Allergen immunotherapy: Basic concepts

Hassan, Ghulam; Kant, Surya; Prakash, Ved; Verma, Ajay Kumar; Saheer, S; Singh, Abhijeet; Singh, Arpita; Jena, Naredra Nath; Wani, Nisar Ahmed

doi:10.4103/0972-6691.116606

Cited by 2 publications

(1 citation statement)

References 63 publications

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“…Additionally, an increase in IgG2 a in the serum shifts the Th1/Th2 immune response towards a Th1-dominated immune response (107). Despite early generation of Tregs following AIT, it may still take years to effectuate a marked reduction in IgE levels in the allergic individuals (108). An analysis of the mechanisms of AIT has been summarized in Fig.…”

Section: Mechanisms Of Aitmentioning

confidence: 99%

Immunotherapies in the treatment of immunoglobulin E‑mediated allergy: Challenges and scope for innovation (Review)

2022

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Immunoglobulin E (IgE)-mediated allergy or hypersensitivity reactions are generally defined as an unwanted severe symptomatic immunological reaction that occurs due to shattered or untrained peripheral tolerance of the immune system. Allergen-specific immunotherapy (AIT) is the only therapeutic strategy that can provide a longer-lasting symptomatic and clinical break from medications in IgE-mediated allergy. Immunotherapies against allergic diseases comprise a successive increasing dose of allergen, which helps in developing the immune tolerance against the allergen. AITs exerttheirspecial effectiveness directly or indirectly by modulating the regulator and effector components of the immune system. The number of success stories of AIT is still limited and it canoccasionallyhave a severe treatment-associated adverse effect on patients. Therefore, the formulation used for AIT should be appropriate and effective. The present review describes the chronological evolution of AIT, and provides a comparative account of the merits and demerits of different AITs by keeping in focus the critical guiding factors, such as sustained allergen tolerance, duration of AIT, probability of mild to severe allergic reactions and dose of allergen required to effectuate an effective AIT. The mechanisms by which regulatory T cells suppress allergen-specific effector T cells and how loss of natural tolerance against innocuous proteins induces allergy are reviewed. The present review highlights the major AIT bottlenecks and the importantregulatory requirements for standardized AIT formulations. Furthermore, the present reviewcalls attention to the problem of 'polyallergy', which is still a major challenge for AIT and the emerging concept of 'component-resolved diagnosis' (CRD) to address the issue. Finally, a prospective strategy for upgrading cRd to the next dimension is provided, and a potential technology for delivering thoroughly standardized AIT with minimal risk is discussed.

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Section: Mechanisms Of Aitmentioning

confidence: 99%

Immunotherapies in the treatment of immunoglobulin E‑mediated allergy: Challenges and scope for innovation (Review)

2022

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Allergy-associated T cell epitope repertoires are surprisingly diverse and include non-IgE reactive antigens

Schulten

Hinz

Oseroff

et al. 2014

World Allergy Organization Journal

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We recently identified T cell epitopes associated with human allergic responses. In a majority of cases, responses focused on a few immunodominant epitopes which can be predicted on the basis of MHC binding characteristics. Several observations from our studies challenged the assumption that T cell epitopes are derived from the same allergen proteins that bind IgE. Transcriptomic and proteomics analysis identified pollen proteins, not bound by IgE. These novel Timothy Grass proteins elicited vigorous Th2 responses, suggesting that unlinked T cell help is operational in pollen-specific responses. Thus, the repertoire of antigens recognized by T cells is much broader than IgE-binding allergens. Additionally, we evaluated the use of epitopes from these novel antigens to assess immunological changes associated with Specific Immunotherapy (SIT). We found that a marked decrease in IL5 production is associated with clinically efficacious SIT, suggesting that these novel antigens are potential immunomarkers for SIT efficacy.

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Allergen immunotherapy: Basic concepts

Cited by 2 publications

References 63 publications

Immunotherapies in the treatment of immunoglobulin E‑mediated allergy: Challenges and scope for innovation (Review)

Immunotherapies in the treatment of immunoglobulin E‑mediated allergy: Challenges and scope for innovation (Review)

Allergy-associated T cell epitope repertoires are surprisingly diverse and include non-IgE reactive antigens

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