Mechanisms of Allergen Immunotherapy Supporting its Disease-Modifying Effect

Bumbăcea, Roxana Silvia; Boustani, Rama; Panaitescu, Carmen; Haidar, Laura; Buzan, Maria‐Roxana; Bumbăcea, Dragoş; Laculiceanu, Alexandru; Cojanu, Cătălina; Spanu, Daniela; Agache, Ioana

doi:10.2217/imt-2021-0325

Cited by 6 publications

(4 citation statements)

References 100 publications

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“…We have reported that the effects of allergen-specific immunotherapy meet this description [12]. In addition, based on the initial promising data for biologicals, we assessed this treatment as a disease-modifying therapy [11,13]. The current findings offer further support for the ability of biologics to lead to remission.…”

Section: Discussionmentioning

confidence: 84%

Evaluation of Clinical Remission in Best-Performing Severe Asthmatic Patients Treated for Three Years with Mepolizumab

Bagnasco,

Bondi,

Caminati

et al. 2024

Biomedicines

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Background: In its severe form, where possible, asthma is treated using biological drugs in order to reduce, as much as possible, the use of systemic steroids. Mepolizumab is effective for severe asthma based on key outcomes such as exacerbation and steroid dependence. Its efficacy in terms of the criteria for clinical remission in the short and long term has become of interest. Objective: We aimed to evaluate the effect of mepolizumab in the achievement of clinical remission after 3 years of administration. Methods: In this study, 71 patients who continued mepolizumab for 3 years were assessed for clinical remission according to six different published sets of remission criteria. Results: According to the criteria, 39–52% of patients experienced complete remission in the first year, increasing to 51–73% at 3 years. By classifying patients according to partial and complete remission criteria, proposed by the SANI, we observe 22% of patients in partial remission at one year, achieving complete remission after three years. The baseline factors associated with earlier remission were a higher FEV1, if we consider classifications requiring an FEV1 ≥ 80%, a low OCS dose, and low FeNO levels, in the patients requiring FEV1 stabilization. Conclusions: Clinical remission is possible for patients treated with mepolizumab. The observations at three years compared with the first year indicated that the factors negatively affecting remission delayed rather than prevented it. Earlier treatment could increase the chances of remission.

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Section: Discussionmentioning

confidence: 84%

Evaluation of Clinical Remission in Best-Performing Severe Asthmatic Patients Treated for Three Years with Mepolizumab

Bagnasco,

Bondi,

Caminati

et al. 2024

Biomedicines

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“…They may also prevent mast cell and basophil activation and induce B cells, which secret these blocking antibodies and are responsible for long‐term immunotolerance 10,91–93 . Further cellular responses involve reduced eosinophil recruitment, suppression of Th2 cells, and induction of regulatory cell populations (from innate lymphoid cells, dendritic cells, T and B cells) and regulatory cytokine responses (IL‐10 and TGF‐β), re‐establishing Th1‐Th2 balance 10,41,49,52,87,92,94–96 . More insights into these mechanisms (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Aqueous formulation from Geer Laboratories: 5,000 AU/mL weekly) Marogna et al 74 Th1-Th2 balance. 10,41,49,52,87,92,[94][95][96] More insights into these mechanisms (e.g. role of T cell exhaustion, 92 T follicular regulatory cells, and their epigenetic effects 97 ) are awaited in a preventive clinical setting.…”

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confidence: 99%

Preventive allergen immunotherapy with inhalant allergens in children

Dwivedi,

Kopanja,

Schmidthaler

et al. 2024

Allergy

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The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen‐specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell‐mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and/or tree pollen‐based pAIT has shown efficacy in preventing disease progression from allergic rhinitis/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head‐to‐head comparative paediatric studies are scarce. Additionally, there are fewer placebo‐controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well‐designed studies.

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“…Allergen immunotherapy (AIT) is the only disease-modifying treatment available for allergic disorders [69]. Although AIT has been used to treat many atopic diseases, its precise mechanism of action remains unclear [70].…”

Section: Mechanism Of Aitmentioning

confidence: 99%

Advancements in Allergen Immunotherapy for the Treatment of Atopic Dermatitis

Guo,

Wu,

Chen

et al. 2024

IJMS

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Atopic dermatitis (AD) is a chronic inflammatory skin condition that affects individuals of all age groups, manifesting as a spectrum of symptoms varying from mild to severe. Allergen immunotherapy (AIT) involves the administration of allergen extracts and has emerged as a potential treatment strategy for modifying immune responses. Its pathogenesis involves epidermal barrier dysfunction, microbiome imbalance, immune dysregulation, and environmental factors. Existing treatment strategies encompass topical steroids to systemic agents, while AIT is under investigation as a potential immune-modifying alternative. Several studies have shown reductions in the severity scoring of atopic dermatitis (SCORAD) scores, daily rescue medication use, and visual analog scale (VAS) scores following AIT. Biomarker changes include increased IgG4 levels and decreased eosinophil counts. This review provides valuable insights for future research and clinical practice, exploring AIT as a viable option for the management of AD.

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Mechanisms of Allergen Immunotherapy Supporting its Disease-Modifying Effect

Cited by 6 publications

References 100 publications

Evaluation of Clinical Remission in Best-Performing Severe Asthmatic Patients Treated for Three Years with Mepolizumab

Evaluation of Clinical Remission in Best-Performing Severe Asthmatic Patients Treated for Three Years with Mepolizumab

Preventive allergen immunotherapy with inhalant allergens in children

Advancements in Allergen Immunotherapy for the Treatment of Atopic Dermatitis

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