Multiple grass mixes as opposed to single grasses for allergen immunotherapy in allergic rhinitis

Abstract

Grass pollen allergy affects approximately 40% of allergic patients. Subcutaneous allergen immunotherapy (SCIT) is the only allergen-specific and disease-modifying treatment available. Currently available therapeutic vaccines for the treatment of grass pollen allergy are based on natural grass pollen extracts which are either made from pollen of one cross-reactive grass species or from several related grass species. Clinical studies have shown that SCIT performed with timothy grass pollen extract is effective for the treatment of grass pollen allergy. Moreover, it has been demonstrated that recombinant timothy grass pollen allergens contain the majority of relevant epitopes and can be used for SCIT in clinical trials. However, recent in vitro studies have suggested that mixes consisting of allergen extracts from several related grass species may have advantages for SCIT over single allergen extracts. Here, we review current knowledge regarding the disease-relevant allergens in grass pollen allergy, available clinical studies comparing SCIT with allergen extracts from timothy grass or from mixes of several related grass species of the Pooideae subfamily, in vitro cross-reactivity studies performed with natural allergen extracts and recombinant allergens and SCIT studies performed with recombinant timothy grass pollen allergens. In vitro and clinical studies performed with natural allergen extracts reveal no relevant advantages of using multiple grass mixes as opposed to single grass pollen extracts. Several studies analysing the molecular composition of natural allergen extracts and the molecular profile of patients' immune responses after SCIT with allergen extracts indicate that the major limitation for the production of a high quality grass pollen vaccine resides in intrinsic features of natural allergen extracts which can only be overcome with recombinant allergen-based technologies.

Phleum pratense molecular pattern across Italy

“…Grass pollens belong to Poaceae family and are classified in many genera. Phleum pratense (Timothy grass) is the most frequent cause of grass allergy in Europe (6), so Phleum pratense (Phl p) is widely employed in diagnostics and immunotherapy (7). There are several molecules belonging to Phl p species.…”

Protein Biomarkers in Asthma

“…Grass Pollen [144] A longitudinal study showed the evolution of sensitization development toward grass pollen molecules in German children from the ages of 3 to 16 years. Some children kept their sensitization profiles, whereas in some others IgE antibodies appeared first to Phl p 1 and then to Phl p 4 and Phl p 5, followed by Phl p 2, Phl p 6, and Phl p 11.…”

About Minimization of Expenses on Allergy Diagnosis in Children: Analysis of Consistency of in Vitro- and in Vivo-Allergic Examinations Results

“…На основании высокой внутригрупповой перекрестной реактивности такие аллергены делят на 10 групп. В ка-честве примера можно выделить аллергены тимофеевки луговой (Phleum pratense), экстракты и отдельные компо-ненты которой (Phl p 1, 2, 5, 6) широко используются в in vitro-и in vivo-диагностике аллергии на пыльцу злаковых трав, и в специфической иммунотерапии [10], а также аллергены овсяницы луговой (Fes p 1, Fes p 4, Fes p 5, Fes p 13) и ежи сборной (Dac g 1, Dac g 2, Dac g 3, Dac g 4, Dac g 5) [11].…”