Venom Immunotherapy: From Proteins to Product to Patient Protection

Feindor, Martin; Heath, Matthew; Hewings, Simon; Velazquez, Thalia L Carreno; Blank, Simon; Grosch, Johannes; Jakob, Thilo; Schmid‐Grendelmeier, Peter; Klimek, Ludger; Golden, David B.K.; Skinner, Murray A.; Krämer, Matthias

doi:10.3390/toxins13090616

Cited by 6 publications

(5 citation statements)

References 71 publications

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“…Common allergy-relevant species of Hymenoptera include bees and yellow jackets, which are found all over the world, but particularly in the northern hemisphere; these and members of the genus Polistes are of great importance in the USA and Southern Europe [47]. In our study, the most prevalent allergen was the bee.…”

Section: Discussionmentioning

confidence: 67%

Hymenoptera Venom Immunotherapy in Dogs: Safety and Clinical Efficacy

Rostaher,

Fischer,

Vigani

et al. 2023

Animals

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Hymenoptera allergens are the main triggers for anaphylaxis in susceptible dogs and humans. Hymenoptera venom specific immunotherapy (VIT), the only disease-modifying treatment, has the potential to prevent future life-threatening reactions in human patients. Prospective clinical data on VIT efficacy in dogs are currently lacking. Therefore, the aim of this study was to show that VIT is not only safe but also efficacious in preventing anaphylaxis in dogs allergic to Hymenoptera. This uncontrolled prospective clinical trial included 10 client-owned dogs with a history of anaphylaxis following repeated Hymenoptera stings. The sensitization to bee and wasp allergens was demonstrated by intradermal testing (IDT) and allergen-specific IgE serology. For VIT induction (induction phase), dogs received a shortened rush immunotherapy protocol with aqueous allergens, which was then followed by monthly injections of 100 µg of alum-precipitated allergen (maintenance phase). VIT efficacy was determined by observing patients’ clinical reactions to re-stings. No systemic adverse events were seen during the induction and maintenance phases. From the seven re-stung dogs, only one developed a mild angioedema at the site of the sting; the remaining dogs were asymptomatic. These results show that VIT represents a safe and effective treatment option for Hymenoptera-allergic dogs.

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Section: Discussionmentioning

confidence: 67%

Hymenoptera Venom Immunotherapy in Dogs: Safety and Clinical Efficacy

Rostaher,

Fischer,

Vigani

et al. 2023

Animals

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“…VIT is recommended in sensitized adults and children with severe reactions to the stings as well as in adults with generalized skin symptoms if the quality of life is impaired [ 177 ]. For VIT, subcutaneous injection is the only route of administration that is used in clinical practice, compared to aeroallergen and food-allergen IT which can be administered SC but also sublingually [ 182 ].…”

Section: Predictive Biomarkers For Ait Outcomes In Allergic Diseasesmentioning

confidence: 99%

Mechanisms and biomarkers of successful allergen-specific immunotherapy

López

Imam

Satitsuksanoa

et al. 2022

Asia Pacific Allergy

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Allergen-specific immunotherapy (AIT) is considered the only curative treatment for allergic diseases mediated by immunoglobulin E (IgE). Currently, the route of administration depends both on the different types of causal allergens and on its effectiveness and safety profile. Several studies have reported the mechanisms and changes in humoral and cellular response underlying AIT; however, the full picture remains unknown. Knowledge of who can benefit from this type of treatment is urgently needed due to the patient safety risks and costs of AIT. In vivo or in vitro biomarkers have become a strategy to predict clinical outcomes in precision medicine. There are currently no standardized biomarkers that allow determining successful responses to AIT, however, some studies have found differences between responders and nonresponders. In addition, different candidates have been postulated that may have the potential to become biomarkers. In this review, we aim to summarize the findings to date related to biomarkers in different IgE-mediated allergic diseases (respiratory, food, and venom allergy) with the potential to define who will benefit from AIT.

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“…In fact, for some major allergens, such as Api m 10, their presence in final formulations was linked to treatment outcome in predominantly sensitized individuals [84]. Both the presence and the stability of such fragile major allergens might be critical in the final preparations [85,86]. Therefore, the greatest value may not be the demonstration of a set quantity but the qualitative demonstration of presence over the applicable timeframe, which is clinically important.…”

Section: Are Major Allergens Important At All?mentioning

confidence: 99%

Major Allergen Content in Allergen Immunotherapy Products: The Limited Value of Numbers

Becker¹,

Fassio²,

Muñoz-Cano³

et al. 2022

J Investig Allergol Clin Immunol

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The prevalence of allergic disorders drastically increased over the last 50 years that today they can be considered epidemic. At present, allergen-specific immunotherapy (AIT) is the only therapy targeting the underlying cause of allergic disorders, and its superior evidence is based on accumulated data from clinical trials and observational studies demonstrating efficacy and safety. However, several aspects remain unsolved, such as harmonization and standardization of manufacturing and quantification procedures across manufacturers, homogeneous reporting of strength, and also the establishment of international reference standards for many allergens. This article discusses the issues related to the measurement of major allergen content in AIT extracts, raising the question of whether comparison of products by different manufacturers are appropriate as basis to choose among the different AIT products. Allergen standardization in immunotherapy products is critical to ensure quality and thereby safety and efficacy. However, lack of harmonization in manufacturing process, allergen quantification (methodologies and references), national regulatory differences, clinical practice, and labeling shows that the comparison of AIT products solely based on major allergen amounts is not rationale and, in fact, impossible. Moreover, further inherent characteristics of products and their clinical use such as their state of extract modification, addition of adjuvant or adjuvant-system, route of administration (sublingual/subcutaneous) and cumulative dose as per posology (including the volume per administration) need to be taken into account, when rating the information given for a specific product. Finally, only convincing clinical data can serve as the product-specific evaluation, or the basis for cross-product comparability, for individual products.

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Venom Immunotherapy: From Proteins to Product to Patient Protection

Cited by 6 publications

References 71 publications

Hymenoptera Venom Immunotherapy in Dogs: Safety and Clinical Efficacy

Hymenoptera Venom Immunotherapy in Dogs: Safety and Clinical Efficacy

Mechanisms and biomarkers of successful allergen-specific immunotherapy

Major Allergen Content in Allergen Immunotherapy Products: The Limited Value of Numbers

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