scholarly journals Recent Advances in Allergen-Specific Immunotherapy as Treatment for Allergic Asthma: A Practical Overview

2021 ◽  
pp. 1-19
Author(s):  
Ana I. Tabar ◽  
Julio Delgado ◽  
Eloina González-Mancebo ◽  
Esozia Arroabarren ◽  
Lorena Soto Retes ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Scientific Society ◽  
Asthma Treatment ◽  
Allergen Specific Immunotherapy ◽  
Global Initiative For Asthma ◽  
Potential Benefits ◽  
Global Initiative ◽  
Improve Health

The Global Initiative for Asthma Report updated in 2019 stated that potential benefits of allergen immunotherapy (AIT), compared to pharmacological and avoidance options, must be weighed against the risk of adverse effects and the inconvenience and cost of the prolonged course of therapy in asthma. Thus, with the aim of clarifying some aspects with regard to the possible use of AIT in allergic asthma treatment armamentarium, a group of expert allergists from the Spanish Allergy and Clinical Immunology Scientific Society (SEAIC), particularly from the Immunotherapy and Asthma Interest Groups developed a frequently asked questions in clinical practice. This document updates relevant topics on the use of AIT in asthma and could facilitate physician clinical decisions and improve health outcomes for individual patients.

Asthma in adults: Principles of treatment

2019 ◽  
Vol 40 (6) ◽  
pp. 396-402 ◽  
Author(s):  
Jason H. Kwah ◽  
Anju T. Peters
Keyword(s):  
Allergic Asthma ◽  
Allergen Immunotherapy ◽  
Laryngopharyngeal Reflux ◽  
Normal Activity ◽  
Forced Expiratory Volume ◽  
Emergency Department Visits ◽  
Activity Level ◽  
Treatment Modalities ◽  
Allergen Specific Immunotherapy ◽  
Principles Of Treatment

The goals of treatment are prevention of fatalities, hospitalizations, and emergency department visits, along with achieving good long-term control of asthma, with reduction of symptoms, maintenance of normal activity level, prevention of exacerbations and accelerated loss of pulmonary function (forced expiratory volume in the first second of expiration [FEV1]), and avoidance of harm from therapies. Treatment is often initiated based on the severity of symptoms, physical examination findings, and, for some patients, the FEV1 or peak expiratory flow rates. Comorbidities such as gastroesophageal reflux disease and laryngopharyngeal reflux, rhinitis or rhinosinusitis, sleep apnea, recurrent infections, smoking, and substance abuse should be addressed. Two treatment modalities are indicated only for individuals with allergic asthma: allergen-specific immunotherapy (commonly known as allergy shots), and biologic therapies that target type-2 (T2) inflammation. Allergen immunotherapy is effective in decreasing symptoms and medication use in select patients with mild-to-moderate allergic asthma. In addition, patients who receive allergen immunotherapy for allergic rhinitis may have a decreased risk of developing asthma. Omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab are monoclonal antibodies that target T2 inflammation and are indicated for either moderate-to-severe or severe asthma. These have been well studied to improve asthma symptoms and have specific characteristics unique to each individual medication. A focus on adherence can be considered in choosing therapy because it is not clear which biologic to choose in T2 high asthma at this time.

Contribution of Kazal-Like Domains of the Serine Protease Inhibitor-1 from Toxoplasma gondii in Asthma Therapeutic Vaccination Effectiveness

2022 ◽  
pp. 1-8
Author(s):  
Ariadna Soto ◽  
Matías Perrone Sibilia ◽  
Vanesa Roxana Sánchez ◽  
Nadia Arcón ◽  
Valentina Martin ◽  
...  
Keyword(s):  
Neutrophil Elastase ◽  
Lung Inflammation ◽  
Specific Immunotherapy ◽  
Serine Protease Inhibitor ◽  
Full Length ◽  
Asthma Treatment ◽  
Promising Candidate ◽  
Allergen Specific Immunotherapy ◽  
Allergic Lung Inflammation ◽  
Control Asthma

<b><i>Background:</i></b> We have previously showed rTgPI-1 tolerogenic adjuvant properties in asthma treatment, turning it a promising candidate for allergen-specific immunotherapy. This therapy is an alternative treatment to control asthma that still presents several concerns related to its formulation. rTgPI-1 contains independent inhibitory domains able to inhibit trypsin and neutrophil elastase, both involved in asthma pathology. <b><i>Objectives:</i></b> In view of the need to design rational therapies, herein we investigated the contribution of the different inhibitory domains in rTgPI-1 therapeutic effectiveness. <b><i>Methods:</i></b> BALB/c mice were rendered allergic by intraperitoneal OVA-alum sensitization and airway challenged. Once the asthmatic phenotype was achieved, mice were intranasally treated with OVA combined with the full-length recombinant protein rTgPI-1 or its truncated versions, Nt (containing trypsin-inhibitory domains) or Ct (containing neutrophil elastase-inhibitory domains). Afterward, mice were aerosol re-challenged. <b><i>Results:</i></b> Asthmatic mice treated with the neutrophil elastase- or the trypsin-inhibitory domains separately failed to improve allergic lung inflammation. Only when all inhibitory domains were simultaneously administered, an improvement was achieved. Still, a better outcome was obtained when mice were treated with the full-length rTgPI-1. <b><i>Conclusions:</i></b> Adjuvant ability depends on the presence of all its inhibitory domains in a single entity, so it should be included in potential asthma treatment formulations as a full-length protein.

scholarly journals CLINICAL EFFICACY OF SUBLINGUAL ALLERGEN IMMUNOTHERAPY WITH ANTIPOLLIN MIXED WEEDS IN ADULTS

2016 ◽  
Vol 13 (4-5) ◽  
pp. 68-71
Author(s):  
E F Glushkova ◽  
O I Sidorovich
Keyword(s):  
Visual Analogue Scale ◽  
Asthma Control ◽  
Clinical Efficacy ◽  
Analogue Scale ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Nasal Congestion ◽  
Respiratory Allergy ◽  
Asthma Control Questionnaire ◽  
Allergen Specific Immunotherapy

Background. To evaluate the effectiveness of one course of sublingual allergen-specific immunotherapy (sASIT) in adults with allergy to wormwood and goose-foot pollen. Materials and methods. 28 adults aged between 20 and 53 years old with various forms of respiratory allergy were included in the study. All of them received sASIT with Antipollin Mixed weeds. The effectiveness of treatment was assessed using a visual analogue scale of rhinoconjunctivitis symptoms and Asthma Control Questionnaire. Results. As a result of sASIT a 61,6% of rhinorrhea, a 61,6% of nasal congestion , a 71,43% of nasal itching, and 82% of eyes itching reduction was shown as well as asthma control was achieved in 83,3% of patients.

scholarly journals Standardized Quantitative Evaluation of Clinical Effectiveness and Side Effect Profile of Subcutaneous and Sublingual Allergen-Specific Immunotherapy in Children: A 5-Year Single Center Experience

2021 ◽  
Vol 19 (3) ◽  
pp. 156-165
Author(s):  
Nazan TÖKMECI ◽  
Ali DEMIRHAN ◽  
Merve TURKEGUN SENGUL ◽  
Burcu CAGLAR YUKSEK ◽  
Aylin KONT ÖZHAN ◽  
...  
Keyword(s):  
Side Effects ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Allergic Diseases ◽  
Visual Analog Score ◽  
Allergen Specific Immunotherapy ◽  
Medication Score ◽  
Asthma Patients ◽  
Systemic Side Effects ◽  
High Responders

Objective: Allergen-specific immunotherapy (allergen-SIT) is a treatment method with variable efficacy in allergic diseases. This study aimed to investigate the effectiveness of allergen immunotherapy, frequency of LRs and SRs and variables affecting these parameters in patients who underwent allergen-SIT. Materials and Methods: In this study, the recorded data of 81 patients, who received subcutaneous (SCIT) or sublingual (SLIT) allergen immunotherapy for respiratory allergic diseases between 2014 and 2019, were analyzed. In asthma and/or allergic rhinoconjunctivitis (ARC) patients, the effectiveness of treatment was evaluated by analysing the change rates in disease symptom, medication and combined scores (symptom + medication) and visual analog score (VAS). Treatment success was defined by the degree of decrease in scores as; high response above 50%; low response between 20-50%; and failure <20%.Results: The mean age of allergen-SIT initiation was 11.4± 3.1 years. Diagnostic distributions of the patients were asthma (± ARC) in 64.2%, and ARC (without asthma) in 35.8%. The mode of allergen-SIT was SCIT in 77.8% (65% asthma and 35% ARC) and SLIT in 22.2% (61.1% asthma and 38.9% ARC). The main allergens used in allergen-SIT were mite (79%), grass-grain pollen (33.3%), alternaria (9.9%) and olea (8.6%). There was a significant decrease in symptoms, medication, combined and VAS scores in the asthma and ARC groups (p <0.0001), when end-SCIT values were compared to baseline. SLIT also resulted in significant decreases in these scores except asthma medication score. Among the asthma patients the rate of high-responders was 88.8% by SCIT and 50% by SLIT, according to combined asthma score. Among the ARC (without asthma) patients the rate of high-responders was 100% for both SCIT and SLIT. SCIT resulted in local (LR) and systemic side effects (SR) in 18% and 0.6% (all Grade I and Grade II) of the total injections performed. A high number of total injections was significantly associated with higher LR and SR rates. While LR was observed in 16.6% of the patients who underwent SLIT, no systemic reaction was found in any of the patients. Conclusion: SCIT was highly successful in the treatment of asthma and ARC in terms of the degree of therapeutic response. SLIT resulted in a high rate of good response in ARC patients, but a lower response degree in asthmatic patients. Systemic side effects were very low as a result of close risk monitoring and the dose adjustments performed. Keywords: Allergen-specific immunotherapy, SCIT, SLIT, efficacy, symptom score, medication score, visual analog score, side effects

scholarly journals Diverse Mechanisms of Allergen Specific Immunotherapy

2019 ◽  
Vol 23 (3) ◽  
pp. 233-249 ◽  
Author(s):  
Lacin Cevhertas ◽  
Mübeccel Akdis
Keyword(s):  
Immune Response ◽  
Molecular Mechanisms ◽  
Allergen Immunotherapy ◽  
Specific Immunotherapy ◽  
Prognostic Markers ◽  
Recent Literature ◽  
Administration Route ◽  
Allergen Specific Immunotherapy ◽  
Disease Modifying ◽  
Disease Modifying Treatment

Allergen immunotherapy (AIT) is widely used to establish a tolerant immune response and it is currently the only disease modifying treatment. There are different routes to administer the allergen, including subcutaneous, sublingual, intralymphatic, epicutaneous, intradermal, and oral and local nasal allergen immunotherapy. Although the optimal administration route depends on the type of allergen, some patients remain unresponsive and so it is important to predict the outcome before and during treatment. Therefore, there is a need to identify candidate prognostic markers for allergen immunotherapy. Herein, we discuss the recent literature on the molecular mechanisms of AIT.

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