Safety of immunotherapy with glutaraldehyde modified allergen extracts in children and adults

Guzmán-Fulgencio, María; Caballero, R.; Lara, Beatríz; Mena, María Novella; Tejera, Marı́a Luisa; Sastre, A; Subiza, J L; Fernández-Caldas, Enrique; Casanovas, Miguel

doi:10.1016/j.aller.2016.08.008

Cited by 11 publications

(8 citation statements)

References 40 publications

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“…Furthermore, a phase-IIb study reported that an ACD-containing synthetic contiguous overlapping peptide (COP) vaccine for Bet v1 improves the quality of life of AR patients [ 86 ]. ACDs have been integrated into many glutaraldehyde allergoids, and patients who receive these treatments develop mild reactions [ 87 ]. However, some reports have indicated that ACDs induce granulomas in the skin and severe reactions inherent to AIT and, in some cases, are associated with neurologic diseases [ 88 , 89 ].…”

Section: Adjuvantsmentioning

confidence: 99%

Allergen Immunotherapy: Current and Future Trends

Pavón-Romero

Parra-Vargas

Ramírez-Jiménez

et al. 2022

Cells

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Allergen immunotherapy (AIT) is the sole disease-modifying treatment for allergic rhinitis; it prevents rhinitis from progressing to asthma and lowers medication use. AIT against mites, insect venom, and certain kinds of pollen is effective. The mechanism of action of AIT is based on inducing immunological tolerance characterized by increased IL-10, TGF-β, and IgG4 levels and Treg cell counts. However, AIT requires prolonged schemes of administration and is sometimes associated with adverse reactions. Over the last decade, novel forms of AIT have been developed, focused on better allergen identification, structural modifications to preserve epitopes for B or T cells, post-traductional alteration through chemical processes, and the addition of adjuvants. These modified allergens induce clinical-immunological effects similar to those mentioned above, increasing the tolerance to other related allergens but with fewer side effects. Clinical studies have shown that molecular AIT is efficient in treating grass and birch allergies. This article reviews the possibility of a new AIT to improve the treatment of allergic illness.

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Section: Adjuvantsmentioning

confidence: 99%

Allergen Immunotherapy: Current and Future Trends

Pavón-Romero

Parra-Vargas

Ramírez-Jiménez

et al. 2022

Cells

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“…Generalmente es bien tolerada y se considera que tiene un buen perfil de seguridad. 1,2 En cuanto a sus componentes, la mayoría también son inofensivos. Además de las fuentes alergénicas, se añaden diferentes sustancias esterilizantes, coadyuvantes o estabilizadoras de la solución.…”

Section: Antecedentesunclassified

Reacción tipo penfigoide por inmunoterapia alérgeno-específica: una reacción adversa inusual

Tomás‐Pérez

Domínguez‐Ortega

2020

RAM

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Antecedentes: En su mayoría, las reacciones adversas por inmunoterapia específica subcutánea de alérgenos están directamente inducidas por la administración del alérgeno; por lo general se presenta enrojecimiento e induración de la zona de inyección y otras lesiones cutáneas son raras.Caso clínico: Mujer de 40 años, con rinoconjuntivitis alérgica y asma por sensibilización al polen de gramíneas, quien recibía mensualmente 0.5 mL de un extracto polimerizado subcutáneo de polen de gramíneas, con glutaraldehído y adsorbido en hidróxido de aluminio. Cinco horas después de la administración de la séptima dosis, la paciente presentó ardor y prurito en la zona de la inyección de la inmunoterapia y, posteriormente, ampollas.Conclusiones: Aunque las reacciones adversas por inmunoterapia específica de alérgenos son raras y difíciles de demostrar, es importante realizar los análisis que se requieran para identificar las causas o su relación con los síntomas a fin de evitar reacciones futuras.

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“…These modifications reduce side effects and, therefore, enhance the utility and safety of AIT. [2][3][4] However, the tolerogenic potency of allergoids compared to natural allergen extracts is controversially discussed. [5][6][7][8] Mechanisms underlying extract and allergoid immunotherapies have not been explored side by side.…”

Section: Introductionmentioning

confidence: 99%

“…Until today, modified allergens (allergoids) with destroyed conformational IgE epitopes, for example, by chemical modification, are well‐accepted standard in clinical use. These modifications reduce side effects and, therefore, enhance the utility and safety of AIT 2‐4 . However, the tolerogenic potency of allergoids compared to natural allergen extracts is controversially discussed 5‐8 …”

Section: Introductionmentioning

confidence: 99%

Immunological effects of adjuvanted low‐dose allergoid allergen‐specific immunotherapy in experimental murine house dust mite allergy

Heldner

Alessandrini

Rußkamp

et al. 2021

Allergy

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Background Native allergen extracts or chemically modified allergoids are routinely used to induce allergen tolerance in allergen‐specific immunotherapy (AIT), although mechanistic side‐by‐side studies are rare. It is paramount to balance optimal dose and allergenicity to achieve efficacy warranting safety. AIT safety and efficacy could be addressed by allergen dose reduction and/or use of allergoids and immunostimulatory adjuvants, respectively. In this study, immunological effects of experimental house dust mite (HDM) AIT were investigated applying high‐dose HDM extract and low‐dose HDM allergoids with and without the adjuvants microcrystalline tyrosine (MCT) and monophosphoryl lipid A (MPL) in a murine model of HDM allergy. Methods Cellular, humoral, and clinical effects of the different AIT strategies were assessed applying a new experimental AIT model of murine allergic asthma based on physiological, adjuvant‐free intranasal sensitization followed by subcutaneous AIT. Results While low‐dose allergoid and high‐dose extract AIT demonstrated comparable potency to suppress allergic airway inflammation and Th2‐type cytokine secretion of lung‐resident lymphocytes and draining lymph node cells, low‐dose allergoid AIT was less effective in inducing a potentially protective IgG1 response. Combining low‐dose allergoid AIT with MCT or MCT and dose‐adjusted MPL promoted Th1‐inducing mechanisms and robust B‐cell activation counterbalancing the allergic Th2 immune response. Conclusion Low allergen doses induce cellular and humoral mechanisms counteracting Th2‐driven inflammation by using allergoids and dose‐adjusted adjuvants. In light of safety and efficacy improvement, future therapeutic approaches may use low‐dose allergoid strategies to drive cellular tolerance and adjuvants to modulate humoral responses.

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Safety of immunotherapy with glutaraldehyde modified allergen extracts in children and adults

Cited by 11 publications

References 40 publications

Allergen Immunotherapy: Current and Future Trends

Allergen Immunotherapy: Current and Future Trends

Reacción tipo penfigoide por inmunoterapia alérgeno-específica: una reacción adversa inusual

Immunological effects of adjuvanted low‐dose allergoid allergen‐specific immunotherapy in experimental murine house dust mite allergy

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