Antihistaminic Treatment, Allergen‐Specific Immunotherapy, and Blockade of IgE as Alternative Allergy Treatments

Abstract

Allergies mediated by immunoglobulin E (IgE) are the most common immunological hypersensitivity diseases. The prevalence has been continuously increasing in recent decades, and more than 25% of the population is currently afected. Symptoms of allergies can be observed in the skin and respiratory and gastrointestinal tracts, and systemic manifestations include anaphylactic shock. If an allergy is not properly diagnosed and treated, it tends to progress to a severe and chronic debilitating disease. Understanding the mechanisms by which the immune system induces and controls allergic inlammation depends on knowing the structure of several allergens and identifying epitopes, which are critical for the design of new strategies for treating allergies. Strategies for immunotherapy will be reviewed. Allergen-speciic immunotherapy has been used for nearly a century and remains one of the few antigen-speciic treatments for inlammatory diseases. There is a strong rationale for improving the eicacy of allergen-speciic immunotherapy by reducing the incidence and severity of adverse reactions mediated by IgE. Approaches to address this problem, including the use of modiied allergens, synthetic peptides as vaccines, and alternative strategies for blocking IgE, will be discussed.

Allergen-specific immunotherapy in allergic rhinitis

“…Будущие перспективы АСИТ включают разработку альтернативных способов введения аллергенов, иммуномодулирующих адъювантов, аллергоидов [29,30], рекомбинантных вакцин [18,[31][32][33], контейнеров для аллергенов типа вирусоподобных частиц и липосом. Главная цель усовершенствования АСИТ заключается в укорочении существующих протоколов без потери эффективности иммунотерапии, создании лучшего профиля побочных реакций и распространение АСИТ в развивающихся странах [3].…”

Lipid Cubic Systems for Sustained and Controlled Delivery of Antihistamine Drugs

“… 12 , 15 − 17 Because of a lack of selectivity, this class of molecules may also induce deleterious effects such as sedation and a reduced psychomotor performance. 18 To overcome these, less lipophilic second-generation antihistamines have been developed that bind more specifically to H 1 receptors and display a strong affinity for surface P-glycoprotein expressed on vascular endothelial cells reducing the likelihood of their penetration into the CNS. 18 , 19 …”

“… 18 To overcome these, less lipophilic second-generation antihistamines have been developed that bind more specifically to H 1 receptors and display a strong affinity for surface P-glycoprotein expressed on vascular endothelial cells reducing the likelihood of their penetration into the CNS. 18 , 19 …”

“…They have also proven their ability to inhibit mast cell activation and subsequent histamine release, likely through the downregulation of calcium ions in the cell, although the mechanism is still not fully understood. ,− These H 1 -antihistamines are further classified into two groups based on their ability to cross the blood-brain barrier. First-generation antihistamines are lipophilic in nature, have relatively low molecular weight, and lack of recognition by the P-glycoprotein efflux pump; they readily cross this barrier and interact with H 1 receptors through the central nervous system (CNS). ,− Because of a lack of selectivity, this class of molecules may also induce deleterious effects such as sedation and a reduced psychomotor performance . To overcome these, less lipophilic second-generation antihistamines have been developed that bind more specifically to H 1 receptors and display a strong affinity for surface P-glycoprotein expressed on vascular endothelial cells reducing the likelihood of their penetration into the CNS. , …”

“…First-generation antihistamines are lipophilic in nature, have relatively low molecular weight, and lack of recognition by the P-glycoprotein efflux pump; they readily cross this barrier and interact with H 1 receptors through the central nervous system (CNS). ,− Because of a lack of selectivity, this class of molecules may also induce deleterious effects such as sedation and a reduced psychomotor performance . To overcome these, less lipophilic second-generation antihistamines have been developed that bind more specifically to H 1 receptors and display a strong affinity for surface P-glycoprotein expressed on vascular endothelial cells reducing the likelihood of their penetration into the CNS. , …”