Phleum pratense alone is sufficient for allergen specific immunotherapy against allergy to Pooideae grass pollens

Hejl, Charlotte; Ipsen, Hans Henrik; Larsen, Jørgen Nedergaard; Johansen, Niels

doi:10.1097/01.wox.0000302018.35580.0c

Cited by 15 publications

(36 citation statements)

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“…Features of natural extracts for grass pollen immunotherapy Traditionally used for SIT Clinical efficacy documented by several studies But, Contain in addition to allergens undefined allergen source-derived materials May lack important allergens Amounts of different allergens may vary Precise contents of many allergens unknown Variations regarding allergen composition depending on extraction and production protocols and different raw materials Contaminating allergens from other allergen sources Degradation of allergens due to presence of proteases High allergenic activity requires tedious up-dosing protocols Unsuitable for vaccine production according to current quality guide lines grass pollen extracts from different manufacturers differ greatly regarding allergen content and often lack important allergens [11]. Similar results were obtained for other Pooideae grass pollen extracts which were found to contain varying amounts of group 1 and group 5 allergens [18,95].…”

Section: Features Of Natural Extracts For Immunotherapysupporting

confidence: 79%

“…In IgE inhibition studies, timothy grass pollen extract completely inhibited the binding of specific IgE to mixed allergen extracts from different related grass species. Also, cross-reactivity of SCIT-induced IgG 4 was found to be complete [18]. In yet another study, specific IgE binding to extracts of various grass pollen was found to be of the same magnitude when correlated with specific IgE binding to extract of timothy grass pollen in population samples ranging from 1075 to 3293 subjects.…”

Section: Cross-reactivity Among Grassesmentioning

confidence: 80%

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

2013

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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.

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Section: Features Of Natural Extracts For Immunotherapysupporting

confidence: 79%

Section: Cross-reactivity Among Grassesmentioning

confidence: 80%

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

2013

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“…The findings of this study imply that single-allergen immunotherapy may not cover the broad epitopic repertoire at the T-cell level, and therefore may not elicit Treg responses in allergic patients, or deplete the population of species-specific T cells that show minimal cross-reactivity, with a consequent failure to induce tolerance [46]. A study with GRA also reported crossreactivity at the T-cell level [47], but this used an artificial system of two generated T-cell lines, and not T cells isolated from allergic patients (as in reference [46]); therefore, T cells specific for minimally cross-reactive epitopes may have been missed. A mixed grass-pollen extract is more likely to ensure that a broad and well-balanced panel of critical major and minor allergenic epitopes is present, whereas a single grass-pollen preparation would likely restrict the repertoire of allergenic epitopes to which a patient becomes desensitized [36,42].…”

Section: Excipients (Inactive Drug Additives)mentioning

confidence: 90%

Five-grass-pollen sublingual immunotherapy tablet for the treatment of grass-pollen-induced allergic rhinoconjunctivitis: 5 years of experience

Didier

Wahn

Horak

et al. 2014

Expert Review of Clinical Immunology

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OralairÒ (OA) (Stallergenes, Antony, France) is a unique pre-and co-seasonal 5-grass-pollen sublingual immunotherapy tablet launched in 2008, and now approved in 31 countries worldwide for the treatment of grass-pollen allergic rhinitis and rhinoconjunctivitis. OA is the first oral treatment with a consistent, well-balanced allergen extract that mimics natural exposure and sensitization. A wealth of data exists from over 5 years of clinical and realworld experience demonstrating the efficacy and safety of OA for grass-pollen-allergy treatment. OA is highly effective from the first pollen season in all patient subgroups, including children and those with comorbid mild asthma, irrespective of sensitization status and symptom severity. OA also has sustained long-term benefits for symptom control and quality of life. This article provides an overview of the pharmacodynamics and pharmacology of OA; its efficacy, safety, tolerability and cost-effectiveness for the treatment of allergic rhinitis and rhinoconjunctivitis and its role in clinical practice. Allergic rhinitis (AR) is a common chronic inflammatory illness, characterized by rhinorrhea, nasal congestion, sneezing, nasal and ocular pruritis and watery eyes [1]. Inhalation of allergens by sensitized individuals triggers the IgE-mediated release of inflammatory mediators and cytokines, leading to a rapid appearance of symptoms [2]. AR has historically been classified as 'seasonal' or 'perennial' depending on whether symptoms occur with seasonal exposure to aeroallergens or are present throughout the year. Seasonal AR is most commonly attributed to plant pollen and other outdoor allergens, while perennial AR is associated with indoor allergens, such as dust mites, mold, cockroaches and pet dander, although it can also be associated with pollen in areas where this is prevalent year-round [3,4].In 2001, the WHO-sponsored Allergic Rhinitis and its Impact on Asthma meeting produced guidelines proposing an alternative classification of the condition into 'intermittent' or 'persistent' AR, and grading symptoms as 'mild' or 'moderate/severe' [5]. Globally, the prevalence of seasonal ('hay fever') and perennial AR ranges from 7 to 42 and 1 to 13%, respectively, with the former being more common in children than adults [6]. The length of exposure to seasonal allergens is dependent on geographic location and climatic conditions [4]; in Europe, the main pollen season typically occurs from March to July, with slight variations according to latitude [7].Approximately 500 million people worldwide [6], including an estimated 30-60 million in the USA [4] 1309Drug Profile suffer from AR, and its prevalence is increasing in most countries [2]. It is estimated that from 10 to 30% of adults and up to 40% of the pediatric population have AR [3,9]. While AR does not directly lead to mortality, it places a considerable burden on affected individuals, who often have a reduced quality of life (QoL), compared with non-sufferers [10]. The physical symptoms of AR can cause sleep disturbance...

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“…Allergen extracts from Phleum pratense and Betula verrucosa were prepared in house and labeled with FITC at an allergen:FITC molar ratio of 1:20 (24). The FITC-labeled allergen extracts were added to the apical side of polarized AECs with MDDCs attached to the AEC basal side.…”

Section: Allergen Uptake and Allergen-specific Stimulation Of Autologmentioning

confidence: 99%

Effect of Polarization on Airway Epithelial Conditioning of Monocyte-Derived Dendritic Cells

Chhoden

Arge

Vorup-Jensen

et al. 2015

Am J Respir Cell Mol Biol

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Airway epithelial cells (AECs) form polarized barriers that interact with inhaled allergens and are involved in immune homeostasis. We examined how monocyte-derived dendritic cells (MDDCs) are affected by contact with the airway epithelium. In traditional setups, bronchial epithelial cell lines were allowed to polarize on filter inserts, and MDDCs were allowed to adhere to the epithelial basal side. In an optimized setup, the cell application was reversed, and the culture conditions were modified to preserve cellular polarization and integrity. These two parameters were crucial for the MDDCs' immunoregulatory properties; thus, previous observations obtained using traditional setups should be considered with caution. Using the optimized setup, AEC conditioning of MDDCs led to increased expression of programmed death 1 ligand 1, immunoglobulin-like transcript 3, CD40, CD80, and CD23. This increased expression was accompanied by decreased secretion of monocyte chemotactic protein 1 and eotaxin and donor-variable effects on IL-12 and IL-10 secretion. Conditioning varied between maturation states and depended partly on direct contact between AECs and MDDCs. The setup allowed MDDCs on the basal side of the epithelium to sample allergens administered to the apical side. Allergen uptake depended on polarization and the nature of the allergen. AEC conditioning led to decreased birch allergen-specific proliferation of autologous T cells and a trend toward decreased secretion of the Th2-specific cytokines IL-5 and IL-13. In conclusion, we determined that AEC conditioning favoring cellular integrity leads to a tolerogenic MDDC phenotype, which is likely to be important in regulating immune responses against commonly inhaled allergens.

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Phleum pratense alone is sufficient for allergen specific immunotherapy against allergy to Pooideae grass pollens

Cited by 15 publications

References 0 publications

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

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

Five-grass-pollen sublingual immunotherapy tablet for the treatment of grass-pollen-induced allergic rhinoconjunctivitis: 5 years of experience

Effect of Polarization on Airway Epithelial Conditioning of Monocyte-Derived Dendritic Cells

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