How does allergen immunotherapy‐induced tolerance improve the airway epithelial barrier function: A mechanistical‐driven hypothesis

Pfaar, Oliver; Fritzsching, Benedikt; Wolf, Hendrik; Woehlk, Christian; Wüstenberg, Eike

doi:10.1111/all.15835

Cited by 5 publications

(5 citation statements)

References 22 publications

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“…Studies are needed to see if its use reduces progression to asthma and, if so, on identifying those likely to respond to such treatment. Recent evidence suggests that AIT may to some extent repair epithelial barrier function ( 167 ). Upper airway disease needs to be taken more seriously with accurate diagnosis of AR, since it is likely that, if effectively treated early, some asthma may be prevented.…”

Section: Discussionmentioning

confidence: 99%

Pre-asthma: a useful concept for prevention and disease-modification? A EUFOREA paper. Part 1—allergic asthma

Scadding,

McDonald,

Backer

et al. 2024

Front. Allergy

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Asthma, which affects some 300 million people worldwide and caused 455,000 deaths in 2019, is a significant burden to suffers and to society. It is the most common chronic disease in children and represents one of the major causes for years lived with disability. Significant efforts are made by organizations such as WHO in improving the diagnosis, treatment and monitoring of asthma. However asthma prevention has been less studied. Currently there is a concept of pre- diabetes which allows a reduction in full blown diabetes if diet and exercise are undertaken. Similar predictive states are found in Alzheimer's and Parkinson's diseases. In this paper we explore the possibilities for asthma prevention, both at population level and also investigate the possibility of defining a state of pre-asthma, in which intensive treatment could reduce progression to asthma. Since asthma is a heterogeneous condition, this paper is concerned with allergic asthma. A subsequent one will deal with late onset eosinophilic asthma.

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Section: Discussionmentioning

confidence: 99%

Pre-asthma: a useful concept for prevention and disease-modification? A EUFOREA paper. Part 1—allergic asthma

Scadding,

McDonald,

Backer

et al. 2024

Front. Allergy

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“…They may also prevent mast cell and basophil activation and induce B cells, which secret these blocking antibodies and are responsible for long‐term immunotolerance 10,91–93 . Further cellular responses involve reduced eosinophil recruitment, suppression of Th2 cells, and induction of regulatory cell populations (from innate lymphoid cells, dendritic cells, T and B cells) and regulatory cytokine responses (IL‐10 and TGF‐β), re‐establishing Th1‐Th2 balance 10,41,49,52,87,92,94–96 . More insights into these mechanisms (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Several reports, meta-analyses and systematic reviews have substantially improved our understanding of pAIT. 2,11,18,20,21,29,38,[45][46][47][48][49] The prevention of respiratory allergies seems possible, but the effects of pAIT need to be better explored. 2,15,20,50 Currently, implementing pAIT still faces challenges due to age-related factors 27,45 and limited data.…”

Section: Tertiarymentioning

confidence: 99%

“…The evidence for applying preventive allergen immunotherapy (pAIT) is growing rapidly. Several reports, meta‐analyses and systematic reviews have substantially improved our understanding of pAIT 2,11,18,20,21,29,38,45–49 . The prevention of respiratory allergies seems possible, but the effects of pAIT need to be better explored 2,15,20,50 .…”

Section: Introductionmentioning

confidence: 99%

“…Aqueous formulation from Geer Laboratories: 5,000 AU/mL weekly) Marogna et al 74 Th1-Th2 balance. 10,41,49,52,87,92,[94][95][96] More insights into these mechanisms (e.g. role of T cell exhaustion, 92 T follicular regulatory cells, and their epigenetic effects 97 ) are awaited in a preventive clinical setting.…”

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confidence: 99%

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Preventive allergen immunotherapy with inhalant allergens in children

Dwivedi,

Kopanja,

Schmidthaler

et al. 2024

Allergy

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The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen‐specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell‐mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and/or tree pollen‐based pAIT has shown efficacy in preventing disease progression from allergic rhinitis/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head‐to‐head comparative paediatric studies are scarce. Additionally, there are fewer placebo‐controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well‐designed studies.

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