Successful treatment of atopic dermatitis with house dust mite sublingual immunotherapy tablets

Kiatiwat, Ploykarn; Mitthamsiri, Wat; Boonpiyathad, Tadech; Pradubpongsa, Panitan; Sangasapaviliya, Atik

doi:10.12932/ap-231120-1004

Cited by 4 publications

(4 citation statements)

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“…Обязательным условием назначения АСИТ является правильный отбор больных с подтверждённым диагнозом аллергического заболевания, обусловленного сенсибилизацией к причинно-значимым аллергенам. Опыт проведения АСИТ у больных АтД пока недостаточен, вместе с тем доступные литературные данные свидетельствуют о высокой эффективности и безопасности этого метода терапии у больных АтД, сенсибилизированных к аллергенам клещей домашней пыли и пыльцевым аллергенам [2,3,24,[28][29][30][31]. В большинстве случаев при респираторной аллергии для определения причинно-значимого аллергена бывает достаточно данных анамнеза и проведения традиционного аллергологического обследования in vivo [14,34].…”

Section: Discussionunclassified

“…Механизмы АСИТ хорошо изучены и сводятся к снижению тканевой чувствительности к аллергену, снижению неспецифической тканевой гиперреактивности, уменьшению интенсивности аллергического воспаления, развитию толерантности, что свидетельствует в пользу перестройки клеточного ответа с Th2 на Th1 с соответствующим изменением цитокинового профиля [23][24][25][26][27]. В международной литературе опубликованы научные исследования, свидетельствующие о высокой эффективности и безопасности АСИТ у больных АтД разной степени тяжести, сенсибилизированных к ингаляционным аллергенам, в частности к клещам домашней пыли и пыльцевым аллергенам [24, [28][29][30][31], однако существующая доказательная база не позволяет сформулировать окончательные выводы о показаниях к проведению к АСИТ при АтД. Выявление специфических аллергических молекулярных биомаркеров АтД с помощью многокомпонентной молекулярной аллергодиагностки позволяет точно определить причинно-значимые аллергены и разработать персонифицированный подход к назначению АСИТ.…”

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The significance of component-resolved allergy diagnostics in atopic dermatitis patients when prescribing allergen-specific immunotherapy

Elisyutina

Феденко

Smolnikov

et al. 2023

Russian Journal of Allergy

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The paper presents two clinical cases of patients with severe atopic dermatitis (AD) with polyvalent sensitization: in an adult patient and in a child. Standard topical and systemic therapy proved to be an insufficiently effective strategy in these patients. Both patients underwent component-resolved allergy diagnostics, which made it possible to identify the causally significant components of allergens, sensitization to which affects the course of AD. On the basis of the survey, indications for ASIT with causally significant allergens were determined. The performed treatment made it possible to achieve non-drug remission not only of AD, but also of concomitant respiratory allergic diseases. The cases presented by us demonstrate the efficacy and safety of ASIT in patients with proven sensitization to causally significant allergens based on component allergy diagnostics.

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Section: Discussionunclassified

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The significance of component-resolved allergy diagnostics in atopic dermatitis patients when prescribing allergen-specific immunotherapy

Elisyutina

Феденко

Smolnikov

et al. 2023

Russian Journal of Allergy

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“…Therefore, large controlled and randomized clinical trials are needed to study this more. Nevertheless, AIT may be an effective treatment option for selected AD patients ( 172 ).…”

Section: The Efficacy In Armentioning

confidence: 99%

Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?

et al. 2021

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Allergic rhinitis (AR) is an IgE-mediated disease that is characterized by Th2 joint inflammation. Allergen-specific immunotherapy (AIT) is indicated for AR when symptoms remain uncontrolled despite medication and allergen avoidance. AIT is considered to have been effective if it alleviated allergic symptoms, decreased medication use, improved the quality of life even after treatment cessation, and prevented the progression of AR to asthma and the onset of new sensitization. AIT can be administered subcutaneously or sublingually, and novel routes are still being developed, such as intra-lymphatically and epicutaneously. AIT aims at inducing allergen tolerance through modification of innate and adaptive immunologic responses. The main mechanism of AIT is control of type 2 inflammatory cells through induction of various functional regulatory cells such as regulatory T cells (Tregs), follicular T cells (Tfr), B cells (Bregs), dendritic cells (DCregs), innate lymphoid cells (IL-10+ ILCs), and natural killer cells (NKregs). However, AIT has a number of disadvantages: the long treatment period required to achieve greater efficacy, high cost, systemic allergic reactions, and the absence of a biomarker for predicting treatment responders. Currently, adjunctive therapies, vaccine adjuvants, and novel vaccine technologies are being studied to overcome the problems associated with AIT. This review presents an updated overview of AIT, with a special focus on AR.

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“…Importantly, many targetingtype 2-cytokine therapies (for example, IL-4, IL-13, IL-5, IL-31 inhibitors and anti-IgE monoclonal antibodies) currently have shown benefits in AD patients [25,26]. Allergen-specific immunotherapy (ASIT) is an effective IgE-mediated allergic disease therapy, whose efficacy has been demonstrated in house dust mites [27][28][29][30]. However, systemic and local adverse effects were reported in clinical trials for allergen immunotherapy [31][32][33].…”

Section: Introductionmentioning

confidence: 99%

An atopic dermatitis-like murine model by skin-brushed cockroach Per a 2 and oral tolerance induction by Lactococcus lactis-derived Per a 2

Lee,

Wang,

Chen

et al. 2023

PLoS ONE

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Atopic dermatitis (AD) is a complex, chronic inflammatory skin disease. An estimated 57.5% of asthmatic patients and 50.7% of rhinitis patients are allergic to cockroaches in Taiwan. However, the role of cockroaches in the pathogenesis of AD is undetermined. Oral tolerance might be another strategy for protecting against AD and allergic inflammation by regulating T helper 2 (Th2) immune responses. Aim to examine the underlying immunologic mechanism, we developed an AD-like murine model by skin-brushing with cockroach Per a 2. We also investigated whether the systemic inflammation of AD in this murine model could be improved by specific tolerance to Lactococcus lactis-expressing Per a 2, which was administered orally. Repeated painting of Per a 2 without adjuvant to the skin of mice resulted in increased total IgE, Per a 2-specific IgE, and IgG1, but not IgG2a. In addition, epidermal thickening was significantly increased, there were more scratch episodes, and there were increases in total white blood cells (eosinophil, neutrophil, and lymphocyte) and Th2 cytokines (Interleukin (IL)-4, IL-5, IL-9, and IL-13) in a dose-dependent manner. The results revealed that oral administration of L. lactis-Per a 2 ameliorated Per a 2-induced scratch behavior and decreased the production of total IgE, Per a 2-specific IgE, and IgG1. Furthermore, L. lactis-Per a 2 treatment also suppressed inflammatory infiltration, expressions of thymic stromal lymphopoietin (TSLP) and IL-31 in skin lesions, and downregulated splenic IL-4 and IL-13 in Per a 2-induced AD mice. This study provides evidence supporting that repeated brushing of aeroallergens to the skin leads to atopic dermatitis phenotypes and oral allergen-specific immune tolerance can ameliorate AD-like symptoms and systemic inflammation and prevent progression of atopic march.

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Successful treatment of atopic dermatitis with house dust mite sublingual immunotherapy tablets

Cited by 4 publications

References 0 publications

The significance of component-resolved allergy diagnostics in atopic dermatitis patients when prescribing allergen-specific immunotherapy

The significance of component-resolved allergy diagnostics in atopic dermatitis patients when prescribing allergen-specific immunotherapy

Allergic Rhinitis: What Do We Know About Allergen-Specific Immunotherapy?

An atopic dermatitis-like murine model by skin-brushed cockroach Per a 2 and oral tolerance induction by Lactococcus lactis-derived Per a 2

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