Allergens and Adjuvants in Allergen Immunotherapy for Immune Activation, Tolerance, and Resilience

Jensen‐Jarolim, Erika; Roth‐Walter, Franziska; Jordakieva, Galateja; Pali‐Schöll, Isabella

doi:10.1016/j.jaip.2020.12.008

Cited by 36 publications

(38 citation statements)

References 81 publications

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“…A novel approach to ameliorate allergy symptoms was introduced harnessing the potential of targeted micronutrition. Immune resilience, as a phenomenon of activation of innate immune mechanisms, may be key here and help explain the allergen unspecific nature of this approach [3,4,6,35]. This novel scientific concept has been translated into a Food for Special Medical Purpose (FSMP)-available throughout German and Austrian pharmacies ("over the counter") addressing those allergy sufferers who never reach an allergy centre, or are not suited/unwilling to undergo AIT [20].…”

Section: Discussionmentioning

confidence: 99%

Long-term benefits of targeted micronutrition with the holoBLG lozenge in house dust mite allergic patients

Bergmann

Raab²,

Krause

et al. 2022

Allergo J Int

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Summary Purpose The long-term effects of targeted micronutrition with the holoBLG lozenge in house dust mite (HDM) allergic rhinoconjunctivitis (ARC) patients were evaluated at a follow-up visit in an allergen exposure chamber (AEC). Methods Patients who were supplemented for 3‑months with the holoBLG lozenge in a previous study with two controlled HDM-AEC challenges [visits: V1, V3] were recruited for a third AEC challenge (V5) 7–8 months after cessation of supplementation. Symptoms (nose, conjunctival, bronchial, others), well-being, and lung function parameters were recorded exactly as in the previous study. Primary endpoint was change in median Total Nasal Symptom Score (TNSS) at V5 compared to V1. Secondary endpoints included e.g. change in median Total Symptom Score (TSS) and the exploratory analysis of temporal evolution of symptom scores using linear mixed effects models. Results Of the 32 patients included in the original study, 27 could be recruited for the follow-up visit with a third AEC challenge. An improvement of 20% (p = 0.15) in the primary endpoint TNSS [V1: 2.5 (interquartile range [IQR]: 1–4), V5: 2.0 (IQR: 1–3)] was observed; 40% (p = 0.04) improvement was seen for the TSS [V1: 5.0 (IQR: 3–9), V5: 3.0 (IQR: 2–5.5)]. Analysis of temporal evolution of all symptom scores, and the personal well-being revealed sustained, clinically meaningful improvement at V5 compared to V1. No relevant lung function parameter differences were observed. Conclusions Sustained long-term reduction of TNSS (primary endpoint) and sustained long-term improvement of secondary endpoints (temporal evolution of all symptom scores and well-being) were demonstrated 7–8 months after cessation of holoBLG supplementation, indicative of a long-lasting nature of immune resilience induced by holoBLG. Trial registration The study was registered at clinicaltrials.gov (NCT04872868).

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Section: Discussionmentioning

confidence: 99%

Long-term benefits of targeted micronutrition with the holoBLG lozenge in house dust mite allergic patients

Bergmann

Raab²,

Krause

et al. 2022

Allergo J Int

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“…Allergen specific immunotherapy (AIT) is a treatment aiming to improve the health and quality of life of patients suffering from allergic conditions such as rhinitis, rhinoconjunctivitis, food allergy, and asthma (1)(2)(3)(4). Beyond the symptomatic treatment, AIT is an effective option in the long-term because it may alter the natural course of the disease by inducing allergen-specific immune tolerance and suppressing allergic inflammation (5,6). The main routes of administration are subcutaneous injections (SCIT) and sublingual preparations (SLIT) as tablets or drops, hereafter referred together as AIT, which are ideally administered for at least three years to maximize efficacy (1,4).…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of grass pollen specific immunotherapy in children with allergic rhinitis compared to the standard of care symptomatic treatment in Portugal

Farraia

Paciência

Mendes

et al. 2023

Eur Ann Allergy Clin Immunol

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Background. Cost-effectiveness studies evaluating allergen immunotherapy (AIT) in children are scarce. We aim to compare the cost-effectiveness of subcutaneous (SCIT) and sublingual immunotherapy (SLIT) against standard-of-care (SOC) treatment in children with grass pollen allergic rhinitis.Methods. We created a Markov model to compare the three strategies over a 10-year horizon.SOC was the reference to calculate the incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analysis were used to assess models' uncertainty.Results. We obtained an ICER of 12605€ and 6318€ for SLIT and SCIT, respectively. In sensitivity analysis, SCIT was more cost-effective than SLIT. Conclusion.AIT is cost-effective in children with grass pollen allergic rhinitis, especially for the subcutaneous route.

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“…The immune-modulating effect of BLG is based on targeted micronutrition of immune cells, whereby the loading state of the bovine BLG plays a central role [11,13,14]. If BLG is loaded with micronutrients, this is referred to as holo-BLG.…”

Section: Holo-blg-targeted Micronutrition Of Immune Cells Leads To Immune Resiliencementioning

confidence: 99%

Targeted micronutrition for allergic patients—possible applications of a food for special medical purposes

Bergmann¹,

Ehmann²,

Jordakieva

et al. 2021

Allergo J Int

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SummaryA novel and recently launched food for special medical purposes was discussed by a multidisciplinary expert panel as an option for allergic patients. The newly developed lozenge contains the whey protein beta-lactoglobulin (BLG) as well as the micronutrients iron, zinc and vitamin A. BLG loaded with ligands (holo-BLG) is discussed as one factor of the allergy-protective farm effect in numerous scientific studies. Further studies reveal that holo-BLG shuttles its ligands specifically to immune cells, where it balances the specific nutrient demand and can thus lead to immune resilience. Based on the scientific background, the experts see a broad range of possible applications for holo-BLG in the form of a lozenge, for example in patients suffering from multiple allergies, with sensitisation to rare allergens (including occupational allergens), tree pollen-associated food allergies or in general difficult treatment situations (e.g. allergies to animal dander or refusal of allergen immunotherapy). The expert panel describes the holo-BLG lozenge as an innovative and additional option for allergic patients.

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Allergens and Adjuvants in Allergen Immunotherapy for Immune Activation, Tolerance, and Resilience

Abstract: INFORMATION FOR CATEGORY 1 CME CREDITCredit can now be obtained, free for a limited time, by reading the review articles in this issue. Please note the following instructions.

Cited by 36 publications

References 81 publications

Long-term benefits of targeted micronutrition with the holoBLG lozenge in house dust mite allergic patients

Long-term benefits of targeted micronutrition with the holoBLG lozenge in house dust mite allergic patients

Cost-effectiveness analysis of grass pollen specific immunotherapy in children with allergic rhinitis compared to the standard of care symptomatic treatment in Portugal

Targeted micronutrition for allergic patients—possible applications of a food for special medical purposes

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