Allergen immunotherapy for asthma prevention: A systematic review and meta‐analysis of randomized and non‐randomized controlled studies

Farraia, Mariana; Paciência, Inês; Mendes, Francisca de Castro; Rufo, João Cavaleiro; Shamji, Mohamed H.; Agache, Ioana; Moreira, André

doi:10.1111/all.15295

Cited by 39 publications

(39 citation statements)

References 48 publications

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“…A recent meta-analysis suggested a preventive effect of allergen immunotherapy in asthma development, confirming the association found in previous studies. 2 The application of AIT in inhalant allergies is recommended by international medical organizations both for its efficacy and safety. 3–7 While AIT is highly appraised, a discussion continues concerning further optimization of both its efficacy and safety, including its immediate and remote effects.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of molecular profiling of allergen-antibody responses in HDM-immunotherapy patients

Nittner-Marszalska

Kopeć

Foks-Ciekalska

et al. 2022

Human Vaccines & Immunotherapeutics

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Among the potential hazards of HDM immunotherapy (AIT) with HDM allergenic extracts is the possible initiation of de novosensitizations caused by a lack of complementarity between a given HDM vaccine’s content and a patient’s molecular sensitization profile. To investigate whether immunotherapy with HDM extracts affects changes in the profile of sensitizations to allergens contained in the extract and whether neosensitizations occur. Serum samples from patients with HDM allergies (N=63) who received 1 year of treatment with subcutaneous AIT were tested for allergen-specific IgE (sIgE) reactivity to 7 microarrayed HDM allergen molecules (Der p 1, 2,10,11,23; D far 1 and 2) with ImmunoCAP. The HDM non-AIT patients (N=22) who did not receive immunotherapy constituted the study’s control group. The obtained data were analysed at baseline and after 6 and 12 months. In the HDM-AIT group, no neosensitizations after 6 and 12 months of immunotherapy were reported. Conversely, in the HDM non-AIT group, only neosensitizations to Der p 10 were observed. In the study group, sIgE levels against the HDM extract of D . pteronyssinus, D . farinae, rDer p 1, rDer p 2 and Der f 2 decreased after 12 months of AIT ( p < .05). SIgE levels against Der f 1, Der p 10, 11 and 23 remained unchanged in the course of 12 months of immunotherapy. In patients with allergic rhinitis with or without concomitant HDM-induced asthma treated with HDM AIT for 12 months, no neosensitizations related to the examined HDM molecules were observed.

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Section: Introductionmentioning

confidence: 99%

Monitoring of molecular profiling of allergen-antibody responses in HDM-immunotherapy patients

Nittner-Marszalska

Kopeć

Foks-Ciekalska

et al. 2022

Human Vaccines & Immunotherapeutics

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“…AR had been identified to be a crucial risk factor of asthma in many studies [ 34 , 35 ]. There was also evidence suggesting that early intervention of AR such as allergen immunotherapy precluded the development of asthma [ 36 , 37 , 38 , 39 ]. Raised awareness of asthma will push AR patients to take more actions to avoid developing asthma.…”

Section: Discussionmentioning

confidence: 99%

A Questionnaire Survey on the Prevalence and Parents’ Perceptions of Respiratory Allergies in a 3- to 16-Year-Old Population in Wuhan, China

Guo

Wang

Chen

et al. 2022

JCM

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(1) Background: The prevalence of allergic rhinitis (AR) and asthma has increased rapidly in China. However, perceptions of respiratory allergies and barriers to their management have not attracted enough attention. (2) Objective: To investigate the prevalence of, parents’ perceptions of and their unmet needs for information concerning respiratory allergies in a 3- to 16-year-old children population. (3) Methods: A cross-sectional survey was conducted from June to July 2021 in three schools in Wuhan, China. A total of 1963 participants were recruited through cluster sampling for their parents to complete an online questionnaire regarding respiratory allergic symptoms. The diagnosis of respiratory allergies was based on self-reported symptoms and face-to-face physician evaluation. All the participants with respiratory allergies were asked to complete the Brief Illness Perception Questionnaire (B-IPQ), the Asthma Knowledge Questionnaire (AKQ) and a questionnaire regarding their unmet needs for disease management. (4) Results: The prevalence of respiratory allergies was 29.3% (576/1963) in the 3- to 16-year-old population, among whom AR accounted for 25.7%; asthma, 1.8% and AR-complicated asthma (AR&Asthma), 1.9%. The total B-IPQ score was 40.2 ± 10.9 in the participants with respiratory allergies, and there were no differences among the AR, asthma and AR&Asthma groups (all p > 0.05). The B-IPQ score correlated significantly with symptom onset time and a history of atopic dermatitis (p < 0.01). Nearly one fifth, 18.9%, of the participants with respiratory allergies never went to hospital for treatment, but those with higher B-IPQ scores were more likely to seek professional treatment (p < 0.001). The accuracy rates of AKQ were 72.5% in the participants with asthma and 76.7% in those without asthma (p = 0.147). Among the 576 participants with respiratory allergies, 568 (98.6%) had tried to obtain disease-management information from online platforms, and 55.5% (315/568) were dissatisfied with current platforms; the reasons included incomprehensive contents of illness (45.7%), lack of voice from leading experts (40.3%), too many advertisements (37.5%) and similar contents on different platforms (36.8%). (5) Conclusions: The prevalence of respiratory allergies is high in the 3- to 16-years old population in Wuhan, China. Yet the parents’ perceptions of respiratory allergies and knowledge of asthma are insufficient. It is crucial to increase parents’ awareness of the illness and facilitate their access to truly informative and professional platforms.

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“…This result suggested that AITs may be effective for allergic diseases because of the conversion of allergen-specific effector Th2 cells into tolerance-inducing Tr1 cells by repeated allergen administrations. Indeed, many studies [reviewed in ( 10 , 87 )] have demonstrated that AIT can be effective for various allergic diseases, and the frequency of allergen-specific Tr1 cells was correlated with the decrease in clinical scores ( 79 – 82 ). Taken together, these studies suggested that Tr1 cells play a critical role in the induction of immunotolerance to allergens in humans.…”

Section: Clinical Relevance Of Tr1 Cells In Allergy and Aitmentioning

confidence: 99%

Roles of type 1 regulatory T (Tr1) cells in allergen-specific immunotherapy

et al. 2022

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Allergen-specific immunotherapy (AIT) is the only causative treatment for allergic diseases by modification of the immune response to allergens. A key feature of AIT is to induce immunotolerance to allergens by generating antigen-specific regulatory T (Treg) cells in allergic patients. Type 1 regulatory T (Tr1) cells and forkhead box protein 3 (Foxp3)-expressing Treg cells are well known among Treg cell subsets. Foxp3 was identified as a master transcription factor of Treg cells, and its expression is necessary for their suppressive activity. In contrast to Foxp3+ Treg cells, the master transcription factor of Tr1 cells has not been elucidated. Nevertheless, Tr1 cells are generally considered as a distinct subset of Treg cells induced in the periphery during antigen exposure in tolerogenic conditions and can produce large amounts of anti-inflammatory cytokines such as interleukin-10 and transforming growth factor-β, followed by down-regulation of the function of effector immune cells independently of Foxp3 expression. Since the discovery of Tr1 cells more than 20 years ago, research on Tr1 cells has expanded our understanding of the mechanism of AIT. Although the direct precursors and true identity of these cells continues to be disputed, we and others have demonstrated that Tr1 cells are induced in the periphery by AIT, and the induced cells are re-activated by antigens, followed by suppression of allergic symptoms. In this review, we discuss the immune mechanisms for the induction of Tr1 cells by AIT and the immune-suppressive roles of Tr1 cells in AIT.

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Allergen immunotherapy for asthma prevention: A systematic review and meta‐analysis of randomized and non‐randomized controlled studies

Cited by 39 publications

References 48 publications

Monitoring of molecular profiling of allergen-antibody responses in HDM-immunotherapy patients

Monitoring of molecular profiling of allergen-antibody responses in HDM-immunotherapy patients

A Questionnaire Survey on the Prevalence and Parents’ Perceptions of Respiratory Allergies in a 3- to 16-Year-Old Population in Wuhan, China

Roles of type 1 regulatory T (Tr1) cells in allergen-specific immunotherapy

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