1
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Sasamoto K, Nagakura KI, Asaumi T, Fusayasu N, Ohashi-Doi K, Yanagida N, Sato S, Ebisawa M. Efficacy and safety of sublingual immunotherapy using house dust mite tablet for 1-4 years old children with perennial allergic rhinitis. Pediatr Allergy Immunol 2024; 35:e14203. [PMID: 39045695 DOI: 10.1111/pai.14203] [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: 03/20/2024] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) for perennial allergic rhinitis (AR) has not been extensively studied in preschoolers. We investigated the efficacy and safety of house dust mite (HDM) SLIT-tablet for children aged 1-4 years. METHODS Children aged 1-4 years with AR were divided into SLIT (n = 22) and control (n = 12) groups based on their guardians' preferences. The SLIT group received a daily dose of 10,000 JAU of HDM SLIT-tablet for 12 months, whereas the control group received symptomatic treatment only. RESULTS The baseline median age was 41 and 34 months in the SLIT and control groups, respectively, and the median AR symptom score was 4 for both groups. Compared with baseline, the AR symptom score had decreased significantly in the SLIT group after 12 months (score: 3, p = .002), whereas it tended to increase in the control group (score: 6, p = .08). Adverse reactions to SLIT were mild and occurred in eight patients (36%). In the SLIT group, Dermatophagoides (D.) farinae-specific IgE (sIgE) levels increased during the first 6 months and decreased to baseline levels at 12 months. In the control group, D. farinae-sIgE levels had increased significantly at 12 months compared to baseline (p = .01). D. farinae-specific IgG4 and HDM IgE-blocking factor levels were significantly increased at 12 months compared to baseline in the SLIT group only (p < .001). A lower wheezing frequency was seen in the SLIT group (0.3%) compared to the control group (0.7%). CONCLUSION This pilot study demonstrated the efficacy, safety, and immunomodulatory effects of HDM SLIT-tablet in preschoolers with AR.
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Affiliation(s)
- Koki Sasamoto
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Minami-ku Sagamihara, Japan
- Department of Pediatrics, Toho University Ohashi Medical Center, Meguro-ku, Japan
| | - Ken-Ichi Nagakura
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Minami-ku Sagamihara, Japan
| | - Tomoyuki Asaumi
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Minami-ku Sagamihara, Japan
| | - Naoko Fusayasu
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Minami-ku Sagamihara, Japan
| | | | - Noriyuki Yanagida
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Minami-ku Sagamihara, Japan
| | - Sakura Sato
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Minami-ku Sagamihara, Japan
| | - Motohiro Ebisawa
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Minami-ku Sagamihara, Japan
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2
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Larenas Linnemann D, Luna Pech JA. House dust mite liquid SLIT effective in atopic dermatitis even with suboptimal dosing. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:1936-1937. [PMID: 35809996 DOI: 10.1016/j.jaip.2022.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Affiliation(s)
| | - Jorge A Luna Pech
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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3
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Demoly P, Bos C, Vidal C. Worsening of chronic house-dust-mite-induced respiratory allergies: An observational survey in three European countries. World Allergy Organ J 2021; 14:100563. [PMID: 34306302 PMCID: PMC8271175 DOI: 10.1016/j.waojou.2021.100563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 05/25/2021] [Accepted: 06/16/2021] [Indexed: 11/06/2022] Open
Abstract
Background Although respiratory allergies to house dust mites (HDMs) can often be controlled with symptomatic medications, some patients do not achieve satisfactory disease control. Objective To assess fortnightly fluctuations (notably worsening and/or exacerbations) in disease parameters among patients taking only symptomatic medications for HDM allergy. Methods In a 13-month, observational, multicenter survey of adults with a self-reported history of poorly controlled, moderate-to-severe, physician-diagnosed HDM respiratory allergy in France, Italy, and Spain, fortnightly telephone interviews were used to gather information on medication use, symptoms, the disease burden, and medical consultations from late May 2012 to early July 2013. Results A total of 313 patients completed the study (n = 114 in Italy, 92 in France, and 107 in Spain). Although most participants reported improvements in symptoms, a substantial minority (ranging from 12% to 44% per fortnightly telephone interview in 2012 and from 16% to 37% in 2013) complained of worsening. A few study participants did not improve at any time in the study: 4% overall, and 2%, 2%, and 7% in Italy, France and Spain, respectively. A change in the weather and/or contact with other allergens were the most frequent self-reported reasons for worsening, although the answer “I don't know” was also prominent. Conclusion In a 13-month survey of patients with HDM allergy in Italy, France, and Spain, the participants’ symptom status fluctuated significantly — illustrating the complexity of this condition. Although most participants reported improvements, the “never-improver” profile warrants further investigation. More prominence could be given to symptom control and a low exacerbation risk as treatment goals in allergic rhinitis.
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Affiliation(s)
- Pascal Demoly
- Allergy Division, Pulmonology Department, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France.,Sorbonne Université, UMR-S 1136 INSERM, IPLESP, Equipe EPAR, Paris, France
| | | | - Carmen Vidal
- Allergy Service, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
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4
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Mas S, Badran AA, Juárez MJ, Fernández de Rojas DH, Morais S, Maquieira Á. Highly sensitive optoelectrical biosensor for multiplex allergy diagnosis. Biosens Bioelectron 2020; 166:112438. [DOI: 10.1016/j.bios.2020.112438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 01/24/2023]
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5
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Alvaro-Lozano M, Akdis CA, Akdis M, Alviani C, Angier E, Arasi S, Arzt-Gradwohl L, Barber D, Bazire R, Cavkaytar O, Comberiati P, Dramburg S, Durham SR, Eifan AO, Forchert L, Halken S, Kirtland M, Kucuksezer UC, Layhadi JA, Matricardi PM, Muraro A, Ozdemir C, Pajno GB, Pfaar O, Potapova E, Riggioni C, Roberts G, Rodríguez Del Río P, Shamji MH, Sturm GJ, Vazquez-Ortiz M. EAACI Allergen Immunotherapy User's Guide. Pediatr Allergy Immunol 2020; 31 Suppl 25:1-101. [PMID: 32436290 PMCID: PMC7317851 DOI: 10.1111/pai.13189] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Allergen immunotherapy is a cornerstone in the treatment of allergic children. The clinical efficiency relies on a well-defined immunologic mechanism promoting regulatory T cells and downplaying the immune response induced by allergens. Clinical indications have been well documented for respiratory allergy in the presence of rhinitis and/or allergic asthma, to pollens and dust mites. Patients who have had an anaphylactic reaction to hymenoptera venom are also good candidates for allergen immunotherapy. Administration of allergen is currently mostly either by subcutaneous injections or by sublingual administration. Both methods have been extensively studied and have pros and cons. Specifically in children, the choice of the method of administration according to the patient's profile is important. Although allergen immunotherapy is widely used, there is a need for improvement. More particularly, biomarkers for prediction of the success of the treatments are needed. The strength and efficiency of the immune response may also be boosted by the use of better adjuvants. Finally, novel formulations might be more efficient and might improve the patient's adherence to the treatment. This user's guide reviews current knowledge and aims to provide clinical guidance to healthcare professionals taking care of children undergoing allergen immunotherapy.
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Affiliation(s)
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Cherry Alviani
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, UK.,Clinical and Experimental Sciences and Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Elisabeth Angier
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Stefania Arasi
- Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children's research Hospital (IRCCS), Rome, Italy
| | - Lisa Arzt-Gradwohl
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Domingo Barber
- School of Medicine, Institute for Applied Molecular Medicine (IMMA), Universidad CEU San Pablo, Madrid, Spain.,RETIC ARADYAL RD16/0006/0015, Instituto de Salud Carlos III, Madrid, Spain
| | - Raphaëlle Bazire
- Allergy Department, Hospital Infantil Niño Jesús, ARADyAL RD16/0006/0026, Madrid, Spain
| | - Ozlem Cavkaytar
- Department of Paediatric Allergy and Immunology, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Pasquale Comberiati
- Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Stephanie Dramburg
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany
| | - Stephen R Durham
- Immunomodulation and Tolerance Group; Allergy and Clinical Immunology, Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.,the MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Aarif O Eifan
- Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London and Royal Brompton Hospitals NHS Foundation Trust, London, UK
| | - Leandra Forchert
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Max Kirtland
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK
| | - Umut C Kucuksezer
- Aziz Sancar Institute of Experimental Medicine, Department of Immunology, Istanbul University, Istanbul, Turkey
| | - Janice A Layhadi
- Immunomodulation and Tolerance Group; Allergy and Clinical Immunology, Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.,the MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK.,Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development, National Heart and Lung Institute, Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK
| | - Paolo Maria Matricardi
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany
| | - Antonella Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Women and Child Health, University of Padua, Padua, Italy
| | - Cevdet Ozdemir
- Institute of Child Health, Department of Pediatric Basic Sciences, Istanbul University, Istanbul, Turkey.,Faculty of Medicine, Department of Pediatrics, Division of Pediatric Allergy and Immunology, Istanbul University, Istanbul, Turkey
| | | | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
| | - Ekaterina Potapova
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Medical University, Berlin, Germany
| | - Carmen Riggioni
- Pediatric Allergy and Clinical Immunology Service, Institut de Reserca Sant Joan de Deú, Barcelona, Spain
| | - Graham Roberts
- The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, UK.,NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Paediatric Allergy and Respiratory Medicine (MP803), Clinical & Experimental Sciences & Human Development in Health Academic Units University of Southampton Faculty of Medicine & University Hospital Southampton, Southampton, UK
| | | | - Mohamed H Shamji
- Immunomodulation and Tolerance Group; Allergy and Clinical Immunology, Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.,the MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Gunter J Sturm
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
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6
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Meng Y, Wang C, Zhang L. Recent developments and highlights in allergic rhinitis. Allergy 2019; 74:2320-2328. [PMID: 31571226 DOI: 10.1111/all.14067] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 12/16/2022]
Abstract
Allergic rhinitis (AR) is a disease with high prevalence all over the world and therefore needs to be thoroughly investigated and treated accordingly. The mechanisms underlying the pathology and treatment of AR have been widely studied, but many aspects remain unclear and warrant further investigations. This review presents an overview of recently published papers highlighting the risk factors, mechanisms, and treatment of AR. Additionally, recent studies discussing the role of single nucleotide polymorphism, DNA methylation, regulatory B cells, group 2 innate lymphoid cells, immunotherapy, and biologics in AR are also covered.
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Affiliation(s)
- Yifan Meng
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Capital Medical University Beijing China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Capital Medical University Beijing China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Capital Medical University Beijing China
- Beijing Key Laboratory of Nasal Diseases Beijing Institute of Otolaryngology Beijing China
- Department of Allergy Beijing TongRen Hospital Capital Medical University Beijing China
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7
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Komlósi ZI, Kovács N, Sokolowska M, van de Veen W, Akdis M, Akdis CA. Highlights of Novel Vaccination Strategies in Allergen Immunotherapy. Immunol Allergy Clin North Am 2019; 40:15-24. [PMID: 31761116 DOI: 10.1016/j.iac.2019.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Increasing safety while maintaining or even augmenting efficiency are the main goals of research for novel vaccine development and improvement of treatment schemes in allergen immunotherapy (AIT). To increase the efficacy of AIT, allergens have been coupled to innate immunostimulatory substances and new adjuvants have been introduced. Allergens have been modified to increase their uptake and presentation. Hypoallergenic molecules have been developed to improve the safety profile of the vaccines. Administration of recombinant IgG4 antibodies is a new, quick, passive immunization strategy with remarkable efficiency. Results of some current investigations aiming at further improvement of AIT vaccines have been summarized.
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Affiliation(s)
- Zsolt István Komlósi
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Nagyvárad Sqr. 4, Budapest 1089, Hungary.
| | - Nóra Kovács
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Nagyvárad Sqr. 4, Budapest 1089, Hungary; Lung Health Hospital, Munkácsy Mihály Str. 70, Törökbálint 2045, Hungary
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), Hermann-Burchard Strasse 9, Davos Wolfgang CH7265, Switzerland; Christine Kühne - Center for Allergy Research and Education, Hermann-Burchard Strasse 1, Davos Wolfgang CH7265, Switzerland
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), Hermann-Burchard Strasse 9, Davos Wolfgang CH7265, Switzerland; Christine Kühne - Center for Allergy Research and Education, Hermann-Burchard Strasse 1, Davos Wolfgang CH7265, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Hermann-Burchard Strasse 9, Davos Wolfgang CH7265, Switzerland; Christine Kühne - Center for Allergy Research and Education, Hermann-Burchard Strasse 1, Davos Wolfgang CH7265, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Hermann-Burchard Strasse 9, Davos Wolfgang CH7265, Switzerland; Christine Kühne - Center for Allergy Research and Education, Hermann-Burchard Strasse 1, Davos Wolfgang CH7265, Switzerland
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Dias ASO, Santos ICL, Delphim L, Fernandes G, Endlich LR, Cafasso MOSD, Maranhão AL, da Silva SR, Andrade RM, Agrawal A, Linhares UC, Bento CAM. Serum leptin levels correlate negatively with the capacity of vitamin D to modulate the in vitro cytokines production by CD4 + T cells in asthmatic patients. Clin Immunol 2019; 205:93-105. [PMID: 31173888 DOI: 10.1016/j.clim.2019.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/25/2019] [Accepted: 06/03/2019] [Indexed: 12/14/2022]
Abstract
Both obesity and low vitamin D levels have been associated with allergic asthma (AA) severity. In the present study, severity of AA was associated with obesity but to the in vitro IgE production. In those patients, higher levels of IL-5, IL-6 and IL-17 were quantified in CD4+ T-cell cultures as compared with patients with mild and moderate AA. In addition, the lowest IL-10 levels were detected in the cell cultures from patients with a worse prognosis. Interestingly, the occurrence of AA elevates the plasma levels of leptin, and this adipokine was positively correlated with the release of IL-5, IL-6 and IL-17, but inversely correlated with IL-10 production, by CD4+ T-cells from patients. In AA-derived CD4+ T-cell cultures, 1,25(OH)2D3 was less efficient at inhibiting IL-5, IL-6 and IL-17 production, and up regulating IL-10 release, as those from healthy subjects. Interestingly, the in vitro immunomodulatory effects of vitamin D were inversely correlated with serum leptin levels. In summary, our findings suggested that obesity, probably due to the overproduction of leptin, negatively impacts AA as it favors imbalance between Th2/Th17 and regulatory phenotypes. The deleterious effects of leptin may also be due to its ability to counter-regulate the immunosuppressive effects of vitamin D.
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Affiliation(s)
- Aleida S O Dias
- Department of Microbiology and Parasitology, Federal University of the State of Rio de Janeiro, Brazil; Post-graduate Program in Microbiology, University of the State of Rio de Janeiro, Brazil
| | - Isabelle C L Santos
- Department of Microbiology and Parasitology, Federal University of the State of Rio de Janeiro, Brazil
| | - Letícia Delphim
- Department of Microbiology and Parasitology, Federal University of the State of Rio de Janeiro, Brazil
| | - Gabriel Fernandes
- Department of Microbiology and Parasitology, Federal University of the State of Rio de Janeiro, Brazil
| | - Larissa R Endlich
- Department of Microbiology and Parasitology, Federal University of the State of Rio de Janeiro, Brazil
| | | | - Ana Lúcia Maranhão
- Pulmonology Service, Federal University of the State of Rio de Janeiro, Brazil
| | | | - Regis M Andrade
- Department of General Medicine Department, Federal University of the State of Rio de Janeiro, Brazil
| | - Anshu Agrawal
- Department of Medicine, University of California, Irvine, CA, USA
| | - Ulisses C Linhares
- Department of Morphological Sciences, Federal University of the State of Rio de Janeiro, Brazil
| | - Cleonice A M Bento
- Department of Microbiology and Parasitology, Federal University of the State of Rio de Janeiro, Brazil; Post-graduate Program in Microbiology, University of the State of Rio de Janeiro, Brazil.
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Ponce M, Schroeder F, Bannert C, Schmidthaler K, Hansen CS, Lindholm Bøgh K, Soldo R, Tsui SK, Weinhäusel A, Szépfalusi Z, Eiwegger T. Preventive sublingual immunotherapy with House Dust Mite extract modulates epitope diversity in pre-school children. Allergy 2019; 74:780-787. [PMID: 30394551 DOI: 10.1111/all.13658] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/23/2018] [Accepted: 10/10/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The preventive effect of allergen immunotherapy (AIT) on allergy and asthma development is currently assessed using primary and secondary AIT approaches. Knowledge of the immunological effects of these interventions is limited and the impact on epitope diversity remains to be defined. METHODS We used high-density peptide arrays that included all known Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f) allergens and the whole proteome of Der f to study changes in House Dust Mite (HDM) linear peptide recognition during a 2-year preventive double-blind placebo-controlled sublingual HDM AIT pilot study in 2-5-year-old children with sensitization to HDM but without symptoms. RESULTS Preventive AIT-treated patients showed significantly higher IgG epitope diversity to HDM allergens compared to placebo-treated individuals at 24 months of treatment (P < 0.05), while no increase in IgE diversity was seen. At 24 months of treatment, IgG4 diversity for HDM allergens was significantly higher in the pAIT-treated patients compared to placebo group (P < 0.05). Potentially beneficial changes in epitope recognition throughout the treatment are also seen in peptides derived from Der f proteome. CONCLUSION These data suggest a beneficial immunomodulation of preventive sublingual immunotherapy at a molecular level by favoring a broader blocking repertoire and inhibiting epitope spreading.
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Affiliation(s)
- Marta Ponce
- Department of Paediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Fabian Schroeder
- Competence Unit for Molecular Diagnostics AIT, Austrian Institute of Technology Vienna Austria
| | - Christina Bannert
- Department of Paediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Klara Schmidthaler
- Department of Paediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | | | | | - Regina Soldo
- Competence Unit for Molecular Diagnostics AIT, Austrian Institute of Technology Vienna Austria
| | - Stephen Kwok‐Wing Tsui
- Hong Kong Bioinformatics Centre Chinese University of Hong Kong Hong Kong China
- School of Biomedical Sciences Chinese University of Hong Kong Hong Kong China
| | - Andreas Weinhäusel
- Competence Unit for Molecular Diagnostics AIT, Austrian Institute of Technology Vienna Austria
| | - Zsolt Szépfalusi
- Department of Paediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
| | - Thomas Eiwegger
- Department of Paediatrics and Adolescent Medicine Medical University of Vienna Vienna Austria
- Program in Translational Medicine The Hospital for Sick Children Toronto Ontario Canada
- Department of Immunology The University of Toronto Toronto Ontario Canada
- Division of Immunology and Allergy Food allergy and Anaphylaxis Program The Department of Paediatrics The Hospital for Sick Children Toronto Ontario Canada
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10
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Biedermann T, Kuna P, Panzner P, Valovirta E, Andersson M, de Blay F, Thrane D, Jacobsen SH, Stage BS, Winther L. The SQ tree SLIT-tablet is highly effective and well tolerated: Results from a randomized, double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol 2019; 143:1058-1066.e6. [PMID: 30654054 DOI: 10.1016/j.jaci.2018.12.1001] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/08/2018] [Accepted: 12/07/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND The SQ tree sublingual immunotherapy (SLIT)-tablet (ALK-Abelló, Hørsholm, Denmark) is developed for treatment of tree pollen-induced allergic rhinoconjunctivitis (ARC). OBJECTIVE The aim of this pivotal phase III trial was to demonstrate the efficacy and safety of the SQ tree SLIT-tablet. METHODS This was a randomized, double-blind, placebo-controlled trial with 634 subjects (12-65 years) with moderate-to-severe ARC despite use of symptom-relieving medication. Eligible subjects were randomized 1:1 to active or placebo treatment. The primary end point was the average daily ARC total combined score (TCS) during the birch pollen season (BPS) analyzed for subjects with diary data during the BPS. Secondary end points included average daily symptom scores (DSS) during the BPS, average TCS and DSS during the tree pollen season (TPS), and average daily medication scores (DMS) in the BPS and TPS. RESULTS The primary and key secondary end points demonstrated statistically significant and clinically relevant effects of the SQ tree SLIT-tablet compared with placebo. For the BPS, absolute (relative) differences from placebo were 3.02 (40%) for TCS, 1.32 (37%) for DSS, and 1.58 (49%) for DMS (all P < .0001). For the TPS, absolute (relative) differences from placebo were 2.27 (37%) for TCS, 0.99 (33%) for DSS, and 1.20 (47%) for DMS (all P < .0001). Treatment was well tolerated. The most frequently reported treatment-related adverse events were mild or moderate local reactions related to sublingual administration. CONCLUSION The trial demonstrated the efficacy and safety of the SQ tree SLIT-tablet compared with placebo during the BPS and TPS in adolescents and adults with birch pollen-induced ARC (EudraCT 2015-004821-15).
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Affiliation(s)
- Tilo Biedermann
- Department of Dermatology and Allergology, Technical University of Munich, Munich, Germany.
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Petr Panzner
- Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Erkka Valovirta
- Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland; Terveystalo Allergy Clinic, Turku, Finland
| | - Morgan Andersson
- Department of Otorhinolaryngology, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden
| | - Frederic de Blay
- Federation of Translational Medicine Chest Disease Department, University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Dorthe Thrane
- Global Clinical Development, ALK-Abelló, Hørsholm, Denmark
| | | | | | - Lone Winther
- Allergy Clinic, Department of Dermato-Allergology, Gentofte Hospital, Copenhagen, Denmark
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11
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Reitsma S, Subramaniam S, Fokkens WWJ, Wang DY. Recent developments and highlights in rhinitis and allergen immunotherapy. Allergy 2018; 73:2306-2313. [PMID: 30260494 DOI: 10.1111/all.13617] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 09/09/2018] [Accepted: 09/14/2018] [Indexed: 02/06/2023]
Abstract
This review paper aims to provide an overview of recent developments in the field of allergic and non-allergic rhinitis, as well as allergen immunotherapy. Recent advances in phenotyping and endotyping various forms of rhinitis have brought us one step closer towards tailoring treatment more appropriately for a given patient. Updates on local allergic rhinitis are also covered. Allergen immunotherapy (AIT) is an area of significant interest, with multiple original papers and recent position papers and guidelines published. Evidence related to the application of AIT in seasonal and perennial allergic rhinitis (AR), local allergic rhinitis and novel and expanded applications is discussed in the publication.
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Affiliation(s)
- Sietze Reitsma
- Department of Otorhinolaryngology; Amsterdam UMC; University of Amsterdam; Amsterdam The Netherlands
| | - Soma Subramaniam
- Department of Otolaryngology; Ng Teng Fong General Hospital; Singapore Singapore
| | - Wytske W. J. Fokkens
- Department of Otorhinolaryngology; Amsterdam UMC; University of Amsterdam; Amsterdam The Netherlands
| | - De Yun Wang
- Department of Otolaryngology; National University of Singapore; Singapore Singapore
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Bousquet J, Akdis CA, Grattan C, Eigenmann PA, Hoffmann-Sommergruber K, Hellings PW, Agache I. Highlights and recent developments in airway diseases in EAACI journals (2017). Clin Transl Allergy 2018; 8:49. [PMID: 30498567 PMCID: PMC6258432 DOI: 10.1186/s13601-018-0238-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/16/2018] [Indexed: 12/21/2022] Open
Abstract
The European Academy of Allergy and Clinical Immunology (EAACI) owns three journals: Allergy, Pediatric Allergy and Immunology and Clinical and Translational Allergy. One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. There was substantial progress in 2017 in the identification of basic mechanisms of allergic and respiratory disease and the translation of these mechanisms into clinics. Better understanding of molecular and cellular mechanisms, efforts for the development of biomarkers for disease prediction, novel prevention and intervention studies, elucidation of mechanisms of multimorbidies, entrance of new drugs in the clinics as well as recently completed phase three clinical studies and publication of a large number of allergen immunotherapy studies and metaanalyses have been the highlights of the last year.
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Affiliation(s)
- J Bousquet
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.,INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.,3UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Euforea, Brussels, Belgium.,CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - C A Akdis
- 5Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - C Grattan
- 6St John's Institute of Dermatology, Guy's Hospital, London, UK
| | - P A Eigenmann
- 7Pediatric Allergy Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - K Hoffmann-Sommergruber
- 8Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - P W Hellings
- Euforea, Brussels, Belgium.,9Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - I Agache
- 10Transylvania University Brasov, Brasov, Romania
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Shamji MH, Durham SR. Mechanisms of allergen immunotherapy for inhaled allergens and predictive biomarkers. J Allergy Clin Immunol 2017; 140:1485-1498. [PMID: 29221580 DOI: 10.1016/j.jaci.2017.10.010] [Citation(s) in RCA: 281] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/25/2017] [Accepted: 10/25/2017] [Indexed: 12/18/2022]
Abstract
Allergen immunotherapy is effective in patients with IgE-dependent allergic rhinitis and asthma. When immunotherapy is given continuously for 3 years, there is persistent clinical benefit for several years after its discontinuation. This disease-modifying effect is both antigen-specific and antigen-driven. Clinical improvement is accompanied by decreases in numbers of effector cells in target organs, including mast cells, basophils, eosinophils, and type 2 innate lymphoid cells. Immunotherapy results in the production of blocking IgG/IgG4 antibodies that can inhibit IgE-dependent activation mediated through both high-affinity IgE receptors (FcεRI) on mast cells and basophils and low-affinity IgE receptors (FcεRII) on B cells. Suppression of TH2 immunity can occur as a consequence of either deletion or anergy of antigen-specific T cells; induction of antigen-specific regulatory T cells; or immune deviation in favor of TH1 responses. It is not clear whether the altered long-term memory resides within the T-cell or the B-cell compartment. Recent data highlight the role of IL-10-producing regulatory B cells and "protective" antibodies that likely contribute to long-term tolerance. Understanding mechanisms underlying induction and persistence of tolerance should identify predictive biomarkers of clinical response and discover novel and more effective strategies for immunotherapy.
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Affiliation(s)
- Mohamed H Shamji
- Immunomodulation and Tolerance Group; Allergy and Clinical Immunology; Section of Inflammation, Repair and Development; National Heart and Lung Institute; Imperial College London, and the MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Stephen R Durham
- Immunomodulation and Tolerance Group; Allergy and Clinical Immunology; Section of Inflammation, Repair and Development; National Heart and Lung Institute; Imperial College London, and the MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
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