Efficacy and Safety of Oral Immunotherapy with Short Ragweed Extract

Deusen, Mathew A Van; Angelini, Betty; Cordoro, Kelly M.; Seiler, Beth A; Wood, Lindsey; Skoner, David P.

doi:10.1016/s1081-1206(10)63218-8

Cited by 42 publications

(22 citation statements)

References 26 publications

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“…In addition, the increase of Cry j 1-and Cry j 2-specific IgE levels was not altered by the immunotherapy. These findings are similar to both those in our previous pre-treatment experiment (16), in which the oral administration was started before the sensitization procedure, and to the other clinical studies that have evaluated oral immunotherapy (20,21). These results indicate that oral immunotherapy has no inhibitory effect on the IgE-mediated mast cell activation at the nasal mucosa.…”

Section: Discussionsupporting

confidence: 90%

“…A 1-year oral administration of a high dose of grass pollen to patients with hay fever failed to produce any beneficial change in either the clinical symptoms or the serum antigenspecific IgE levels (20). On the other hand, when patients with allergic rhinitis to short ragweed were treated orally with encapsulated short ragweed extract for 6 weeks followed by a nasal antigen challenge, the nasal congestion was significantly suppressed, even though the sneezing, nasal secretion, and the serum antigen-specific IgE antibody levels were not substantially attenuated (21). Since nasal blockage is apparently induced mainly by nasal congestion, our present findings correspond well with those of the latter report (21).…”

Section: Discussionmentioning

confidence: 97%

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Effect of Oral Immunotherapy on Nasal Blockage in Experimental Allergic Rhinitis

et al. 2005

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Abstract. We previously reported that when Japanese cedar pollen was prophylactically p.o. administered before a sensitization stage in a guinea-pig model of allergic rhinitis, pollen-induced nasal blockage was suppressed. In this study, we evaluated whether the oral immunotherapy is also effective when the pollen extract was administered starting from the day when the nasal blockage was clearly induced and whether the effectiveness continued after cessation of the immunotherapy. Sensitized animals were repeatedly challenged by pollen inhalation once every week. After the 7th challenge, the extract was orally administered twice a week until the 30th challenge. At the 11th challenge, the oral immunotherapy showed inhibition of the biphasic nasal blockage. The effectiveness was consistently observed during the immunotherapy until the 30th challenge. Furthermore, the increased nasal responsiveness to intranasal application of leukotriene D 4 was markedly suppressed by the immunotherapy. Interestingly, even after cessation of the therapy, inhibition of the nasal blockage was sustained for more than 2 months. Nevertheless, neither sneezing nor antigen-specific IgE antibody production was substantially influenced by the immunotherapy. In conclusion, Oral immunotherapy may be clinically useful for allergic nasal blockage. Mechanisms underlying the effectiveness may be associated with the hyporesponsiveness of the nasal mucosa to released mediators.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Effect of Oral Immunotherapy on Nasal Blockage in Experimental Allergic Rhinitis

et al. 2005

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“…An older study investigating the utility of oral ragweed immunotherapy reported that nasal symptom scores during the natural allergen season were numerically but not statistically lower in the SLIT group versus the placebo group 167. However, a more recent double-blind, placebo-controlled study of 634 patients with allergies to timothy grass pollen demonstrated that sublingual timothy grass tablet significantly improved all ocular and nasal symptom scores, including blocked nose 168.…”

Section: Immunotherapymentioning

confidence: 98%

Treatment of congestion in upper respiratory diseases

Meltzer

Caballero²,

Fromer³

et al. 2010

IJGM

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Congestion, as a symptom of upper respiratory tract diseases including seasonal and perennial allergic rhinitis, acute and chronic rhinosinusitis, and nasal polyposis, is principally caused by mucosal inflammation. Though effective pharmacotherapy options exist, no agent is universally efficacious; therapeutic decisions must account for individual patient preferences. Oral H1-antihistamines, though effective for the common symptoms of allergic rhinitis, have modest decongestant action, as do leukotriene receptor antagonists. Intranasal antihistamines appear to improve congestion better than oral forms. Topical decongestants reduce congestion associated with allergic rhinitis, but local adverse effects make them unsuitable for long-term use. Oral decongestants show some efficacy against congestion in allergic rhinitis and the common cold, and can be combined with oral antihistamines. Intranasal corticosteroids have broad anti-inflammatory activities, are the most potent long-term pharmacologic treatment of congestion associated with allergic rhinitis, and show some congestion relief in rhinosinusitis and nasal polyposis. Immunotherapy and surgery may be used in some cases refractory to pharmacotherapy. Steps in congestion management include (1) diagnosis of the cause(s), (2) patient education and monitoring, (3) avoidance of environmental triggers where possible, (4) pharmacotherapy, and (5) immunotherapy (for patients with allergic rhinitis) or surgery for patients whose condition is otherwise uncontrolled.

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“…Treated patients had increased antiragweed IgG and displayed regulated IgE increases during ragweed season [95]. Subsequent double-blind studies demonstrated both the safety and clinical benefit in some patients, as manifested by decreased nasal reactivity and regulated IgE levels during ragweed season [98,99].…”

Section: Oral Allergen Immunotherapymentioning

confidence: 98%

Oral tolerance in the treatment of inflammatory autoimmune diseases

Wardrop

1999

Inflamm. res.

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Oral tolerance refers to the oral administration of protein antigens, which induces a state of systemic nonresponsiveness specific for the fed antigen. This method of inducing immune non-responsiveness has been applied to the prevention and treatment of experimental animal models of autoimmune disease. Extensive research in this area over the past ten years has led to the conclusion that two mechanisms are operative in the mediation of oral tolerance--active suppression and clonal anergy/deletion. A number of factors have been identified that determine which mechanism of tolerance is operative--antigen dose, antigen form, and the timing of antigen administration. Work from these animal models has recently been extended into human clinical trials of multiple sclerosis, rheumatoid arthritis, diabetes, uveitis, and allergy, with differing degrees of success. In this review, a discussion is provided of the animal model systems where oral tolerance has been applied and the clinical trials where an oral tolerization approach has been attempted. Moreover, recent mechanistic studies are reviewed and a model proposed for the induction of oral tolerance.

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Efficacy and Safety of Oral Immunotherapy with Short Ragweed Extract

Cited by 42 publications

References 26 publications

Effect of Oral Immunotherapy on Nasal Blockage in Experimental Allergic Rhinitis

Effect of Oral Immunotherapy on Nasal Blockage in Experimental Allergic Rhinitis

Treatment of congestion in upper respiratory diseases

Oral tolerance in the treatment of inflammatory autoimmune diseases

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