Real‐world benefits of allergen immunotherapy for birch pollen‐associated allergic rhinitis and asthma

Wahn, Ulrich; Bachert, Claus; Heinrich, Joachim; Richter, Hartmut; Zielen, Stefan

doi:10.1111/all.13598

Cited by 110 publications

(145 citation statements)

References 33 publications

Supporting

Mentioning

121

Contrasting

Unclassified

Order By: Relevance

“…The selection of a patient population that is more likely to have a disease-related event, such as exacerbations, organ function decline, or death. (38)(39)(40). A good example of heterogeneous disease appearance is in CRSwNP: in Chinese populations, polyps appear with a tendency toward neutrophil predominance, whereas polyps in Western populations are mostly eosinophilic (41)(42)(43).…”

Section: Prognostic Enrichmentmentioning

confidence: 99%

Precision medicine and phenotypes, endotypes, genotypes, regiotypes, and theratypes of allergic diseases

Agache

Akdiş

2019

Journal of Clinical Investigation

233

184

View full text Add to dashboard Cite

in which microRNAs (miRNAs) play a central role (Table 3). High-throughput profiling studies of well-characterized patients, including analyses of gene expression (e.g., microarrays and RNA sequencing transcriptomics), can help to identify combined signatures for type 2 and non-type 2 endotypes. They are enriching the available data for the identification of new potential targets. As critical components in the regulation of tissue homeostasis, miRNAs represent a very attractive field of precision medicine research in asthma and allergic diseases, as they have been linked to many biological mechanisms underlying Th2 cell and macrophage polarization, regulation of ILC2 biology, steroidresistant asthma phenotype, airway smooth muscle dysfunction, and impaired antiviral innate immunity (Table 3 and refs. 15-25). Thus, miRNAs represent a modifiable downstream target that will expand the precision medicine approach beyond the type 2/ non-type 2 paradigm. In one notable example of this approach, the use of gene expression microarrays on bronchial epithelial cells obtained from patients with asthma led to the identification of periostin, an IL-13-responsive biomarker (26-30). However, expression signatures are not highly specific for type 2 asthma: a recent study showed type 2 airway gene expression in a subset of patients with chronic obstructive pulmonary disease (COPD) (31).

show abstract

Section: Prognostic Enrichmentmentioning

confidence: 99%

Precision medicine and phenotypes, endotypes, genotypes, regiotypes, and theratypes of allergic diseases

Agache

Akdiş

2019

Journal of Clinical Investigation

233

184

View full text Add to dashboard Cite

show abstract

“…Currently, allergen‐specific immunotherapy (AIT) is the only curative treatment that induces clinical and immunological tolerance to causative allergens in allergic patients . AIT efficiently decreases symptoms of allergic asthma, rhinitis, and insect sting allergy . A primary feature of AIT is to change the course of the disease by changing the underlying pathology on local and systemic immune response .…”

Section: Introductionmentioning

confidence: 99%

Der p 1‐specific regulatory T‐cell response during house dust mite allergen immunotherapy

Boonpiyathad

Sokołowska

Morita

et al. 2019

Allergy

View full text Add to dashboard Cite

Background: Allergen-specific immunotherapy (AIT) is the only available treatment for allergic diseases that can induce specific immune tolerance to allergens. The key mechanisms involved in this process include changes in allergen-specific regulatory T (Treg) cells. Methods:We studied 25 allergic rhinitis patients undergoing subcutaneous house dust mite-specific immunotherapy. Peripheral blood mononuclear cells were studied before and after 10, 30 weeks, and 3 years of AIT. Der p 1-specific T regulatory cell responses were investigated by characterization of Der p 1-MHC class II tetramerpositive cells and correlated with nasal symptom score. Results: Twelve of 25 AIT patients matched with their MHC class II expression to the Der p 1 peptide-MHC class II tetramers. A significant increase in the numbers of Der p 1-specific FOXP3 + Helios + CD25 + CD127 − Treg cells after 30 weeks was observed, which slightly decreased after 3 years of AIT. In contrast, Der p 1-specific immunoglobulin-like transcript 3 (ILT3) + CD25 + Treg cells decreased substantially from baseline after 3 years of AIT. ILT3 + Treg cells displayed compromised suppressive function and low FOXP3 expression. In addition, Der p 1-specific IL-10 and IL-22 responses have increased after 30 weeks, but only IL-10 + Der p 1-specific Treg cells remained present at high frequency after 3 years of AIT. Increased number of FOXP3 + Helios + and IL-10 + and decreased ILT3 + Treg cell responses correlated with improved allergic symptoms. Conclusion: The results indicate that AIT involves upregulation of the activated allergen-specific Treg cells and downregulation of dysfunctional allergen-specific Treg cell subset. Correction of dysregulated Treg cells responses during AIT is associated with improved clinical response. K E Y W O R D Sallergen-specific T cells, antigen-specific immunotherapy, house dust mite allergy, Treg Abbreviations: AIT, antigen-specific immunotherapy; AR, allergic rhinitis; HDM, house dust mite; ILT3, immunoglobulin-like transcript 3; Treg, T regulatory.

show abstract

“…Furthermore, it has become evident that at least 3 years of treatment is needed to confer long-term clinical tolerance. 11,12 To overcome these limitations, several newer approaches are under investigation with altered administration or allergen preparation. 13 Intralymphatic immunotherapy (ILIT) is being trialled for aeroallergens with the aim to shorten the treatment period to 2 months using three ultrasound-guided injections of low-dose allergen applied with 1-month intervals.…”

Section: Allergen Immunotherapy: a Prototype Of Precision Medicinementioning

confidence: 99%

“…These approaches are deemed safe, but in a minority of patients, a strong reaction can already be observed at the (very low) starting dose, postponing or stopping further therapy. Furthermore, it has become evident that at least 3 years of treatment is needed to confer long‐term clinical tolerance . To overcome these limitations, several newer approaches are under investigation with altered administration or allergen preparation …”

Section: Introductionmentioning

confidence: 99%

Recent developments and highlights in immune monitoring of allergen immunotherapy

Zelm

McKenzie

Varese

et al. 2019

Allergy

View full text Add to dashboard Cite

Allergic diseases are the most common chronic immune-mediated disorders and can manifest with an enormous diversity in clinical severity and symptoms. Underlying mechanisms for the adverse immune response to allergens and its downregulation by treatment are still being revealed. As a result, there have been, and still are, major challenges in diagnosis, prediction of disease progression/evolution and treatment.Currently, the only corrective treatment available is allergen immunotherapy (AIT).AIT modifies the immune response through long-term repeated exposure to defined doses of allergen. However, as the treatment usually needs to be continued for several years to be effective, and can be accompanied by adverse reactions, many patients face difficulties completing their schedule. Long-term therapy also potentially incurs high costs. Therefore, there is a great need for objective markers to predict or to monitor individual patient's beneficial changes in immune response during therapy so that efficacy can be identified as early as possible. In this review, we specifically address recent technical developments that have generated new insights into allergic disease pathogenesis, and how these could potentially be translated into routine laboratory assays for disease monitoring during AIT that are relatively inexpensive, robust and scalable. K E Y W O R D Sallergen immunotherapy, allergy, biomarker, immune monitoring | 2343 ZELM Et aL.

show abstract

Real‐world benefits of allergen immunotherapy for birch pollen‐associated allergic rhinitis and asthma

Abstract: Birch pollen AIT demonstrated real-world benefits up to 6 years post-treatment cessation through significantly reduced AR and asthma medication intake, and significantly decreased risk of new-onset asthma medication use on-treatment.

Cited by 110 publications

References 33 publications

Precision medicine and phenotypes, endotypes, genotypes, regiotypes, and theratypes of allergic diseases

Precision medicine and phenotypes, endotypes, genotypes, regiotypes, and theratypes of allergic diseases

Der p 1‐specific regulatory T‐cell response during house dust mite allergen immunotherapy

Recent developments and highlights in immune monitoring of allergen immunotherapy

Contact Info

Product

Resources

About