Immunotherapy with short ragweed fraction A:D-glutamic acid:D-lysine polymer in ragweed hay fever

New and old adjuvants in allergen-specific immunotherapy: With a focus on nanoparticles

Allergic diseases have remarkably increased in recent years. Nowadays, efforts for curing and management of these disorders are an important concern worldwide. Allergen-specific immunotherapy (ASIT) has recently gained more attention as a means for the management of allergic diseases. Adjuvants or helper agents are materials applied for better stimulating and shifting of protective responses, and these belong to an extremely diverse collection of complexes. The main function of adjuvants includes acting as depot foundations, transferring vehicles, and immunostimulators. Immunostimulatory adjuvants have gained increasing attention for ASIT. In this regard, the present study provides a review of old and new adjuvants used in allergen immunotherapy.

Review of novel particulate antigen delivery systems with special focus on treatment of type I allergy

For the treatment of infectious diseases, cancer and allergy, the directed induction of an appropriate immune response is the ultimate goal. Therefore, with the development of pure, often very small proteins, peptides or DNA by molecular biology techniques, the research for suitable adjuvants or delivery systems became increasingly important. Particle formulations are made of a variety of materials, including lipids, proteins or amino acids, polysaccharides, polyacrylic substances or organic acids. Microparticles serve as vehicles and provide a depot for the entrapped or coupled antigen. The release occurs in a pulsatile or continuous manner, a feature, which is well controllable for many particulate systems. Particles attract antigen presenting cells to the administration site, thereby guaranteeing the efficient presentation of the antigen to the immune system. Importantly, particles also protect the entrapped substance. This is especially necessary after oral application to avoid gastric or tryptic breakdown. In this article, the design and construction of different antigen delivery systems and their immune effects, with special focus on the suitability for allergy treatment, are discussed.

Modified forms of allergen immunotherapy

There have been many attempts to modify allergens and thus to improve upon conventional immunotherapy, which has been proved effective but has several drawbacks. These include the risk of systemic reactions and the time and cost involved. The modifications have taken three major approaches. One approach, to impede allergen release from the site of deposition, has met with limited success. An example is alum precipitation, which has modestly reduced the number of injections and incidence of systemic reactions. A second approach, to suppress specific IgE production and to induce specific tolerance, has not been successful in man. The third approach, to reduce allergenicity while retaining immunogenicity of allergens, has been the most successful and appears to have the most promise. One example is polymerized allergens, which have been shown to be safe, efficacious, and immunogenic in multiple clinical trials. Other examples include allergoids and glutaraldehyde-treated, tyrosine-adsorbed allergens.

Chronic rhinitis

The author provides a well-detailed update on chronic rhinitis, the most common disease of the respiratory tract. Discussed are the anatomy and physiology of the nose, investigation of the patient, etiology, and treatment, including avoidance of provoking factors, pharmacologic therapy, and immunotherapy.