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Holzhauser T, Schuler F, Dudek S, Kaul S, Vieths S, Mahler V. [Recombinant allergens, peptides, and virus-like particles for allergy immunotherapy]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:1412-1423. [PMID: 33095280 PMCID: PMC7648003 DOI: 10.1007/s00103-020-03231-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/24/2020] [Indexed: 11/05/2022]
Abstract
Currently, extract-based therapeutic allergens from natural allergen sources (e.g., house dust mites, tree and grass pollen) are used for allergen-specific immunotherapy (AIT), the only causative therapy that can exhibit positive disease-modifying effects by tolerance induction and prevention of disease progression. Due to variations in the natural composition of the starting materials and different manufacturing processes, there are variations in protein content, allergen composition, and allergenic activity of similar products, which poses specific challenges for their standardization. The identification of the nucleotide sequences of allergenic proteins led to the development of molecular AIT approaches. This allows for the application of exclusively relevant structures as chemically synthesized peptides, recombinant single allergens, or molecules with hypoallergenic properties that potentially allow for an up-dosing with higher allergen-doses without allergic side effects leading more quickly to effective cumulative doses. Further modifications of AIT preparations to improve allergenic and immunogenic properties may be achieved, e.g., by including the use of virus-like particles (VLPs). To date, the herein described therapeutic approaches have been tested in clinical trials only. This article provides an overview of published molecular approaches for allergy treatment used in clinical AIT studies. Their added value and challenges compared to established therapeutic allergens are discussed. The aim of these approaches is to develop highly effective and well-tolerated AIT preparations with improved patient acceptance and adherence.
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Affiliation(s)
- Thomas Holzhauser
- Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und Biomedizinische Arzneimittel (PEI), Paul-Ehrlich-Straße 51-59, 63225, Langen, Deutschland.
| | - Frank Schuler
- Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und Biomedizinische Arzneimittel (PEI), Paul-Ehrlich-Straße 51-59, 63225, Langen, Deutschland
| | - Simone Dudek
- Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und Biomedizinische Arzneimittel (PEI), Paul-Ehrlich-Straße 51-59, 63225, Langen, Deutschland
| | - Susanne Kaul
- Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und Biomedizinische Arzneimittel (PEI), Paul-Ehrlich-Straße 51-59, 63225, Langen, Deutschland
| | - Stefan Vieths
- Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und Biomedizinische Arzneimittel (PEI), Paul-Ehrlich-Straße 51-59, 63225, Langen, Deutschland
| | - Vera Mahler
- Paul-Ehrlich-Institut, Bundesinstitut für Impfstoffe und Biomedizinische Arzneimittel (PEI), Paul-Ehrlich-Straße 51-59, 63225, Langen, Deutschland
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Worm M, Reese I, Ballmer-Weber B, Beyer K, Bischoff SC, Classen M, Fischer PJ, Fuchs T, Huttegger I, Jappe U, Klimek L, Koletzko B, Lange L, Lepp U, Mahler V, Niggemann B, Rabe U, Raithel M, Saloga J, Schäfer C, Schnadt S, Schreiber J, Szépfalusi Z, Treudler R, Wagenmann M, Watzl B, Werfel T, Zuberbier T, Kleine-Tebbe J. Guidelines on the management of IgE-mediated food allergies: S2k-Guidelines of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Medical Association of Allergologists (AeDA), the German Professional Association of Pediatricians (BVKJ), the German Allergy and Asthma Association (DAAB), German Dermatological Society (DDG), the German Society for Nutrition (DGE), the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS), the German Society for Oto-Rhino-Laryngology, Head and Neck Surgery, the German Society for Pediatric and Adolescent Medicine (DGKJ), the German Society for Pediatric Allergology and Environmental Medicine (GPA), the German Society for Pneumology (DGP), the German Society for Pediatric Gastroenterology and Nutrition (GPGE), German Contact Allergy Group (DKG), the Austrian Society for Allergology and Immunology (Æ-GAI), German Professional Association of Nutritional Sciences (VDOE) and the Association of the Scientific Medical Societies Germany (AWMF). ALLERGO JOURNAL INTERNATIONAL 2015; 24:256-293. [PMID: 27069841 PMCID: PMC4792347 DOI: 10.1007/s40629-015-0074-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Margitta Worm
- />Department of Dermatology, Venereology, and Allergology, Charité University Hospital, Berlin, Germany
- />Allergy-Center-Charité Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Imke Reese
- />Nutrition Counseling and Treatment with Specialist Focus on Allergy, Munich, Germany
| | | | - Kirsten Beyer
- />Department of Pediatrics, Division of Pneumology and Immunology, Charité University Hospital, Berlin, Germany
| | - Stephan C. Bischoff
- />Institute for Nutritional Medicine and Prevention, Hohenheim University, Stuttgart, Germany
| | - Martin Classen
- />Department of Pediatric and Adolescent Medicine, Klinikum Links der Weser gGmbH, Bremen, Germany
| | - Peter J. Fischer
- />Specialist Practice for Pediatric and Adolescent Medicine with Focus on Allergology and Pediatric Pneumology, Schwäbisch Gmünd, Germany
| | - Thomas Fuchs
- />Department of Dermatology, Georg-August University, Gõttingen, Germany
| | - Isidor Huttegger
- />University Clinic for Pediatric and Adolescent Medicine, Paracelsus Private Medical University, Salzburg Regional Clinics, Salzburg, Austria
| | - Uta Jappe
- />Department of Dermatology, Allergology, and Venereology, Schleswig-Holstein University Hospital, Lübeck, Germany
| | - Ludger Klimek
- />Center for Rhinology and Allergology, Wiesbaden, Germany
| | - Berthold Koletzko
- />Dr. von Haunersches Children‘s Hospital, Division of Metabolic Diseases and and Nutritional Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Lars Lange
- />Pediatric and Adolescent Medicine, St.-Marien Hospital, Bonn, Germany
| | | | - Vera Mahler
- />Department of Dermatology, Erlangen University Hospital, Erlangen, Germany
| | - Bodo Niggemann
- />Department of Pediatrics, Division of Pneumology and Immunology, Charité University Hospital, Berlin, Germany
| | - Ute Rabe
- />Specialist Department of Pneumology, Division for Asthma and Allergology, Johanniter Hospital Treuenbrietzen gGmbH, Treuenbrietzen, Germany
| | - Martin Raithel
- />Gastroenterology, Pneumology, and Endocrinology, Erlangen University, Erlangen, Germany
| | - Joachim Saloga
- />Department of Dermatology, Mainz University Hospital, Mainz, Germany
| | | | - Sabine Schnadt
- />German Allergy and Asthma Association, Monchengladbach, Germany
| | - Jens Schreiber
- />Division of Pneumology, University Hospital of the Otto-von-Guericke University, Magdeburg, Germany
| | - Zsolt Szépfalusi
- />Department of Pediatric and Adolescent Medicine, Vienna Medical University, Vienna, Austria
| | - Regina Treudler
- />Department of Dermatology, Venereology, and Allergology, Leipzig University, Leipzig, Germany
| | - Martin Wagenmann
- />Department of Oto-Rhino-Laryngology, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Bernhard Watzl
- />Max-Rubner Institute, Nutritional Physiology and Biochemistry, Karlsruhe, Germany
| | - Thomas Werfel
- />Department of Dermatology, Allergology, and Venereology, Hannover Medical University, Hannover, Germany
| | - Torsten Zuberbier
- />Department of Dermatology, Venereology, and Allergology, Charité University Hospital, Berlin, Germany
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