| Literature DB >> 26185961 |
F Moreno Benítez1,2, M Espinazo Romeu1,2, A Letrán Camacho1,2, S Mas3, F J García-Cózar2,4, A I Tabar5,6.
Abstract
BACKGROUND: Allergen immunotherapy is a treatment modality which can be applied using different vaccines. The aim of this study was to quantify and compare the allergen content of different house dust mites (HDM)' sublingual treatments and to review the evidence on their efficacy.Entities:
Keywords: allergen content; efficacy; evidence-based medicine; house dust mites’ sublingual allergen immunotherapy; weekly dosage
Mesh:
Substances:
Year: 2015 PMID: 26185961 PMCID: PMC5049613 DOI: 10.1111/all.12694
Source DB: PubMed Journal: Allergy ISSN: 0105-4538 Impact factor: 13.146
Composition, additives and manufacturing details of vaccines tested
| Extracts | Product name – Biological potency | Marketing laboratory | First Batch | Second Batch | Additives | ||||
|---|---|---|---|---|---|---|---|---|---|
| Reference | Manufacture date | Expiration date | Reference date | Manufacture date | Expiration date | ||||
| 1 | Staloral 300 Rapid – 300 IR/ml | Stallergenes | 0001085047 | 02/2013 | 02/2014 | 0001111523 | 07/2013 | 07/2014 | Sodium chloride, glycerol, purified water |
| 2 | SLITone ULTRA – 300 SRU | Alk‐Abello | 027016251001 | 02/2013 | 09/2013 | 027191671001 | 09/2013 | 06/2014 | Sodium chloride, glycerol, purified water, sodium bicarbonate |
| 3 | TOL Forte – 30 HEPL/ml | Laboratorios Leti | 2369041100 | No data | 11/2013 | 2481042100 | No data | 02/2014 | Sodium chloride, phenol, sodium phosphate monobasic dihydrate, sodium phosphate dibasic dodecahydrate, glycerol, purified water |
| 4 | Allergovac Sublingual Plus – 223 432 SU/ml | Bial‐Aristegui | ESX0181074 | 02/2013 | 02/2014 | ESB0673682 | 09/2013 | 09/2014 | Sodium chloride, glycerol, phenol, purified water |
| 5 | Sublivac – 10 000 AU/ml | Hal Allergy | 059779 | 02/2013 | 12/2013 | 064456 | 09/2013 | 08/2014 | Sodium chloride, glycerol, phenol, purified water |
Figure 1SDS‐PAGE (silver nitrate® staining is shown): Samples were loaded in sequence (blinded order), 1: Staloral Rapid 300; 2: SLITone ULTRA; 3: TOL Forte; 4: Sublingual Allergovac Plus; 5: Sublivac, with 6 and 7 being native controls for Der p 1 and Der p 2, respectively. M = marker for molecular weight between 250 and 10 kDa. First lane corresponds to molecular weight marker, followed by extracts 1–5. Lanes 7 and 8 correspond to native Der p1 and Der p2 extracts. Bottom figures show bicinchoninic acid‐measured protein levels for each extract (mg/ml). No significant differences were observed between the two studied batches of each extract in the SDS‐PAGE gels. (Data not shown).
Figure 2Immunoblotting. After transfer of proteins to PVDF membranes, they were faced against the following monoclonal antibodies: A) anti‐Der p 1, B) anti‐Der f 1, C) anti (Der p 2+ Der f 2). M = Marker MW. Blinded order: 1: Staloral 300 Rapid, 2: SLITone ULTRA, 3: TOL Forte, 4: Allergovac Sublingual Plus, 5: Sublivac, 6: Control nDer p 1, 7: Control nDer f 1, 8: Control nDer p 2+ nDer f 2. On the top of gel, band intensity is shown for each sample present in gel, as measured in gels without signal saturation. Bands were quantified using Quantity One software.
Measurements of allergen content with MARIA® and ProteOn
| Content in μg/ml | MARIA | ProteOn |
|---|---|---|
| Mean ± SD | Mean ± SD | |
| Der p 1 | ||
| Staloral 300 Rapid | 12.4 ± 1.6 | 11.1 ± 1.0 |
| SLITone ULTRA | 14.5 ± 1.0 | 12.8 ± 0.8 |
| TOL Forte | 0.6 ± 0.3 | 0.5 ± 0.1 |
| Allergovac Sublingual Plus | 0.6 ± 0.1 | 2.5 ± 0.0 |
| Sublivac | 2.0 ± 1.4 | 1.1 ± 0.1 |
| Der f 1 | ||
| Staloral 300 Rapid | 12.4 ± 1.3 | 9.3 ± 0.7 |
| SLITone ULTRA | 6.2 ± 1.8 | 5.3 ± 1.9 |
| TOL Forte | 0.3 ± 0.3 | 0.9 ± 0.1 |
| Allergovac Sublingual Plus | 0.2 ± 0.1 | 1.0 ± 0.3 |
| Sublivac | 2.8 ± 1.7 | 4.4 ± 1.9 |
| Der p 2+ Der f 2 | ||
| Staloral 300 Rapid | 0.6 ± 0.4 | 3.4 ± 0.3 |
| SLITone ULTRA | 1.5 ± 0.2 | 5.8 ± 1.6 |
| TOL Forte | 0.1 ± 0.1 | 1.1 ± n/a |
| Allergovac Sublingual Plus | 0.2 ± n/a | 0.6 ± 0.8 |
| Sublivac | 0.2 ± 0.0 | 0.3 ± 0.3 |
n/a, not applicable; SD, standard deviation.
Products are displayed in blinded order (1: Staloral 300 Rapid, 2: SLITone Ultra, 3: TOL Forte, 4: Allergovac Sublingual Plus, 5: Sublivac).
The data obtained with the antibody Der p 2+ Der f 2 supplied by Indoor Biotechnologies gave results which were too low, far from the expected values in the controls used for the MARIA assay (approximately 10 times lower than expected).
Calculation of daily, weekly and monthly ordinary dosages (μg) according to the measurements made with MARIA and ProteOn
| Daily dosage (μg/day) | Weekly dosage (μg/week) | Monthly | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Staloral 300 Rapid | SLITone ULTRA | TOL Forte | Allergovac Sublingual Plus | Sublivac | Staloral 300 Rapid | SLITone ULTRA | TOL Forte | Allergovac Sublingual Plus | Sublivac | Staloral 300 Rapid | SLITone ULTRA | TOL Forte | Allergovac Sublingual Plus | Sublivac | |
| Calculation of dosages according to determinations of MARIA | |||||||||||||||
|
Der p 1 | 9.95 ± 1.26 | 7.23 ± 0.48 | 0.06 ± 0.03 | 0.15 ± 0.02 | 0.43 ± 0.3 | 29.84 ± 3.78 | 50.63 ± 3.34 | 0.40 ± 0.23 | 0.74 ± 0.11 | 3.01 ± 2.08 | 129.5 ± 16.4 | 219.7 ± 14.5 | 1.73 ± 1.0 | 3.2 ± 0.5 | 13.7 ± 9.0 |
|
Der f 1 | 9.93 ± 1.06 | 3.11 ± 0.91 | 0.03 ± 0.03 | 0.05 ± 0.02 | 0.61 ± 0.36 | 29.78 ± 3.19 | 21.77 ± 6.38 | 0.23 ± 0.20 | 0.24 ± 0.08 | 4.27 ± 2.49 | 129.3 ± 13.9 | 94.5 ± 27.71 | 0.98 ± 0.8 | 1.0 ± 0.4 | 18.5 ± 10.79 |
|
Der p 2+ Der f 2 | 0.46 ± 0.32 | 0.76 ± 0.1 | 0.01 ± 0.01 | 0.04 ± n/a | 0.04 ± 0.01 | 1.39 ± 0.95 | 5.34 ± 0.72 | 0.05 ± 0.04 | 0.18 ± n/a | 0.31 ± 0.07 | 6.0 ± 4.1 | 23.2 ± 3.1 | 0.24 ± 0.2 | 0.78 ± n/a | 1.36 ± 0.32 |
| Calculation of the dosage according to determinations of ProteOn | |||||||||||||||
|
Der p 1 | 9.25 ± 0.27 | 6.42 ± 0.38 | 0.05 ± 0.01 | 0.6 ± 0.01 | 0.24 ± 0.02 | 26.59 ± 2.44 | 44.94 ± 2.67 | 0.32 ± 0.04 | 2.99 ± 0.05 | 1.67 ± 0.13 | 115.4 ± 10.6 | 195.0 ± 11.6 | 1.9 ± 0.5 | 12.97 ± 0.22 | 7.05 ± 0.28 |
|
Der f 1 | 7.41 ± 0.54 | 2.67 ± 0.97 | 0.09 ± 0.01 | 0.23 ± 0.06 | 0.94 ± 0.4 | 22.23 ± 1.61 | 18.67 ± 6.76 | 0.63 ± 0.04 | 1.15 ± 0.30 | 6.57 ± 2.83 | 96.5 ± 7.0 | 81.0 ± 29.3 | 2.4 ± 0.2 | 4.97 ± 1.32 | 28.5 ± 12.3 |
|
Der p 2+ Der f 2 | 2.74 ± 0.20 | 2.91 ± 0.79 | 0.10 ± n/a | 0.00 ± 0.20 | 0.07 ± 0.07 | 8.21 ± 0.61 | 11.97 ± 0.89 | 0.70 ± n/a | 0.71 ± 0.98 | 0.47 ± 0.48 | 35.6 ± 2.6 | 88.4 ± 24.1 | 3.0 ± n/a | 3.07 ± n/a | 2.02 ± 2.12 |
n/a, not applicable; SD, standard deviation;
Administered volumes according to index record: Extract 1: 800 μl/day, 2400 μl/week, 10 416 μl/month; Extract 2: 500 μl/day, 3500 μl/week, 15 190 μl/month; Extract 3: 95 μl/day, 665 μl/week, 2886.1 μl/month; Extract 4: 240 μl/day, 1200 μl/week, 5208 μl/month; Extract 5: 215 μl/day, 1505 μl/week, 6531.7 μl/month.
A month has been equalled to 4.34 weeks.
Affinity constants of Der p 1, Der f 1 and Der p 2+ Der f 2 for the different extracts
| Der p 1 | Der f 1 | Der p 2+ Der f 2 | |
|---|---|---|---|
| KD (10−10 M) | KD (10−10 M) | KD (10−10 M) | |
| Staloral 300 Rapid (Mean ± SD) | 2.86 ± 2.57 | 4.77 ± 4.16 | 40.1 ± n.a. |
| SLITone ULTRA (Mean ± SD) | 0.92 ± 0.31 | 5.52 ± 6.90 | 29.3 ± n.a. |
| TOL Forte (Mean ± SD) | 37.5 ± 3.75 | 537 ± 753 | 3750 ± n.a. |
| Allergovac Sublingual Plus (Mean ± SD) | 13.0 ± 18.2 | 26.1 ± 32.5 | 47.3 ± n.a. |
| Sublivac (Mean ± SD) | 4.57 ± 4.60 | 36.1 ± 8.98 | 11.2 ± n.a. |
SD, standard deviation.
Association (KA) and disassociation (KD) constants are shown in Appendix S1.