Differential induction of allergen-specific IgA responses following timothy grass subcutaneous and sublingual immunotherapy

Shamji, Mohamed H.; Larson, David; Eifan, Aarif O.; Scadding, Guy W.; Qin, Tielin; Lawson, Kaitie; Sever, Michelle L.; Macfarlane, Ellen; Layhadi, Janice A.; Würtzen, Peter Adler; Parkin, Rebecca; Sanda, Srinath; Harris, Kristina M.; Nepom, Gerald T.; Togias, Alkis; Durham, Stephen R.

doi:10.1016/j.jaci.2021.03.030

Cited by 59 publications

(67 citation statements)

References 27 publications

(35 reference statements)

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“…Healthy individuals show for example allergen-specific IgA antibodies but no IgE, and allergic patients show lower total IgA levels and a relative deficiency in allergen-specific IgA antibodies in their serum compared to healthy controls (13,14). In neonatal studies, S-IgA in breast milk has been linked to reduced risk for developing atopic diseases (99)(100)(101)(102). At a later age, high salivary S-IgA levels were associated with less development of allergic symptoms in a group of sensitized Swedish children (103).…”

Section: Role Of Iga In Allergic Rhinitismentioning

confidence: 99%

“…Although, we know that both the subcutaneous (SCIT) and sublingual (SLIT) administration routes are very effective in treating AR, several unanswered questions remain regarding its mechanisms. Successful AIT is associated with an increase in IgA responses ( 100 ); in a 2-year double blind trial, grass pollen AIT induced a shift in allergen-specific antibody response toward IgA2, which correlated with increased local TGF-β expression and induced monocyte IL-10 expression ( 147 ). A recent study comparing subcutaneous and sublingual grass pollen AIT reported mainly increases in allergen specific IgA after sublingual AIT compared to the subcutaneous form, suggesting a more important role of this immunoglobulin in the mechanism of SLIT compared to SCIT ( 101 ).…”

Section: Treatments Affecting Iga Biologymentioning

confidence: 99%

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The Role of IgA in Chronic Upper Airway Disease: Friend or Foe?

et al. 2022

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Chronic upper airway inflammation is amongst the most prevalent chronic disease entities in the Western world with prevalence around 30% (rhinitis) and 11% (rhinosinusitis). Chronic rhinitis and rhinosinusitis may severely impair the quality of life, leading to a significant socio-economic burden. It becomes more and more clear that the respiratory mucosa which forms a physiological as well as chemical barrier for inhaled particles, plays a key role in maintaining homeostasis and driving disease. In a healthy state, the mucosal immune system provides protection against pathogens as well as maintains a tolerance toward non-harmful commensal microbes and benign environmental substances such as allergens. One of the most important players of the mucosal immune system is immunoglobulin (Ig) A, which is well-studied in gut research where it has emerged as a key factor in creating tolerance to potential food allergens and maintaining a healthy microbiome. Although, it is very likely that IgA plays a similar role at the level of the respiratory epithelium, very little research has been performed on the role of this protein in the airways, especially in chronic upper airway diseases. This review summarizes what is known about IgA in upper airway homeostasis, as well as in rhinitis and rhinosinusitis, including current and possible new treatments that may interfere with the IgA system. By doing so, we identify unmet needs in exploring the different roles of IgA in the upper airways required to find new biomarkers or therapeutic options for treating chronic rhinitis and rhinosinusitis.

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Section: Role Of Iga In Allergic Rhinitismentioning

confidence: 99%

Section: Treatments Affecting Iga Biologymentioning

confidence: 99%

The Role of IgA in Chronic Upper Airway Disease: Friend or Foe?

et al. 2022

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“…Moreover, IgG4 prevents mast–cell activation through FcγIII. AIT also enhanced local allergen-specific IgA1 and IgA2 in patients with grass–pollen allergy ( 32 , 33 ). Thus, secretory IgA provides protection by blocking allergens absorbed into the mucosa.…”

Section: The Cellular Immune Response Following Aitmentioning

confidence: 99%

“…Oral DCs transport sublingual antigens to the submandibular lymph nodes and induce antigen-specific Tregs. In addition, SLIT induces mucosal and serum-specific-IgA responses, which may contribute significantly to tolerance induction ( 32 , 71 ). A clear difference between SCIT and SLIT is the effective dosing range of allergen management.…”

Section: Administration Routesmentioning

confidence: 99%

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Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?

et al. 2021

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Allergic rhinitis (AR) is an IgE-mediated disease that is characterized by Th2 joint inflammation. Allergen-specific immunotherapy (AIT) is indicated for AR when symptoms remain uncontrolled despite medication and allergen avoidance. AIT is considered to have been effective if it alleviated allergic symptoms, decreased medication use, improved the quality of life even after treatment cessation, and prevented the progression of AR to asthma and the onset of new sensitization. AIT can be administered subcutaneously or sublingually, and novel routes are still being developed, such as intra-lymphatically and epicutaneously. AIT aims at inducing allergen tolerance through modification of innate and adaptive immunologic responses. The main mechanism of AIT is control of type 2 inflammatory cells through induction of various functional regulatory cells such as regulatory T cells (Tregs), follicular T cells (Tfr), B cells (Bregs), dendritic cells (DCregs), innate lymphoid cells (IL-10+ ILCs), and natural killer cells (NKregs). However, AIT has a number of disadvantages: the long treatment period required to achieve greater efficacy, high cost, systemic allergic reactions, and the absence of a biomarker for predicting treatment responders. Currently, adjunctive therapies, vaccine adjuvants, and novel vaccine technologies are being studied to overcome the problems associated with AIT. This review presents an updated overview of AIT, with a special focus on AR.

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International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

Wise

Damask

Roland

et al. 2023

Int Forum Allergy Rhinol

113

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Background In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR‐Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR‐Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence‐based findings and recommendation from the full document. Methods ICAR‐Allergic Rhinitis 2023 employed established evidence‐based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. Results ICAR‐Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. Conclusion The ICAR‐Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.

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Differential induction of allergen-specific IgA responses following timothy grass subcutaneous and sublingual immunotherapy

Cited by 59 publications

References 27 publications

The Role of IgA in Chronic Upper Airway Disease: Friend or Foe?

The Role of IgA in Chronic Upper Airway Disease: Friend or Foe?

Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

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