Standardized extracts modified allergens-allergoids

Maasch, H.J.; Marsh, David G.

doi:10.1007/bf02802259

Cited by 43 publications

(2 citation statements)

References 25 publications

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“…180 Allergoids are chemically modified natural allergens, usually by polymerization or treatment with formaldehyde or glutaraldehyde, which show strongly reduced IgE-binding capacity. 181,182 Recombinant birch (Bet v 1) allergens have been tested in clinical trials, showing an improvement in clinical symptoms. 183,184 Hypoallergenic B-cell epitopes based on grass pollen (Phl p 1) are safe and effective in AIT.…”

Section: Pharmaco -Economy Of Ait/ Cos T-effec Tiv Ene Ssmentioning

confidence: 99%

“…Synthetic and recombinant hypoallergens can exhibit strongly reduced IgE‐binding capacity and allergenic activity but contain allergen‐specific T‐cell epitopes (long synthetic peptides, recombinant hypoallergenic allergen derivatives) or carrier compounds providing T‐cell help (peptide carrier‐based B‐cell epitopes) 180 . Allergoids are chemically modified natural allergens, usually by polymerization or treatment with formaldehyde or glutaraldehyde, which show strongly reduced IgE‐binding capacity 181,182 …”

Section: Advances In Ait Compound Technologymentioning

confidence: 99%

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Hot topics in allergen immunotherapy, 2023: Current status and future perspective

Zemelka‐Wiacek,

Agache,

Akdis

et al. 2023

Allergy

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The importance of allergen immunotherapy (AIT) is multifaceted, encompassing both clinical and quality‐of‐life improvements and cost‐effectiveness in the long term. Key mechanisms of allergen tolerance induced by AIT include changes in memory type allergen‐specific T‐ and B‐cell responses towards a regulatory phenotype with decreased Type 2 responses, suppression of allergen‐specific IgE and increased IgG1 and IgG4, decreased mast cell and eosinophil numbers in allergic tissues and increased activation thresholds. The potential of novel patient enrolment strategies for AIT is taking into account recent advances in biomarkers discoveries, molecular allergy diagnostics and mobile health applications contributing to a personalized approach enhancement that can increase AIT efficacy and compliance. Artificial intelligence can help manage and interpret complex and heterogeneous data, including big data from omics and non‐omics research, potentially predict disease subtypes, identify biomarkers and monitor patient responses to AIT. Novel AIT preparations, such as synthetic compounds, innovative carrier systems and adjuvants, are also of great promise. Advances in clinical trial models, including adaptive, complex and hybrid designs as well as real‐world evidence, allow more flexibility and cost reduction. The analyses of AIT cost‐effectiveness show a clear long‐term advantage compared to pharmacotherapy. Important research questions, such as defining clinical endpoints, biomarkers of patient selection and efficacy, mechanisms and the modulation of the placebo effect and alternatives to conventional field trials, including allergen exposure chamber studies are still to be elucidated. This review demonstrates that AIT is still in its growth phase and shows immense development prospects.

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Section: Pharmaco -Economy Of Ait/ Cos T-effec Tiv Ene Ssmentioning

confidence: 99%

Section: Advances In Ait Compound Technologymentioning

confidence: 99%

Hot topics in allergen immunotherapy, 2023: Current status and future perspective

Zemelka‐Wiacek,

Agache,

Akdis

et al. 2023

Allergy

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Heat denaturation, a simple method to improve the immunotherapeutic potential of allergens

et al. 2005

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Allergen-specific immunotherapy (SIT) leads to a long-term amelioration of IgE-and Th2-mediated allergic diseases. However, SIT efficiency is low, with years of treatment along with frequent allergic side effects. The goal of this study was to reduce the side effects by destroying IgE-binding epitopes, i.e. by heat-denaturation, while preserving the therapeutic effect. Mice were immunised with bee venom, birch pollen, grass pollen or cat hair allergens, or with ovalbumin. Heat-denatured allergens bound less IgE but enhanced Th1-dependent IgG2a production as measured by ELISA. The strong IgG2a antibody responses also prevented allergic anaphylaxis in mice, as measured by body temperature drop after a challenge with a high allergen dose. We found that optimal heat-denaturation of allergens left a small proportion in the native conformation to sufficiently stimulate B cells, while non-B cell-mediated effects were probably amplified. The enhanced immunogenicity of heat-denatured allergens is likely explained by enhanced antigen presentation to T cells due to the particulate nature of heat-denatured proteins. This enables Th1 skewing of the immune response with strong production of IgG2a in mice. Therefore, heat-denaturation represents probably the simplest way to enhance the efficiency of SIT while reducing its side effects. IntroductionIgE-mediated type I hypersensitivity is characterised by prominent activity of mast cells, eosinophils, T helper type 2 (Th2) cells and cytokine actions. Allergenspecific immunotherapy (SIT) leads to long-term amelioration of allergic symptoms and is therefore recommended as a first-line therapy for allergies [1]. During SIT, gradually increasing allergen doses are subcutaneously administered until a maintenance dose is reached, and then treatment continues for 3-5 years. Such lengthy treatment, requiring 30-80 allergen injections, is very costly [2]. Also, SIT frequently causes adverse events due to the interaction of specific IgE with the injected allergen. These adverse events frequently include a local reaction at the site of allergen injection, but also life-threatening systemic reactions such as asthma and anaphylaxis. This is why the administered allergen doses must be kept relatively low, which unfortunately favours Th2 immune responses in contrast to higher doses [3][4][5].Several strategies have been developed to tackle the problems of SIT, i.e. to reduce its side effects and to enhance its immunogenicity. One strategy is to replace the currently used aluminium salts, which have Th2-polarizing properties, with novel adjuvants such as Tolllike receptor ligands [6,7] that trigger Th1 responses. Another strategy is to increase safety and tolerability of SIT by injecting the allergen in a form that is not recognised by IgE, such as naked DNA vaccines Heat-denaturation is well known to reduce the reactogenicity of allergens with IgE, as cooked foods are usually well or better tolerated by allergic individuals [24][25][26]. In this study, we tested whether this very simple strate...

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Clinical Experience with Recombinant Molecules for Allergy Vaccination

Cromwell¹,

Niederberger

Horak

et al. 2011

Vaccines Against Allergies

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Numerous allergens have been cloned and produced by the use of recombinant DNA technology. In several cases recombinant variants with reduced IgE-reactivity have also been developed as candidates for allergen specific immunotherapy. Only very few of these proteins have as yet been tested in the clinic, and the major focus has been on birch and grass pollen, two of the most common causes of IgE-mediated allergic disease. This article serves to justify the rational for using recombinant products and reviews the progress that has been made to date with their clinical assessment.

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Standardized extracts modified allergens-allergoids

Cited by 43 publications

References 25 publications

Hot topics in allergen immunotherapy, 2023: Current status and future perspective

Hot topics in allergen immunotherapy, 2023: Current status and future perspective

Heat denaturation, a simple method to improve the immunotherapeutic potential of allergens

Clinical Experience with Recombinant Molecules for Allergy Vaccination

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