Treatment strategies of co-existing non-allergic diseases in relation to allergen immunotherapy

In the last decades, significant progress in research and clinics has been made to offer possible innovative therapeutics for the management of allergic diseases. However, current allergen immunotherapy shows limitations concerning the long-term efficacy and safety due to local side effects and risk of anaphylaxis. Thus, effective and safe vaccines with reduced dose of allergen have been developed using adjuvants. Nevertheless, the use of adjuvants still has several disadvantages, which limits its use in human vaccines. In this context, several novel adjuvants for allergen immunotherapy are currently being investigated and developed. Currently, nanoparticles-based allergen-delivery systems have received much interest as potential adjuvants for allergen immunotherapy. It has been demonstrated that the incorporation of allergens into a delivery system plays an important role in the efficacy of allergy vaccines. Several nanoparticles-based delivery systems have been described, including biodegradable and nondegradable polymeric carriers. Therefore, this paper provides an overview of the current adjuvants used for allergen immunotherapy. Furthermore, nanoparticles-based allergen-delivery systems are focused as a novel and promising strategy for allergy vaccines.

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Impact of Tree Pollen Distribution on Allergic Diseases in Serbia: Evidence of Implementation of Allergen Immunotherapy to Betula verrucosa

Medicina ◽

10.3390/medicina56020059 ◽

2020 ◽

Vol 56 (2) ◽

pp. 59 ◽

Cited By ~ 1

Author(s):

Rajna Minić ◽

Mirjana Josipović ◽

Vesna Tomić Spirić ◽

Marija Gavrović-Jankulović ◽

Aleksandra Perić Popadić ◽

...

Keyword(s):

Allergen Immunotherapy ◽

Practical Importance ◽

Allergic Diseases ◽

Pollen Concentration ◽

Tree Pollen ◽

Starting Point ◽

Pollen Species ◽

Allergenic Plants ◽

Betula Verrucosa ◽

The Relationship

Background and objectives: The relationship between air pollen quantity and the sensitization of allergic patients is crucial for both the diagnosis and treatment of allergic diseases. Weather conditions influence the distribution of allergenic pollen and increases in pollen concentration may negatively affect the health of allergic patients. The aim of this study was to analyze the implementation of allergen immunotherapy with regard to air pollen concentration. Material and Methods: Here we examined the relationship between Betula air pollen concentration and the usage of Betula verrucosa allergen immunotherapy in Serbia. Examination covered the period from 2015 to 2018. Measurement of airborne pollen concentration was performed with Lanzoni volumetric pollen traps. The evidence of the usage of sublingual allergen immunotherapy (SLIT) was gathered from patients with documented sensitization to specific pollen. Results: During this period tree pollens were represented with 58% ± 21% of all measured air pollen species, while Betula pollen represented 15% ± 8% of all tree pollens. Betula pollination peaked in April. Allergen immunotherapy to Betula verrucosa in Serbia is entirely conducted as sublingual immunotherapy and represents 47.1% ± 1.4% of issued tree pollen SLIT. The use of pollen SLIT increased by 68% from 2015 to 2018, with an even greater increase in usage recorded for Betula SLIT—80%. Conclusions: This analysis shows a clear causative relationship between pollination and the type/prevalence of applied allergen immunotherapy. Information about the flowering seasons of allergenic plants is very important for people who suffer from allergy, for clinical allergologists, as well as for governing authorities. The presented data is of practical importance to the proper timing of immunotherapy initiation and of importance for urban landscaping. The obtained data can be the starting point for the instatement of a thorough epidemiological study and the inclusion of Serbia on the pollen map of Europe.

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COVID-19-vaccination in patients receiving allergen immunotherapy (AIT) or biologics - EAACI recommendations

10.22541/au.162452341.15060228/v1 ◽

2021 ◽

Author(s):

Marek Jutel ◽

María José Torres ◽

Oscar Palomares ◽

Cezmi Akdis ◽

Thomas Eiwegger ◽

...

Keyword(s):

Immune Response ◽

Immune Modulation ◽

Allergen Immunotherapy ◽

Expert Panel ◽

Allergic Diseases ◽

Treatment Modalities ◽

European Academy ◽

Type 3

Immune modulation is a key therapeutic tool for allergic diseases and asthma. It can be achieved in an antigen-specific way via allergen immunotherapy (AIT) or in endotype-driven approach using biologicals that target the major pathways of the type 2 (T2) immune response: IgE, IL-5 and IL-4/IL-13. COVID-19 vaccine provides an excellent opportunity to tackle the global pandemics and is currently being applied in an accelerated rhythm worldwide. It works as well through immune modulation. Thus, as there is an obvious interference between these treatment modalities recommendations on how they should be applied in sequence are expected. The European Academy of Allergy and Clinical Immunology (EAACI) gathered an outstanding expert panel under its Research and Outreach Committee (ROC). This expert panel was called to evaluate the evidence and formulate recommendation on the administration of COVID-19 vaccine in patients with allergic diseases and asthma receiving AIT or biologicals. The panel also formulated recommendations for COVID-19 vaccine in association with biologicals targeting the type 1 or type 3 immune response. In formulating recommendations, the panel evaluated the mechanisms of COVID-19 infection, of COVID-19 vaccine, of AIT and of biologicals and considered the data published for other anti-infectious vaccines administered concurrently with AIT or biologicals.

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Year-round treatment initiation for a 6-grasses pollen allergoid in specific immunotherapy of allergic rhinoconjunctivitis and asthma

Immunotherapy ◽

10.2217/imt-2019-0086 ◽

2019 ◽

Vol 11 (18) ◽

pp. 1569-1582

Author(s):

Vera Mahler ◽

Stefan Zielen ◽

Martin Rosewich

Keyword(s):

Grass Pollen ◽

Pollen Season ◽

Allergen Immunotherapy ◽

Specific Immunotherapy ◽

Treatment Initiation ◽

Allergic Diseases ◽

Phleum Pratense ◽

Specific Igg4 ◽

Group A ◽

Group B

Aim: Allergen immunotherapy (AIT) is an effective treatment for allergic diseases. We investigate whether treatment-initiation during the pollen season is safe. Methods: RCT-IIIb-trial of 6-grass-pollen-allergoid (Allergovit®) in grass pollen-allergic patients (18–65 years) with moderate–severe rhinitis/rhinoconjunctivitis (± controlled asthma), randomized 2:1 to treatment-initiation during (Group-A) versus outside the pollen season (Group-B). Results: Of 240 patients (32.8 ± 9.9 years, 19.5% asthma) treated, 84.9% (Group-A) and 86.6% (Group-B) reached maintenance dose without delay. Treatment-emergent adverse events occurred in 108 (68.4%/Group-A) and 41 patients (56.2%/Group-B) leading to premature trial-termination in 11 patients (7%/A) versus 3 (4.1%/B). Across groups, physicians (for 190 patients; 85.2%) and patients (192; 86.1%) rated the tolerability as ‘very good’–‘good’. Phleum pratense-specific IgG4 increased in both groups (p < 0.0001). Conclusion: Year-round allergen immunotherapy-initiation with this preparation is safe.

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Coronavirus disease 2019, allergic diseases, and allergen immunotherapy: Possible favorable mechanisms of interaction

Allergy and Asthma Proceedings ◽

10.2500/aap.2021.42.210013 ◽

2021 ◽

Vol 42 (3) ◽

pp. 187-197

Author(s):

Désirée E. Larenas-Linnemann ◽

José A. Ortega-Martell ◽

María V. Blandón-Vijil ◽

Noel Rodríguez-Pérez ◽

Jorge A. Luna-Pech ◽

...

Keyword(s):

Immune Response ◽

Allergen Immunotherapy ◽

Respiratory Infections ◽

Clinical Manifestations ◽

Allergic Diseases ◽

Allergic Patient ◽

Human Immune System ◽

Human Immune ◽

The Moment ◽

Immune Changes

Background: Both, allergen immunotherapy (AIT) and SARS-COV-2 infection cause a set of immunologic changes that respectively vary during the course of the treatment or the disease. Objective: To review immune changes brought along by each of these entities and how they might interrelate. Methods: We start presenting a brief review of the structure of the new coronavirus and how it alters the functioning of the human immune system. Subsequently, we describe the immune changes induced by AIT and how these changes could be favorable or unfavorable in the allergic patient infected with SARS-CoV-2 at a particular point of time during the evolving infection. Results: We describe how a healthy immune response against SARS-CoV-2 develops, versus an immune response that is initially suppressed by the virus, but ultimately overactivated, leading to an excessive production of cytokines (cytokine-storm-like). These changes are then linked to the clinical manifestations and outcomes of the patient. Reviewing the immune changes secondary to AIT, it becomes clear how AIT is capable of restoring a healthy innate immunity. Investigators have previously shown that the frequency of respiratory infections is reduced in allergic patients treated with AIT. On the other hand it also increases immunoregulation. Conclusion: As there are many variables involved, it is hard to predict how AIT could influence the allergic patient's reaction to a SARS-CoV-2 infection. In any case, AIT is likely to be beneficial for the patient with allergic rhinitis and/or allergic asthma in the context of the SARS-CoV-2 pandemic as controlling allergic diseases leads to a reduced need for contact with healthcare professionals. The authors remind the reader that everything in this article is still theoretical, since at the moment, there are no published clinical trials on the outcome of COVID-19 in allergic patients under AIT.

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Immunomodulatory Treatment Strategies for Allergic Diseases

Current Drug Targets - Inflammation & Allergy ◽

10.2174/1568010033344507 ◽

2003 ◽

Vol 2 (1) ◽

pp. 31-46 ◽

Cited By ~ 5

Author(s):

Eva-Maria Varga ◽

Kayhan Nouri-Aria ◽

Stephen Till ◽

Stephen Durham

Keyword(s):

Treatment Strategies ◽

Allergic Diseases ◽

Immunomodulatory Treatment

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Új, epicutan módszer az allergia oki kezelésére

Orvosi Hetilap ◽

10.1556/650.2017.30762 ◽

2017 ◽

Vol 158 (23) ◽

pp. 895-899

Author(s):

László Endre

Keyword(s):

Allergen Immunotherapy ◽

Allergic Diseases ◽

Bacterial Toxin ◽

Recombinant Allergens ◽

The Future ◽

Causal Treatment ◽

Recommended Therapy

Abstract: The only causal treatment for the allergic diseases is the allergen immunotherapy. Besides oral and injection forms, an epicutaneous form is known as well. During the immunization process the use of an adjuvant material is advisable besides the allergen. That adjuvant material can be (besides of the aluminium hydroxid and tyrosine) a bacterial toxin, too. In idealistic circumstances we can substitute the native allergen with its recombinant variant, which could keep its immunogenicity but had lost the allergenicity. In the future the recommended therapy could be the safe, painless, epicutaneous hyposensitization, with recombinant allergens, with bacterial toxin as adjuvants. Orv Hetil. 2017; 158(23): 895–899.

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Eosinophil oesophagitis étrendi és gyógyszeres vonatkozásai

Orvosi Hetilap ◽

10.1556/650.2015.30164 ◽

2015 ◽

Vol 156 (23) ◽

pp. 927-932

Author(s):

Dorottya Kocsis ◽

Zsolt Tulassay ◽

Márk Juhász

Keyword(s):

Atopic Dermatitis ◽

Lamina Propria ◽

Eosinophilic Esophagitis ◽

Inflammatory Infiltrate ◽

Treatment Strategies ◽

Allergic Diseases ◽

Dietary Modification ◽

Food Impaction ◽

First Line ◽

Anti Inflammatory

Eosinophilic esophagitis is considered to be a chronic antigen-driven disease whereby food and/or aeroallergens induce a chronic inflammatory infiltrate in the esophagus leading to pathological hyperplasia of the epithelial and muscular layers, fibrosis of the lamina propria and symptoms of dysphagia and food impaction. Eosinophilic esophagitis is often associated with other allergic diseases such as asthma or atopic dermatitis. Current first line treatments of the disease include strict dietary modification and topical anti-inflammatory steroids. In this review the authors summarize currently available treatment strategies of eosinophilic esophagitis. Orv. Hetil, 2015, 156(23), 927–932.

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