Immunotherapy as an effective tool in allergy treatment

Mailing, H.‐J.

doi:10.1111/j.1398-9995.1998.tb04082.x

Cited by 154 publications

(111 citation statements)

References 82 publications

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“…Controlled studies have shown efficacy in patients with allergic rhinitis/conjunctivitis, allergic asthma, and allergic reactions from stinging insects (1,2). Effective treatment is correlated with the use of standardized vaccines in maintenance doses containing 5-20 g of major allergen for 3-5 years (3).…”

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confidence: 99%

Allergy Vaccine Engineering: Epitope Modulation of Recombinant Bet v 1 Reduces IgE Binding but Retains Protein Folding Pattern for Induction of Protective Blocking-Antibody Responses

Holm

Gajhede

Ferreras

et al. 2004

The Journal of Immunology

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Human type 1 immediate allergic response symptoms are caused by mediator release from basophils and mast cells. This event is triggered by allergens aggregating preformed IgE Abs bound to the high-affinity receptor (FcεRI) on these cells. Thus, the allergen/IgE interaction is crucial for the cascade leading to the allergic and anaphylactic response. Two genetically engineered forms of the white birch pollen major allergen Bet v 1 with point mutations directed at molecular surfaces have been characterized. Four and nine point mutations led to a significant reduction of the binding to human serum IgE, suggesting a mutation-induced distortion of IgE-binding B cell epitopes. In addition, the mutated allergens showed a decrease in anaphylactic potential, because histamine release from human basophils was significantly reduced. Retained α-carbon backbone folding pattern of the mutated allergens was indicated by x-ray diffraction analysis and circular dichroism spectroscopy. The rBet v 1 mutants were able to induce proliferation of T cell lines derived from birch pollen allergic patients. The stimulation indices were similar to the indices of nonmutated rBet v 1 and natural Bet v 1 purified from birch pollen. The ability of anti-rBet v 1 mutant specific mouse IgG serum to block binding of human serum IgE to rBet v 1 demonstrates that the engineered rBet v 1 mutants are able to induce Abs reactive with nonmodified Bet v 1. rBet v 1 mutants may constitute vaccine candidates with improved efficacy/safety profiles for safer allergy vaccination.

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confidence: 99%

Allergy Vaccine Engineering: Epitope Modulation of Recombinant Bet v 1 Reduces IgE Binding but Retains Protein Folding Pattern for Induction of Protective Blocking-Antibody Responses

Holm

Gajhede

Ferreras

et al. 2004

The Journal of Immunology

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“…In 1998, Malling published: immunotherapy as an effective tool in allergy treatment [49] in the allergy: a symposium review. The authors of this review stated on the bases of a number of DBPC studies, they could affirm that the clinical efficacy of immunotherapy in rhinitis and asthma, when potent and standardized extracts were applied in carefully selected patients, was well documented.…”

Section: From Subcutaneous Immunotherapy To Sublingual Immunotherapy:mentioning

confidence: 99%

“…Compared with the efficacy of drug treatment of allergic diseases, the grading seems sensible. A symptom/medication score amelioration of <30% does not seem to justify the immunotherapy involving a potential risk of side-effects and will probably not be considered worthwhile by patients" [49]. Fifteen RCTs investigated the efficacy of SCIT in grass-pollen allergy [13,[50][51][52][53][54][55][56][57][58][59][60][61][62][63], of which 14 proved clinical efficacy.…”

Section: From Subcutaneous Immunotherapy To Sublingual Immunotherapy:mentioning

confidence: 99%

Unmet Needs in Understanding Sublingual Immunotherapy to Grass Pollen

Lorenzo¹,

Leto-Barone²,

Piana³

et al. 2017

Immunotherapy - Myths, Reality, Ideas, Future

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The lack of medication for allergy symptoms at the end of the last millennium has been the promoter of the idea of treating allergies as if you were treating an infectious disease, by vaccination prophylaxis. Two forms of AIT 1) subcutaneous immunotherapy (SCIT) and 2) sublingual immunotherapy (SLIT) are used in the world. Considerable interest has emerged in SLIT both scientifically and especially financially. SLIT is not a new treatment modality. First description dates back to 1900 when H. Curtis. It was relatively widely used until the late 1970's mainly in US by homeopathic therapists.A number of case series describing experience with the oral route were published during the 1920s and 1930s, but it seems to have been perceived not as efficacious nor as well tolerated as subcutaneous immunotherapy. The companies producing allergen immunotherapy have an alliance with important opinion leaders on both shores of the Atlantic.If SLIT did not work for 40 years, why should it work for respiratory allergic diseases today? This question is the mother of all questions in the field of respiratory allergic diseases. The purpose of this chapter is to provide past and current information about immunotherapy, and discuss controversies over efficacy and safety, and dosing considerations for SLIT to grass.

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“…En la actualidad la inmunoterapia subcutánea con extractos alergénicos es un tratamiento de eficacia reconocida tanto en la anafilaxia por veneno de himenópteros como en las enfermedades alérgicas respiratorias [1][2][3][4] . La pauta convencional de administración del tratamiento es segura ya que ocasiona un reducido número de reacciones adversas 5,6 , pero ha sido establecida arbitrariamente sin que se haya demostrado que sea la pauta óptima de administración.…”

Section: Introductionunclassified

Inmunoterapia con pautas agrupadas

Echechipía

García

Aldunate³

et al. 2003

Anales Sis San Navarra

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RESUMENTras haber sido demostradas la eficacia y la seguridad de la inmunoterapia con extractos alergénicos, en los últimos años se ha hecho patente la necesidad de perfeccionar aquellos aspectos del tratamiento que son mejorables, como es su forma de dosificación. La pauta convencional de la inmunoterapia subcutánea en la fase de incremento de dosis es lenta en alcanzar la dosis considerada eficaz. Por ello se han venido ensayando otras pautas alternativas a la convencional, como las pautas agrupadas, que acorten este periodo de incremento de dosis. Siempre y cuando se garantice la seguridad del tratamiento estas pautas ofrecen las ventajas de reducir el gasto económico y de tiempo, de disminuir la incomodidad del tratamiento y mejorar la adherencia del paciente al mismo y, posiblemente, de alcanzar la eficacia clínica más rápidamente. Sin embargo, no es fácil determinar la pauta de administración idónea (más corta y con el menor número de reacciones adversas) y en este artículo se revisan los problemas existentes a la hora de diseñar estas pautas agrupadas. Por último, se presentan los resultados de un estudio comparativo entre la pauta convencional y una pauta agrupada, de diseño doble ciego, realizado por nosotros, en el que se demuestra que la pauta agrupada es más rápida en conseguir la eficacia clínica deseada, adelanta en el tiempo la disminución de la sensibilidad cutánea al alergeno y la modificación de los parámetros inmunológicos, todo ello con una frecuencia de reacciones adversas baja y similar a la registrada con la pauta convencional.Palabras Clave. Inmunoterapia con extractos alergénicos. Pautas. Eficacia. Seguridad. ABSTRACTOnce the efficacy and safety of immunotherapy with allergen extracts has been shown, recently it has become evident the need for perfecting those aspects of the treatment that can be improved, such as its dosage form. The conventional dosage of subcutaneous immunotherapy in the phase of dose increase is slow in reaching an efficient level. For this reason other alternative dosages to the conventional one have been tried out, such as grouped dosages, which shorten this period of dose increase. On condition that the safety of the treatment is guaranteed, these doses offer the advantages of reducing the economic cost and the time involved, of reducing the discomfort of the treatment and of improving the patient's adherence to the treatment, and possibly of reaching clinical efficacy more rapidly. Nonetheless, it is not easy to determine the suitable dosage of administration (the shortest and with the least number of adverse reactions) and this article reviews the existing problems when it comes to designing these grouped doses. Finally, we present the results of a comparative study between the conventional dose and a grouped dose, with a double blind design, carried out by us, which shows that the grouped dose is quicker in achieving the desired clinical efficacy, shortens the times of reduction of cutaneous sensitivity to the allergen and of modification of the immunological p...

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Immunotherapy as an effective tool in allergy treatment

Cited by 154 publications

References 82 publications

Allergy Vaccine Engineering: Epitope Modulation of Recombinant Bet v 1 Reduces IgE Binding but Retains Protein Folding Pattern for Induction of Protective Blocking-Antibody Responses

Allergy Vaccine Engineering: Epitope Modulation of Recombinant Bet v 1 Reduces IgE Binding but Retains Protein Folding Pattern for Induction of Protective Blocking-Antibody Responses

Unmet Needs in Understanding Sublingual Immunotherapy to Grass Pollen

Inmunoterapia con pautas agrupadas

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