Current developments for improving efficacy of allergy vaccines

Abstract

Allergic diseases are prevalent worldwide. Allergen immunotherapy (AIT) is a current treatment for allergy, leading to modification of the natural course of disease. Mechanisms of efficacy include Treg through release of IL-10 and TGF-β and specific IgG4 blocking antibodies. Subcutaneous and sublingual routes are popular, but uptake is limited by inconvenience and safety concerns. Inclusion criteria limit application to a small proportion of allergic patients. New forms of immunotherapy are being investigated for more efficacious, convenient and safer options with promising advances in recent years. The rationale of reducing vaccine allergenicity to increase safety while improving immunogenicity led to investigation of T-cell epitope-based peptides and recombinant allergen derivatives. Additionally, different routes of administration and adjuvants and adjunct therapies are being explored. This review discusses the current status of AIT and recent advances to improve clinical efficacy, safety and long-term immune tolerance.

Effect of Heat Processing on IgE Reactivity and Cross‐Reactivity of Tropomyosin and Other Allergens of Asia‐Pacific Mollusc Species: Identification of Novel Sydney Rock Oyster Tropomyosin Sac g 1

“…Diagnostic precision will be enhanced by including the appropriate range of purified allergens from relevant species including those prepared from raw or cooked extracts as appropriate. Coupled with promising advances in delivering hypoallergenic preparations, knowledge of clinically important mollusc allergens provides crucial platform knowledge for the development of much needed safe and efficacious specific immunotherapy for mollusc allergy …”

Recent advances in the use of nanoparticles for allergen‐specific immunotherapy

“…Prevention of these side‐effects resulting in safer therapy as well as a more efficient treatment—even though there is no reliable biomarker predictive of AIT efficacy so far—is a main goal for improving strategies in AIT. Approaches to achieve this goal include a molecular‐based diagnosis to refine the prescription, and a therapy with physically adsorbed allergens as (semi‐) depot extracts, modified allergens like allergoids or hypoallergenic recombinant allergens or peptides or co‐administration of anti‐IgE antibodies . Another concept as an alternative to AIT aims at shifting the imbalance of T‐cell subtypes toward a more balanced one by unspecific induction of Th1 cells with adjuvant moieties, for example, immunostimulatory DNA, monophosphoryl lipid A, or lactic acid bacteria.…”

Subcutaneous immunotherapy using modified Phl p5a‐derived peptides efficiently alleviates allergic asthma in mice

“…Moreover, since T-cell epitopes are dependent on MHC use, a wider variety of T-cell epitopes will be needed to obtain a formulation that can be applied in most GP allergic individuals, while keeping the peptides as short as possible (20 AA) to prevent IgE cross-linking and adverse events. 7 Consequently, the net dosage of each individual peptide in the mixture used will be relatively low. We postulate that sialylation of the peptides used in such formulations is a valuable approach to increase efficiency of peptide SCIT.…”