Profilin Desensitization in Two Patients with Plant-Derived Food Allergy

Nucera, Eleonora; Aruanno, Arianna; Rizzi, Angela; Buonomo, Alessandro; Pecora, Valentina; Colagiovanni, Amira; Pascolini, Lucilla; Ricci, Anna Giulia; Schiavino, Domenico

doi:10.1177/039463201202500225

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…In recent years, SLIT with inhalant allergens has been used to treat oral allergic syndromes induced by foods [219-221]. Larger and more rigorous studies are needed to confirm its efficacy.…”

Section: Chapter 10: Methodology Of Clinical Trialsmentioning

confidence: 99%

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Canonica

Cox

Pawankar

et al. 2014

World Allergy Organization Journal

446

421

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We have prepared this document, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2013 Update”, according to the evidence-based criteria, revising and updating chapters of the originally published paper, “Sublingual Immunotherapy: World Allergy Organization Position Paper 2009”, available at http://www.waojournal.org. Namely, these comprise: “Mechanisms of sublingual immunotherapy;” “Clinical efficacy of sublingual immunotherapy” – reporting all the data of all controlled trials published after 2009; “Safety of sublingual immunotherapy” – with the recently published Grading System for adverse reactions; “Impact of sublingual immunotherapy on the natural history of respiratory allergy” – with the relevant evidences published since 2009; “Efficacy of SLIT in children” – with detailed analysis of all the studies; “Definition of SLIT patient selection” – reporting the criteria for eligibility to sublingual immunotherapy; “The future of immunotherapy in the community care setting”; “Methodology of clinical trials according to the current scientific and regulatory standards”; and “Guideline development: from evidence-based medicine to patients' views” – including the evolution of the methods to make clinical recommendations.Additionally, we have added new chapters to cover a few emerging crucial topics: “Practical aspects of schedules and dosages and counseling for adherence” – which is crucial in clinical practice for all treatments; “Perspectives and new approaches” – including recombinant allergens, adjuvants, modified allergens, and the concept of validity of the single products. Furthermore, “Raising public awareness about sublingual immunotherapy”, as a need for our patients, and strategies to increase awareness of allergen immunotherapy (AIT) among patients, the medical community, all healthcare stakeholders, and public opinion, are also reported in detail.

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Section: Chapter 10: Methodology Of Clinical Trialsmentioning

confidence: 99%

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Canonica

Cox

Pawankar

et al. 2014

World Allergy Organization Journal

446

421

View full text Add to dashboard Cite

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“…On the basis of the principles of these studies, therefore, our goal was to develop a specific immunotherapy with the purified cross-reactive allergen to allow our patients to resume a normal diet. We relied on the methods (dose and length of the induction phase) previously used 12 and at the end of the treatment we found again the same immunological changes in allergological evaluation. In fact we observe a decreased mean diameter of profilin wheal in SPT in five of the seven patients and a decreased profilin specific IgE values in six patients that repeated the test.…”

Section: Discussionmentioning

confidence: 73%

“…In 2009 we published the results 12 about profilin desensitization in two patients with clinical sensitization to a wide range of vegetables food with consequences to diet and metabolic imbalance. So in this case series we aimed to increase the patient numbers to confirm our previous discoveries.…”

Section: Discussionmentioning

confidence: 99%

Profilin desensitization: A case series

Nucera

Aruanno

Rizzi

et al. 2016

Int J Immunopathol Pharmacol

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The role of profilin as an allergen has long been questioned. The capacity of profilin to induce respiratory symptoms has recently been demonstrated; moreover, over 50% of patients sensitized to profilin experienced symptoms after the ingestion of plant-derived foods, suggesting that profilin should be considered as a clinically relevant food allergen.We describe the cases of seven allergic patients with oral allergy syndrome and other adverse reactions after eating plant-derived food, that have been undergone to profilin desensitization treatment.The protocol started with a drop of profilin solution (50 µg/mL) diluted 1:10(18) in water until the highest dose of 10 drops of undiluted solution three times a week. At the end of the treatment we observed a decreased mean diameter of profilin wheal in skin prick test (SPT) in five of the seven participants and in profilin specific IgE values in six patients that repeated the test. Regarding basophil activation test (BAT) and the detection of IgG4, we do not have significant results because the tests have to be repeated in some patients. Regarding the double-blind placebo-controlled challenges, after about 10 months of induction phase all the patients showed tolerance to several foods that they previously did not tolerate.Moreover, the immunotherapy with profilin has proved to be safe because no serious adverse events have been reported in our patients.In summary, the results of this exploratory study of sublingual immunotherapy (SLIT) for profilin allergy show that it can be a promising therapeutic option that could modify the clinical reactivity of the patients to the intake of plant-derived food.

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New Directions in Immunotherapy

Cox

Compalati

Kündig

et al. 2013

Curr Allergy Asthma Rep

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Allergen immunotherapy (AIT) is effective in reducing the clinical symptoms associated with allergic rhinitis, asthma and venom-induced anaphylaxis. Subcutaneous (SCIT) and sublingual immunotherapy (SLIT) with unmodified allergen extracts are the most widely prescribed AIT regimens. The efficacy of these 2 routes appears comparable, but the safety profile with SLIT is more favorable allowing for home administration and requiring less patient time. However, both require that the treatment is taken regularly over several years, e.g., monthly in a supervised medical setting with SCIT and daily at home with SLIT. Despite the difference in treatment settings, poor adherence has been reported with both routes. Emerging evidence suggests that AIT may be effective in other allergic conditions such as atopic dermatitis, venom sting-induced large local reactions, and food allergy. Research with oral immunotherapy (OIT) for food allergies suggest that many patients can be desensitized during treatment, but questions remain about whether this can produce long term tolerance. Further studies are needed to identify appropriate patients and treatment regimens with these conditions. Efforts to develop safer and more effective AIT for inhalant allergies have led to investigations with modified allergens and alternate routes. Intralymphatic (ILIT) has been shown to produce long-lasting clinical benefits after three injections comparable to a 3-year course of SCIT. Epicutaneous (EPIT) has demonstrated promising results for food and inhalant allergies. Vaccine modifications, such as T cell epitopes or the use of viral-like particles as an adjuvant, have been shown to provide sustained clinical benefits after a relatively short course of treatment compared to the currently available AIT treatments, SLIT and SCIT. These newer approaches may increase the utilization and adherence to AIT because the multi-year treatment requirement of currently available AIT is a likely deterrent for initiating and adhering to treatment.

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Profilin Desensitization in Two Patients with Plant-Derived Food Allergy

Cited by 6 publications

References 17 publications

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Sublingual immunotherapy: World Allergy Organization position paper 2013 update

Profilin desensitization: A case series

New Directions in Immunotherapy

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