Immunological comparison of allergen immunotherapy tablet treatment and subcutaneous immunotherapy against grass allergy

Aasbjerg, Kristian; Backer, Vibeke; Lund, G.; Holm, Jens Christian; Nielsen, Niels-Christian; Holse, Mille; Wagtmann, Valery R; Würtzen, Peter Adler

doi:10.1111/cea.12241

Cited by 63 publications

(72 citation statements)

References 49 publications

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“…Facilitated allergen binding (FAB) inhibition after 1 month was less than 5% for SCIT and nonexistent for SLIT 30. Nevertheless, in our study, LPP immunotherapy led to FAB inhibition that after 4 weeks was 26.4% greater than that at baseline (370‐μg group).…”

Section: Discussioncontrasting

confidence: 60%

A randomized, double‐blind, placebo‐controlled, dose‐finding trial with Lolium perenne peptide immunotherapy

Mösges

Kasche

Raskopf

et al. 2017

Allergy

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BackgroundA novel subcutaneous allergen immunotherapy formulation (gpASIT+™) containing Lolium perenne peptides (LPP) and having a short up‐dosing phase has been developed to treat grass pollen–induced seasonal allergic rhinoconjunctivitis. We investigated peptide immunotherapy containing the hydrolysate from perennial ryegrass allergens for the optimum dose in terms of clinical efficacy, immunogenicity and safety.MethodsThis prospective, double‐blind, placebo‐controlled, phase IIb, parallel, four‐arm, dose‐finding study randomized 198 grass pollen–allergic adults to receive placebo or cumulative doses of 70, 170 or 370 μg LPP. All patients received weekly subcutaneous injections, with the active treatment groups reaching assigned doses within 2, 3 and 4 weeks, respectively. Efficacy was assessed by comparing conjunctival provocation test (CPT) reactions at baseline, after 4 weeks and after completion. Grass pollen–specific immunoglobulins were analysed before and after treatment.ResultsConjunctival provocation test (CPT) response thresholds improved from baseline to V7 by at least one concentration step in 51.2% (170 μg; P = .023), 46.3% (370 μg), and 38.6% (70 μg) of patients receiving LPP vs 25.6% of patients receiving placebo (modified per‐protocol set). Also, 39% of patients in the 170‐μg group became nonreactive to CPT vs 18% in the placebo group. Facilitated allergen‐binding assays revealed a highly significant (P < .001) dose‐dependent reduction in IgE allergen binding across all treatment groups (70 μg: 17.1%; 170 μg: 18.8%; 370 μg: 26.4%). Specific IgG4 levels increased to 1.6‐fold (70 μg), 3.1‐fold (170 μg) and 3.9‐fold (370 μg) (mPP).ConclusionThree‐week immunotherapy with 170 μg LPP reduced CPT reactivity significantly and increased protective specific antibodies.

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Section: Discussioncontrasting

confidence: 60%

A randomized, double‐blind, placebo‐controlled, dose‐finding trial with Lolium perenne peptide immunotherapy

Mösges

Kasche

Raskopf

et al. 2017

Allergy

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“…17,18,27 We found a significant inverse correlation when reaching maintenance between IgG 4 levels induced by AIT and the apparent reduction of the IgE signal, suggesting that an increase of greater than 0.56 ISU of IgG 4 (second and third tertiles) leads to a measurable decrease by competing with IgE for epitopes of the limited amount of allergen spotted on the chip. This is probably an underestimate of the suppressive effect of IgG 4 because the concentration of IgE to the major allergens Phl p 1 and Phl p 5 in simultaneous ImmunoCAP measurements increased significantly.…”

Section: Igg 4 Induced By Scit Suppresses Isac Ige Measurementsmentioning

confidence: 71%

“…25 ISAC measurement of IgE to treatment allergens is suppressed by AIT As in a previous study, 26 we found comparable pretreatment IgE concentrations with both ImmunoCAP and ISAC. SCIT upregulated allergen-specific IgE levels 17,18,27 when measured with the ImmunoCAP method where allergen is in excess. In contrast, signals in the ISAC measurement of allergen-specific IgE were significantly reduced by SCIT.…”

Section: Baseline Measurementsmentioning

confidence: 99%

Pretreatment IgE sensitization patterns determine the molecular profile of the IgG4 response during updosing of subcutaneous immunotherapy with timothy grass pollen extract

Schmid

Würtzen

Dahl

et al. 2016

Journal of Allergy and Clinical Immunology

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“…Unlike the clinical responses, the 2 groups showed differences in their immunological responses, which are generally not confounded by placebo effect in AIT studies [33, 34]. The induced cross-reactive IgE is dependent on the BT sensitization.…”

Section: Discussionmentioning

confidence: 99%

Clinical Response to Subcutaneous Dermatophagoides pteronyssinus Immunotherapy in Children with Allergic Rhinitis and Asthma Is Independent of Sensitization to Blomia tropicalis Allergens

Shi

Zheng²,

Chen

et al. 2018

Int Arch Allergy Immunol

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Background: Dermatophagoides pteronyssinus (DP) and Blomia tropicalis (BT) are the dominant house dust mites inducing allergic diseases in tropical climates. It is not known whether the efficacy of DP subcutaneous immunotherapy (SCIT) is similar in patients sensitized to DP alone or to both DP and BT. Method: Ninety-five children (5–17 years old) affected by asthma with rhinitis and sensitized to both DP and BT received 3 years of DP-SCIT. Clinical symptom and medication scores, serum-specific IgE and IgG₄ were evaluated during DP-SCIT. Patients were grouped based on DP and BT co-sensitization or cross-reactivity, according to positive or negative IgE to BT major allergen (BTMA). Results: After 3 years of DP-SCIT, all patients had significant reductions in symptoms and medication use. In all, 65% of the patients were free of asthma symptoms and medication use; in addition, 3% was free of rhinitis symptoms. FEV₁ in all patients were greater than 95% of predicted. DP-SCIT induced significant increases in DP- and BT-specific IgG₄. In 50% of patients, DP-specific IgG₄ increased more than 67-fold. BT-specific IgG₄ increased more than 2.5 fold. A moderate correlation (r = 0.48–0.61, p < 0.01) was found between specific IgE against DP and BT in the BTMA– group (n = 34) before and after DP-SCIT, whereas no correlation was found in the BTMA+ group (n = 61). The 2 BTMA groups responded similarly with regard to clinical improvement and increase in specific IgG₄ to both DP and BT. No safety finding of concern were reported in either group. Conclusion: DP-SCIT may be of clinical benefit to patients with IgE sensitizations to both DP and BT. DP-SCIT induces IgG₄ that cross-react with BT allergens.

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Immunological comparison of allergen immunotherapy tablet treatment and subcutaneous immunotherapy against grass allergy

Cited by 63 publications

References 49 publications

A randomized, double‐blind, placebo‐controlled, dose‐finding trial with Lolium perenne peptide immunotherapy

A randomized, double‐blind, placebo‐controlled, dose‐finding trial with Lolium perenne peptide immunotherapy

Pretreatment IgE sensitization patterns determine the molecular profile of the IgG4 response during updosing of subcutaneous immunotherapy with timothy grass pollen extract

Clinical Response to Subcutaneous <b><i>Dermatophagoides pteronyssinus</i></b> Immunotherapy in Children with Allergic Rhinitis and Asthma Is Independent of Sensitization to <b><i>Blomia tropicalis</i></b> Allergens

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