Disease-Modifying Effect of Japanese Cedar Pollen Sublingual Immunotherapy Tablets

Yonekura, Syuji; Gotoh, Minoru; Kaneko, Shinya; Maekawa, Yuriko; Okubo, Kimihiro; Okamoto, Yoshitaka

doi:10.1016/j.jaip.2021.06.060

Cited by 30 publications

(28 citation statements)

References 16 publications

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“…There are now three studies in adults 90 , 93 , 94 and one in children aged 5–12 years 95 that confirm that daily sublingual allergy tablet treatment for 3 years induces long-term clinical benefits for at least 2 years after stopping the treatment (see Supplementary Table 1 ). Sublingual tablet therapy given over 12 months for HDM-induced perennial rhinitis was shown to be effective in four separate studies 96 – 99 .…”

Section: Insights From the Past 20 Yearsmentioning

confidence: 91%

“…Systematic reviews and meta-analyses have confirmed efficacy of pre-seasonal or co-seasonal immunotherapy for seasonal rhinitis and continuous treatment for perennial rhinitis due to HDM allergens 87 . Recent adequately powered randomized controlled trials of sublingual tablets have shown consistent efficacy in seasonal allergic rhinitis due to grass 85 , 86 , ragweed 88 , birch 89 and Japanese cedar 90 pollen allergy. The effect size of the treatment on symptoms and/or use of rescue medication is consistently 30–40% better than placebo treatment, similar to that observed in a phase 3 trial of subcutaneous immunotherapy with grass pollen extract, and compares favourably with the World Allergy Organization’s proposed minimal important difference for clinical efficacy of 20% 91 .…”

Section: Insights From the Past 20 Yearsmentioning

confidence: 97%

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Allergen immunotherapy: past, present and future

2022

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Allergen immunotherapy is a form of therapeutic vaccination for established IgE-mediated hypersensitivity to common allergen sources such as pollens, house dust mites and the venom of stinging insects. The classical protocol, introduced in 1911, involves repeated subcutaneous injection of increasing amounts of allergen extract, followed by maintenance injections over a period of 3 years, achieving a form of allergen-specific tolerance that provides clinical benefit for years after its discontinuation. More recently, administration through the sublingual route has emerged as an effective, safe alternative. Oral immunotherapy for peanut allergy induces effective ‘desensitization’ but not long-term tolerance. Research and clinical trials over the past few decades have elucidated the mechanisms underlying immunotherapy-induced tolerance, involving a reduction of allergen-specific T helper 2 (T H 2) cells, an induction of regulatory T and B cells, and production of IgG and IgA ‘blocking’ antibodies. To better harness these mechanisms, novel strategies are being explored to achieve safer, effective, more convenient regimens and more durable long-term tolerance; these include alternative routes for current immunotherapy approaches, novel adjuvants, use of recombinant allergens (including hypoallergenic variants) and combination of allergens with immune modifiers or monoclonal antibodies targeting the T H 2 cell pathway.

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Section: Insights From the Past 20 Yearsmentioning

confidence: 91%

Section: Insights From the Past 20 Yearsmentioning

confidence: 97%

Allergen immunotherapy: past, present and future

2022

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“…The disease modifying concept explains the achievement of long-lasting benefits after an intervention, with topical glucocorticosteroids (GCS) being continued. Similarly, disease modification can be achieved by allergen immunotherapy, leading to a profound suppression of inflammation [43][44][45]. This current study aimed to corroborate this concept through the complete removal of diseased sinus mucosa and regrowth of the adjacent nasal mucosa, although some scar formation cannot be ruled out.…”

Section: Immunology and Disease Modificationmentioning

confidence: 92%

Olfaction in nasal polyp patients after Reboot surgery: an endotype-based prospective study

Gomes

Delemarre

Holtappels

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose To report biomarkers present in the olfactory mucosa in chronic rhinosinusitis with nasal polyps (CRSwNP) in comparison with nasal polyps and to nasal mucosal tissues from control patients. To evaluate the kinetics of smell over 6 months in patients who underwent Reboot surgery. Methods Cohort study from May 2021 to May 2022. We collected samples of olfactory mucosa and nasal polyps from 16 CRSwNP patients and inferior turbinate samples from 20 control subjects. The study was not randomized for surgical and/or medical treatment. Samples were analyzed by Luminex and Unicap 100 to measure biomarkers of inflammation (IL1-β, IL4, IL5, IL6, IL17, CCL3, CCL4, G-CSF, SE-IgE, total IgE and ECP). 12 of the CRSwNP patients underwent Extended Sniffin’tests at timepoints 1–4 days pre-surgery, and 1, 3 and 6 months after Reboot surgery. Results Type-2 markers were significantly elevated in OM and polyp tissue in CRSwNP ( n = 16) vs. controls ( n = 20), P < 0.05. TDI scores improved already 1 month ( P < 0.05) after surgery and remained stable for 6 months. Type-2 inflammation in nasal polyps was associated with decreased sense of smell and taste before surgery, but improved after surgery ( P = 0.048). Type-3 inflammation was present in the olfactory mucosa and was associated with a better sense of smell before surgery, but a smaller improvement of smell afterward. Conclusions Type-2 inflammation is present in the olfactory mucosa in CRSwNP patients and is associated with smell loss. Reboot surgery, aiming to completely remove inflamed sinus mucosa, significantly improves the smell in this group of patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-022-07813-w.

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“…77 Japanese cedar pollen (JCP) SLIT tablets have been shown to improve the clinical efficacy of JC pollinosis within a 5-year study period, and a 3-year-treatment provided a longer-term efficacy than an 18 month-treatment, suggesting that JCP-SLIT efficacy is regulated in a treatment durationdependent manner. 78 In recent years, several studies have focused on the relationship between the underlying molecular mechanisms and clinical effectiveness of AIT. IL-10 producing ILC2 and Tfr cells have been shown to be lower in GP allergic AR patients, while the induction of IL-10 + ILC2 and Tfr cells were noticed in patients receiving GPor HDM-SCIT and SLIT.…”

Section: Subcutaneous Immunotherapy (Scit) and Sublingual Immunothera...mentioning

confidence: 99%

“…This might be due to the single Der p‐SCIT inducing both Der p‐sIgG4 and Der f‐sIgG4 production, which induces tolerance 77 . Japanese cedar pollen (JCP) SLIT tablets have been shown to improve the clinical efficacy of JC pollinosis within a 5‐year study period, and a 3‐year‐treatment provided a longer‐term efficacy than an 18 month‐treatment, suggesting that JCP‐SLIT efficacy is regulated in a treatment duration–dependent manner 78 …”

Section: Mechanism‐oriented Treatmentmentioning

confidence: 99%

Update on pathomechanisms and treatments in allergic rhinitis

Zhang

Feng

Zhang

2022

Allergy

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Allergic rhinitis (AR) is a global health problem with increasing prevalence and association with an enormous medical and socioeconomic burden. New recognition of immune cells such as type 2 innate lymphocytes (ILC2s), T helper (Th2) 2 cells, follicular helper T cells, follicular regulatory T cells, regulatory T cells, B cells, dendritic cells, and epithelial cells in AR pathogenesis has been updated in this review paper. An in‐depth understanding of the mechanisms underlying AR will aid the identification of biomarkers associated with disease and ultimately provide valuable parameters critical to guide personalized targeted therapy. As the only etiological treatment option for AR, allergen‐specific immunotherapy (AIT) has attracted increasing attention, with evidence for effectiveness of AIT recently demonstrated in several randomized controlled trials and long‐term real‐life studies. The exploration of biologics as therapeutic options has only involved anti‐IgE and anti‐type 2 inflammatory agents; however, the cost‐effectiveness of these agents remains to be elucidated precisely. In the midst of the currently on‐going COVID‐19 pandemic, a global life‐threatening disease, although some studies have indicated that AR is not a risk factor for severity and mortality of COVID‐19, this needs to be confirmed in multi‐centre, real‐life studies of AR patients from different parts of the world.

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Disease-Modifying Effect of Japanese Cedar Pollen Sublingual Immunotherapy Tablets

Cited by 30 publications

References 16 publications

Allergen immunotherapy: past, present and future

Allergen immunotherapy: past, present and future

Olfaction in nasal polyp patients after Reboot surgery: an endotype-based prospective study

Update on pathomechanisms and treatments in allergic rhinitis

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