect sting allergy. However, as allergen doses are frequently adapted to the individual patient, there are few data on dose-response relationship in SIT. Allergen products for SIT are being increasingly required to conform to regulatory requirements for human medicines, which include the need to demonstrate dose-dependent effects. METHODS This report, produced by a Task Force of the EAACI Immunotherapy Interest Group, evaluates the currently available data on dose-response relationships in SIT and aims to provide recommendations for the design of future studies. RESULTS Fifteen dose-ranging studies fulfilled the inclusion criteria and twelve reported a dose-response relationship for clinical efficacy. Several studies also reported a dose-response relationship for immunological and safety endpoints. Due to the use of different reference materials and methodologies for the determination of allergen content, variations in study design, and choice of endpoints, no comparisons could be made between studies and, as a consequence, no general dosing recommendations can be made. CONCLUSION Despite recently introduced guidelines on the standardization of allergen preparations and study design, the Task Force identified a need for universally accepted standards for the measurement of allergen content in SIT preparations, dosing protocols, and selection of clinical endpoints to enable dose-response effects to be compared across studies.
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Affiliation(s)
- M A Calderón
- National Heart and Lung Institute, Imperial College London, UK.
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Nouri HR, Sankian M, Vahedi F, Afsharzadeh D, Rouzbeh L, Moghadam M, Varasteh A. Diagnosis of Chenopodium album allergy with a cocktail of recombinant allergens as a tool for component-resolved diagnosis. Mol Biol Rep 2011; 39:3169-78. [PMID: 21713408 DOI: 10.1007/s11033-011-1083-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Accepted: 06/11/2011] [Indexed: 11/30/2022]
Abstract
Chenopodium album pollen is one of the main sources of pollen allergy in desert and semi-desert areas and contains three identified allergens, so the aim of this study is comparison of the diagnostic potential of C. album recombinant allergens in an allergenic cocktail and C. album pollen extract. Diagnostic potential of the allergenic cocktail was investigated in 32 individuals using skin prick test and obtained results were compared with the acquired results from C. album pollen extract. Specific IgE reactivity against the pollen extract and allergenic cocktail was determined by ELISA and western blotting tests. Inhibition assays were performed for the allergenic cocktail characterization. The exact sensitization profile of all patients was identified which showed that 72, 81 and 46% of allergic patients had IgE reactivity to rChe a 1, rChe a 2 and rChe a 3, respectively. Almost all of C. album allergic patients (30/32) had specific IgE against the allergenic cocktail. In addition, there was a high correlation between IgE levels against the allergenic cocktail and IgE levels against the pollen extract. The allergenic cocktail was able to completely inhibit IgE binding to natural Che a 1, Che a 2 and Che a 3 in C. album extract. In addition, positive skin test reactions were seen in allergic patients that tested by the allergenic cocktail. The reliable results obtained from this study confirmed that the allergenic cocktail with high diagnostic potential could be replaced with natural C. album allergen extracts in skin prick test and serologic tests.
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Affiliation(s)
- Hamid Reza Nouri
- Immunobiochemistry Lab, Immunology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Abedini S, Sankian M, Falak R, Tehrani M, Talebi F, Shirazi FG, Varasteh AR. An approach for detection and quantification of fruits' natural profilin: natural melon profilin as a model. FOOD AGR IMMUNOL 2011. [DOI: 10.1080/09540105.2010.524918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Samaneh Abedini
- a Immunology Research Center, Bu-Ali Research Institute , Mashhad University of Medical Sciences , Mashhad, Iran
| | - Mojtaba Sankian
- a Immunology Research Center, Bu-Ali Research Institute , Mashhad University of Medical Sciences , Mashhad, Iran
| | - Reza Falak
- b Immunology Department, Faculty of Medicine , Iran University of Medical Sciences , Tehran, Iran
| | - Mohsen Tehrani
- a Immunology Research Center, Bu-Ali Research Institute , Mashhad University of Medical Sciences , Mashhad, Iran
| | - Farideh Talebi
- a Immunology Research Center, Bu-Ali Research Institute , Mashhad University of Medical Sciences , Mashhad, Iran
| | - Frough Golsaz Shirazi
- a Immunology Research Center, Bu-Ali Research Institute , Mashhad University of Medical Sciences , Mashhad, Iran
| | - Abdol-Reza Varasteh
- a Immunology Research Center, Bu-Ali Research Institute , Mashhad University of Medical Sciences , Mashhad, Iran
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European and Mexican vs US diagnostic extracts of Bermuda grass and cat in skin testing. Ann Allergy Asthma Immunol 2011; 106:421-8. [PMID: 21530875 DOI: 10.1016/j.anai.2010.11.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 11/11/2010] [Accepted: 11/21/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND Laboratory testing of various diagnostic extracts has shown lower potencies for several European and Mexican extracts relative to the US Food and Drug Administration (FDA) reference (10,000 BAU/mL). Quantitative skin prick testing (QSPT) with Dermatophagoides pteronyssinus extracts have previously shown a similar picture. OBJECTIVE To compare European and Mexican Bermuda grass (BG) and cat diagnostic extracts against an FDA-validated extract using QSPT. METHODS Six diagnostic BG and cat extracts (1 reference FDA extract, 3 European extracts, 1 imported nonstandardized extract from the United States, and 1 Mexican extract) were tested with quadruplicate QSPT, as a concentrate and as 2 serial 2-fold dilutions, in cat and BG allergic individuals. RESULTS BG showed good dose response in wheal size for the concentrate (1:2-1:4 dilutions; steep part of the curve). Cat showed poorer dose response. The Wilcoxon test for linked random samples was used to investigate whether the distribution of the reference differed from each of the test extracts to a statistically significant degree (2-sided asymptotic significance, α = .05). All BG and 2 cat extracts were statistically less potent than the 10,000 BAU/mL US reference. European BG extracts were 7,700, 4,100, and 1,600 BAU/mL, and cat extracts were 12,500, 4,400, and 5,100 BAU/mL. CONCLUSIONS The potency of some diagnostic extracts of BG and cat used in Europe, Mexico, and the United States differs, with the US extracts being generally more potent. On the basis of provocation tests, optimal diagnostic concentrations should be determined. Similar comparisons using other manufacturers and therapeutic extracts might be interesting.
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Cloning and expression of Che a 1, the major allergen of Chenopodium album in Escherichia coli. Appl Biochem Biotechnol 2010; 163:895-905. [PMID: 20872185 DOI: 10.1007/s12010-010-9093-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 09/13/2010] [Indexed: 01/03/2023]
Abstract
Chenopodium album is a weedy annual plant in the genus Chenopodium. C. album pollen represents a predominant allergen source in Iran. The main C. album pollen allergens have been described as Che a 1, Che a 2, and Che a 3. The aim of this work was to clone the Che a 1 in Escherichia coli to establish a system for overproduction of the recombinant Che a 1 (rChe a 1). In order to clone this allergen, the pollens were subjected to RNA extraction. A full-length fragment encoding Che a 1 was prepared by polymerase chain reaction amplification of the first-strand cDNA synthesized from extracted RNA. Cloning was carried out by inserting the cDNA into the pET21b+ vector, thereafter the construct was transformed into E. coli Top10 cells and expression of the protein was induced by IPTG. The rChe a 1 was purified using histidine tag in recombinant protein by means of Ni-NTA affinity chromatography. IgE immunoblotting, ELISA, and inhibition ELISA were done to evaluate IgE binding of the purified protein. In conclusion, the cDNA for the major allergen of the C. album pollen, Che a 1, was successfully cloned and rChe a 1 was purified. Inhibition assays demonstrated allergic subjects sera reacted with rChe a 1 similar to natural Che a 1 in crude extract of C. album pollen. This study is the first report of using the E. coli as a prokaryotic system for Che a 1 cloning and production of rChe a 1.
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Frati F, Scurati S, Puccinelli P, David M, Hilaire C, Capecce M, Marcucci F, Incorvaia C. Development of a sublingual allergy vaccine for grass pollinosis. Drug Des Devel Ther 2010; 4:99-105. [PMID: 20689696 PMCID: PMC2915534 DOI: 10.2147/dddt.s10044] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Indexed: 11/23/2022] Open
Abstract
Grass pollen is a very common cause of allergic rhinitis and asthma. The only treatment targeting the underlying causes of allergy is immunotherapy (IT). Sublingual immunotherapy (SLIT) has been introduced to solve the problem of systemic reactions to subcutaneous IT (SCIT). This article evaluates the characteristics of the allergen extract, Staloral, in terms of practical administration, effectiveness, safety, and mechanism of action. Efficacy data were obtained from double-blind, placebo-controlled studies using Staloral in patients sensitized to grass pollen, while practical administration, cost-effectiveness, and mechanism of action data were provided by well designed studies. The efficacy and safety of Staloral, as demonstrated by review of published studies which used doses up to 1125 times those administered with SCIT, shows that this allergen extract has optimal characteristics for treating patients with seasonal allergies due to grass pollens. The main mechanism of action is the interaction between dendritic cells of the oral mucosa and the subsequent tolerance induced in T-cells.
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Affiliation(s)
- Franco Frati
- Medical and Scientific Department, Stallergenes, Milan, Italy
- University Department of Medical and Surgical Specialties and Public Health, Perugia, Italy
| | - Silvia Scurati
- Medical and Scientific Department, Stallergenes, Milan, Italy
| | | | | | | | | | - Francesco Marcucci
- University Department of Medical and Surgical Specialties and Public Health, Perugia, Italy
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Moore M, Tucker M, Grier T, Quinn J. Effects of summer mailing on in vivo and in vitro relative potencies of standardized timothy grass extract. Ann Allergy Asthma Immunol 2010; 104:147-51. [PMID: 20306818 DOI: 10.1016/j.anai.2009.11.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Allergen extracts can degrade when exposed to temperatures significantly beyond the optimum storage recommendation of 4 degrees C. Many allergen extracts are mailed to their final destinations throughout the year with exposure to varied environmental conditions. OBJECTIVE To evaluate the effect of summer mailing on the in vitro and in vivo potency of timothy grass extract. METHODS Standardized timothy grass extracts, 10,000 and 100,000 BAU/mL, were mailed round-trip between San Antonio, Texas, and Phoenix, Arizona, during August 2007. In-transit temperatures were recorded using a portable temperature logger. After mailing of the extracts, we performed quantitative in vitro enzyme-linked immunosorbent assay inhibition and in vivo ID50 EAL (Intradermal Dilution for 50-mm Sum of Erythema Determines Bioequivalent Allergy Units) analysis. RESULTS Measured extract exposure temperatures were greater than 20 degrees C for 11 days and 30 degrees C for 6 hours during standard mailing in weather temperatures exceeding 38 degrees C. Enzyme-linked immunosorbent assay inhibition results for the 100,000- and 10,000-BAU/mL control samples were 97,900 and 10,580 BAU/mL, respectively, and for the mailed extracts were 96,800 and 7830 BAU/mL, respectively. These measurements fell within the current Food and Drug Administration lot release limits (67%-149%) and stability limits (50%-200%) relative to the standardized reference. The ID50EAL determinations of the control vs mailed extracts were 12.98 vs. 12.28, 12.66 vs. 12.32, and 11.97 vs 11.70 for the 3 patients. These differences were not statistically significant. CONCLUSIONS Mailing of timothy grass extract produced no significant reductions in in vitro relative potencies or in vivo skin test reactivity in 3 sensitive patients.
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Affiliation(s)
- Meredith Moore
- Department of Allergy/Immunology (Wilford Hall Medical Center), San Antonio Uniformed Services Health Education Consortium, Lackland AFB, Texas 78236, USA.
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Peden D, Reed CE. Environmental and occupational allergies. J Allergy Clin Immunol 2010; 125:S150-60. [PMID: 20176257 DOI: 10.1016/j.jaci.2009.10.073] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 10/23/2009] [Accepted: 10/28/2009] [Indexed: 11/25/2022]
Abstract
Airborne allergens are the major cause of allergic rhinitis and asthma. Daily exposure comes from indoor sources, chiefly at home but occasionally at schools or offices. Seasonal exposure to outdoor allergens, pollens, and molds is another important source. Exposure to unusual substances at work causes occupational asthma, accounting for about 5% of asthma in adults. Indoor and outdoor air pollutants trigger airway inflammation and increase the severity of asthma. Diesel exhaust particles increase the production of IgE antibodies. Identification and reduction of exposure to allergens is a very important part of the management of respiratory allergic diseases. The first section of this chapter discusses domestic allergens, arthropods (mites and cockroaches), molds, and mammals (pets and mice). Indoor humidity and water damage are important factors in the production of mite and mold allergens, and discarded human food items are important sources of proliferation of cockroaches and mice. Means of identifying and reducing exposure are presented. The second section discusses outdoor allergens: pollens and molds. The particular plants or molds and the amount of exposure to these allergens is determined by the local climate, and local pollen and mold counts are available to determine the time and amount of exposure. Climate change is already having an important effect on the distribution and amount of outdoor allergens. The third section discusses indoor and outdoor air pollution and methods that individuals can take to reduce indoor pollution in addition to eliminating cigarette smoking. The fourth section discusses the diagnosis and management of occupational asthma.
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Affiliation(s)
- David Peden
- Department of Pediatrics, University of North Carolina, Chapel Hill, USA
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Frati F, Scurati S, Puccinelli P, Justicia JL, Adamec T, Sieber HJ, Ras L, David M, Marcucci F, Incorvaia C. Development of an allergen extract for sublingual immunotherapy--evaluation of Staloral. Expert Opin Biol Ther 2009; 9:1207-15. [PMID: 19601728 DOI: 10.1517/14712590903146869] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Specific immunotherapy (IT) is an effective treatment for rhinitis and asthma caused by aeroallergens sensitization. Sublingual IT (SLIT) was introduced to solve the problem of systemic reactions to subcutaneous IT (SCIT) and developed to represent an actual treatment option. It is now generally accepted that allergen doses much higher than those administered by SCIT must be used to achieve clinical efficacy on allergic symptoms. OBJECTIVE To evaluate the characteristics of Staloral, an allergen extract produced by Stallergenes (Antony, France) in terms of practical administration, efficacy, safety and mechanism of action. METHODS Data were obtained from 20 double-blind, placebo-controlled studies using Staloral in patients sensitized to pollens and house-dust mites, and also from open studies concerning practical administration and the mechanism of action. RESULTS/CONCLUSION Efficacy and safety of Staloral, as demonstrated by the revision of the studies, which used doses up to 1125 times those administered with SCIT, are very satisfactory and confer to this allergen extract optimal characteristics for treating patients with seasonal allergies due to pollens or with perennial symptoms induced by dust mites. The main mechanism of action is the interaction with dendritic cells of the oral mucosa and the subsequent tolerance induced in T cells.
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Affiliation(s)
- Franco Frati
- Scientific and Medical Department, Stallergenes Italia, Milan, Italy.
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Ballmer-Weber B, Fernández-Rivas M. Food allergy: A clinician’s criteria for including sera in a serum bank. Food Chem Toxicol 2008; 46 Suppl 10:S2-5. [DOI: 10.1016/j.fct.2008.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Chapman MD, Ferreira F, Villalba M, Cromwell O, Bryan D, Becker WM, Fernández-Rivas M, Durham S, Vieths S, van Ree R. The European Union CREATE project: a model for international standardization of allergy diagnostics and vaccines. J Allergy Clin Immunol 2008; 122:882-889.e2. [PMID: 18762328 DOI: 10.1016/j.jaci.2008.07.030] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Revised: 06/30/2008] [Accepted: 07/08/2008] [Indexed: 01/23/2023]
Abstract
Allergen measurements are used extensively in the formulation of allergy diagnostics and vaccines, yet no purified international allergen standards are available for calibration purposes. The aims of the European Union CREATE project were to develop international standards with verifiable allergen content. Purified natural and recombinant allergens were analyzed by means of SDS-PAGE, mass spectrometry, circular dichroism spectra, and small-angle x-ray scattering. IgE reactivity was assessed by means of direct RAST, RAST inhibition, immunoblotting, and basophil histamine release with sera from 961 allergic patients. Three recombinant allergens, rBet v 1, rPhl p 5a, and rDer p 2, were structurally indistinguishable from their natural counterparts and showed excellent IgE reactivity suitable for use as certified reference materials. A second tier of allergens (rPhl p 5b, rOle e1, rDer p 1, rDer f 1, and rDer f 2) was identified that could provide suitable candidates for certified reference materials with minor improvements to the recombinant proteins. Only rPhl p 1 was considered unsuitable as a reference material. Quantitative ELISAs were identified that accurately measured each allergen, except for rPhl p 1. The CREATE project has provided a major step forward in allergen standardization and provides a model for the development of a comprehensive panel of international reference preparations that will harmonize allergen measurements worldwide.
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Gavrović-Jankulović M, Spasić M, Ćirković Veličković T, Stojanović M, Inić-Kanada A, Dimitrijević L, Lindner B, Petersen A, Becker WM, Jankov RM. Quantification of the thaumatin-like kiwi allergen by a monoclonal antibody-based ELISA. Mol Nutr Food Res 2008; 52:701-7. [DOI: 10.1002/mnfr.200700286] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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