Adequate Clinical Trials of Immunotherapy

K, Aas

doi:10.1111/j.1398-9995.1982.tb04111.x

Cited by 33 publications

(7 citation statements)

References 29 publications

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“…As a means of substantiating the diagnosis or of proving that the shock organ is involved, challenge tests should preferably be used, but in clear-cut allergic conditions they appear to be less important. Some investigators have suggested that bronchial provocation tests should be performed and be positive before starting immunotherapy in asthmatic patients (1,195). As bronchial provocation challenge differs from natural exposure in a number of ways, its use as an ultimate diagnostic test remains controversial.…”

Section: 41 Methodsmentioning

confidence: 99%

“…Only allergens causing most of the patient's symptoms should be used for imrnunotherapy. In patients with multiple allergies, it is often difficult to define clearly the allergens mainly responsible for the combination of symptoms (1). Immunotherapy with one allergen is unlikely to be effective in the presence of multiple allergies.…”

Section: Evaluation Of the Patientmentioning

confidence: 99%

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Position Paper: Immunotherapy

Mailing¹,

Weeke²

1993

Allergy

335

109

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PrefaceThe only real argument for establishing a specific diagnosis in allergic diseases is the institution of a specific treatment. Allergen avoidance and immunotherapy represent the only specific treatments we are able to offer allergic patients. The capacity of drug treatment is limited to the elimination or diminishing of symptoms, and no studies have been able to show that pharmacologic treatment of allergic diseases, not even corticosteroids, modifies the spontaneous, long-term course of the disease. Costbenefit studies of immunotherapy present problems, and we recommend that immunotherapy be an integrated part of the treatment of allergic disorders, thus reducing the disease severity, improving the quality of life of allergics, and diminishing the risk and cost of pharmacotherapy.The first EAACI Immunotherapy Position Paper was published in 1988. New insights into the pathogenesis of allergic diseases and recent publications on immunotherapy have called for a revision of the Immunotherapy Position Paper. However, allergenspecific immunotherapy is a controversial treatment, and drafting this 1992 revised Position Paper is difficult since: 1) We intend to recommend that immunotherapy be performed in the most scientific way, but supportive data are not always sufficient. 2) Although clinical experience is encouraging, particularly with recent high-quality extracts, a further reduction in the number of patients treated by immunotherapy, while we wait for further scientific data, will make improvements more difficult, and eventually lead to a halt in the production of allergen extracts. Our Position Paper, therefore, aims at reaching a consensus, balancing science, theory, and current practice in most European countries, at the same time intending to improve the scientific value of the 1992 revised EAACI Immunotherapy Position Paper .The outlines of the 1992 revised EAACI Immunotherapy Position Paper were debated at a one-day meetingin February 1991, in Copenhagen, Denmark, sponsored by ALK, Denmark. The first edition was drafted at a three-day meeting in May 1991, in Madrid, Spain, organized by Dr Emilio Alvarez-Cuesta and kindly sponsored by Abell6, Spain. The final revised edition of the Position Paper represents the opinion of the members of the EAACI Immu-notherapy Subcommittee and includes comments from the EAACI associate European national societies of allergology. Hans-Jrargen Malling Bent Weeke aluminium-containing allergen extracts. Allergy 1985: 40: 59. FROSTAD AB, GRIMMER 0, SANDVIK L, MOXNES A. AAS K. Clinical effects of hyposensitization using a purified allergen preparation from timothy pollen as compared to crude aqueous extracts from timothy pollen and a four-grass pollen mixture respectively. Clin Allergy 1983: 13: 337-57. 60. FURIN MJ. NORMAN PS. CRETICOS PS, et al. Immunotherapy decreases antigen-induced eosinophil cell migration into the nasal cavity. J Allergy Clin Imrnunol 1991: 88: 27-32. 61. GEHA RS. Use of IgE-derived peptides to treat allergy. Ann Allergy 1991: 66: 359-60. 62. GEORGIT...

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Section: 41 Methodsmentioning

confidence: 99%

Section: Evaluation Of the Patientmentioning

confidence: 99%

Position Paper: Immunotherapy

Mailing¹,

Weeke²

1993

Allergy

335

109

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“…Challenge testing has been advocated as a way to overcome these problems [4]. It has the advantage of being less influenced by operator bias and thereby limits the necessity for placebo treatment in the eontrol groups.…”

Section: Assessing Effectivenessmentioning

confidence: 99%

Does immunotherapy have a role in the treatment of asthma?

Weeke¹

1986

Clin Experimental Allergy

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“…These observa tions have stimulated many studies devoted to both the characterization of the allergens involved in the initial sensitization and subsequent provocation, and in devising more efficient immunotherapeutic re gimes. With regard to the latter, however, although it has been shown that, subject to stringent selection cri teria, the technique is of value [1,22], our lack of knowledge regarding the mechanisms involved in IgE regulation per se has precluded the optimization of such approaches in humans.…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity and Tolerogenicity of a Major House Dust Mite Allergen, <i>Der p</i> l from <i>Dermatophagoides pteronyssinus</i>, in Mice and Rats

Stewart¹,

Holt²

1987

Int Arch Allergy Immunol

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Primary immunization of different inbred strains of mice with the house dust mite allergen Der p I (from Dermatophagoides pteronyssinus) adsorbed to adjuvant revealed differences in IgE but not IgG responses. Thus, the CBA and C57 Black strains were shown to be high IgE responders in that persistent IgE was induced which lasted for several months. In contrast, the C3H, AKR and Balb/c strains were judged to be poor responders. Subsequent experiments showed that such responses were adjuvant-independent, refractory to irradiation (850 rad) and that they could be adoptively transferred using immune spleen cells in a dose-dependent manner. At sub-optimal doses, adoptively transferred IgE responses were initiated by either intraperitoneal or intranasal challenge of recipients with allergen in the absence of adjuvant. Allergen-specific IgE in rats was also shown to be strain-dependent, with Brown Norway rats, in contrast to Wistar Furth (WF) and Lou/M rats, being the highest responder strain studied. Repeated intranasal administration of soluble allergen induced IgE tolerance in rats but not mice. However, tolerance was restricted to the low IgE responder phenotype strain, WF.

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Adequate Clinical Trials of Immunotherapy

Cited by 33 publications

References 29 publications

Position Paper: Immunotherapy

Position Paper: Immunotherapy

Does immunotherapy have a role in the treatment of asthma?

Immunogenicity and Tolerogenicity of a Major House Dust Mite Allergen, <i>Der p</i> l from <i>Dermatophagoides pteronyssinus</i>, in Mice and Rats

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