Recent Advances in Allergen-Specific Immunotherapy as Treatment for Allergic Asthma: A Practical Overview

Abstract

The Global Initiative for Asthma Report updated in 2019 stated that potential benefits of allergen immunotherapy (AIT), compared to pharmacological and avoidance options, must be weighed against the risk of adverse effects and the inconvenience and cost of the prolonged course of therapy in asthma. Thus, with the aim of clarifying some aspects with regard to the possible use of AIT in allergic asthma treatment armamentarium, a group of expert allergists from the Spanish Allergy and Clinical Immunology Scientific Society (SEAIC), particularly from the Immunotherapy and Asthma Interest Groups developed a frequently asked questions in clinical practice. This document updates relevant topics on the use of AIT in asthma and could facilitate physician clinical decisions and improve health outcomes for individual patients.

Substance P promotes immunotherapy efficacy for airway allergy

“…However, the therapeutic effects of AIT were various or even exacerbated the clinical symptoms as reported by different studies. 8 , 33 Although the various results of AIT may be because the heterogeneity in study design and reporting of outcomes, 8 , 33 the fact suggests the therapeutic efficacy of AIT is needed. Our data provide a potential agent, SP, can be used to favor AIT.…”

Asthma and Allergy: Unravelling a Tangled Relationship with a Focus on New Biomarkers and Treatment

“…Furthermore, molecular-based diagnostics has a direct effect on the strategy of choosing which allergens should be used in AIT [ 24 ]. Of note, it is recognized that molecular diagnosis allows for a personalized AIT thus sparing patients the burden of multiple treatments or unnecessary lifestyle modifications involved in allergen avoidance [ 25 ]. In this scenario, the component resolved diagnosis (CRD) stands as a promising starting point as it allows to precisely identify the number and type of recognized molecules in the individual patient that are clinically relevant.…”

“…Most patients with allergic asthma seen by specialists are polysensitized, and many of them are also poly-allergic (sensitizations with clinical relevance) because polysensitization does not necessarily mean that all sensitivities are clinically significant. To date, while in Europe allergen immunotherapy practice recommends that 1 or 2 of the most important allergens for the patient are to be included in the same extract, in the United States, mixtures including many or most of the sensitizing allergens are commonly administered [ 25 ].…”

“…Identifying sensitizations in allergic rhinitis subjects may also help guide AIT for potential asthma prevention. Therefore, positive specific IgE is considered a useful biomarker for AIT candidate selection in the context of a clear history of symptoms on exposure to the relevant allergen [ 25 ]. To date, AIT stands as the only treatment approach able to alter the natural course of allergic respiratory diseases by decreasing frequency and severity of symptoms and progression of rhinitis to asthma [ 25 , 53 ].…”

“…Therefore, positive specific IgE is considered a useful biomarker for AIT candidate selection in the context of a clear history of symptoms on exposure to the relevant allergen [ 25 ]. To date, AIT stands as the only treatment approach able to alter the natural course of allergic respiratory diseases by decreasing frequency and severity of symptoms and progression of rhinitis to asthma [ 25 , 53 ]. As AIT works through induction of allergen-specific tolerance, its effectiveness relies on the inclusion of relevant allergens in adequate concentrations to achieve tolerance.…”