Marek Jutel1, Cezmi A Akdis. 1. aDepartment of Clinical Immunology, Wrocław Medical University bALL-MED Medical Research Institute, Wrocław, Poland cSwiss Institute of Allergy and Asthma Research, Davos, Switzerland.
Abstract
PURPOSE OF REVIEW: Allergen-specific immunotherapy is the only curative treatment for allergic diseases. In spite of the great progress in both vaccine development and the methods of allergen immunotherapy (AIT) in recent years, several key problems related to limited efficacy, side-effects, low patient adherence and the relatively high costs due to the long duration (3-5 years) remain to be solved. The current approaches aiming at optimization of AIT are reviewed, including both conceptual studies in experimental models and proof-of-concept - as well as large, multicenter clinical studies. RECENT FINDINGS: The most promising approaches to improve efficacy and safety of vaccine-based AIT include bypassing IgE binding and targeting allergen-specific T cells using hypoallergenic recombinant allergen derivatives and immunogenic peptides, the use of new adjuvants and stimulators of the innate immune response, the fusion of allergens to immune modifiers and peptide carrier proteins and new routes of vaccine administration. SUMMARY: The cloning of allergen proteins and genetic engineering enabled the production of vaccines that have well defined molecular, immunologic and biologic characteristics as well as modified molecular structure. These new compounds along with new immunization protocols can bring us closer to the ultimate goal of AIT, that is, complete cure of a large number of allergic patients.
PURPOSE OF REVIEW: Allergen-specific immunotherapy is the only curative treatment for allergic diseases. In spite of the great progress in both vaccine development and the methods of allergen immunotherapy (AIT) in recent years, several key problems related to limited efficacy, side-effects, low patient adherence and the relatively high costs due to the long duration (3-5 years) remain to be solved. The current approaches aiming at optimization of AIT are reviewed, including both conceptual studies in experimental models and proof-of-concept - as well as large, multicenter clinical studies. RECENT FINDINGS: The most promising approaches to improve efficacy and safety of vaccine-based AIT include bypassing IgE binding and targeting allergen-specific T cells using hypoallergenic recombinant allergen derivatives and immunogenic peptides, the use of new adjuvants and stimulators of the innate immune response, the fusion of allergens to immune modifiers and peptide carrier proteins and new routes of vaccine administration. SUMMARY: The cloning of allergen proteins and genetic engineering enabled the production of vaccines that have well defined molecular, immunologic and biologic characteristics as well as modified molecular structure. These new compounds along with new immunization protocols can bring us closer to the ultimate goal of AIT, that is, complete cure of a large number of allergicpatients.
Authors: Jane Al-Kouba; Andrew N Wilkinson; Malcolm R Starkey; Rajeev Rudraraju; Rhiannon B Werder; Xiao Liu; Soi-Cheng Law; Jay C Horvat; Jeremy F Brooks; Geoffrey R Hill; Janet M Davies; Simon Phipps; Philip M Hansbro; Raymond J Steptoe Journal: JCI Insight Date: 2017-06-02
Authors: Carolin Cornelius; Katrin Schöneweis; Fanny Georgi; Milena Weber; Verena Niederberger; Petra Zieglmayer; Katarzyna Niespodziana; Michael Trauner; Harald Hofer; Stephan Urban; Rudolf Valenta Journal: EBioMedicine Date: 2016-08-08 Impact factor: 8.143