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Aktuelle Entwicklungen zur Therapie der Erdnussallergie. ALLERGO JOURNAL 2021. [DOI: 10.1007/s15007-021-4774-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Storni F, Zeltins A, Balke I, Heath MD, Kramer MF, Skinner MA, Zha L, Roesti E, Engeroff P, Muri L, von Werdt D, Gruber T, Cragg M, Mlynarczyk M, Kündig TM, Vogel M, Bachmann MF. Vaccine against peanut allergy based on engineered virus-like particles displaying single major peanut allergens. J Allergy Clin Immunol 2020; 145:1240-1253.e3. [PMID: 31866435 DOI: 10.1016/j.jaci.2019.12.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Peanut allergy is a severe and increasingly frequent disease with high medical, psychosocial, and economic burden for affected patients and wider society. A causal, safe, and effective therapy is not yet available. OBJECTIVE We sought to develop an immunogenic, protective, and nonreactogenic vaccine candidate against peanut allergy based on virus-like particles (VLPs) coupled to single peanut allergens. METHODS To generate vaccine candidates, extracts of roasted peanut (Ara R) or the single allergens Ara h 1 or Ara h 2 were coupled to immunologically optimized Cucumber Mosaic Virus-derived VLPs (CuMVtt). BALB/c mice were sensitized intraperitoneally with peanut extract absorbed to alum. Immunotherapy consisted of a single subcutaneous injection of CuMVtt coupled to Ara R, Ara h 1, or Ara h 2. RESULTS The vaccines CuMVtt-Ara R, CuMVtt-Ara h 1, and CuMVtt-Ara h 2 protected peanut-sensitized mice against anaphylaxis after intravenous challenge with the whole peanut extract. Vaccines did not cause allergic reactions in sensitized mice. CuMVtt-Ara h 1 was able to induce specific IgG antibodies, diminished local reactions after skin prick tests, and reduced the infiltration of the gastrointestinal tract by eosinophils and mast cells after oral challenge with peanut. The ability of CuMVtt-Ara h 1 to protect against challenge with the whole extract was mediated by IgG, as shown via passive IgG transfer. FcγRIIb was required for protection, indicating that immune complexes with single allergens were able to block the allergic response against the whole extract, consisting of a complex allergen mixture. CONCLUSIONS Our data suggest that vaccination using single peanut allergens displayed on CuMVtt may represent a novel therapy against peanut allergy with a favorable safety profile.
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Affiliation(s)
- Federico Storni
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland; Department of BioMedical Research, University of Bern, Bern, Switzerland; Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Andris Zeltins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Ina Balke
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | | | | | - Lisha Zha
- International Immunology Center of Anhui Agricultural Center, Anhui, China
| | - Elisa Roesti
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland
| | - Paul Engeroff
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland
| | - Lukas Muri
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Diego von Werdt
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Thomas Gruber
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Mark Cragg
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences Unit, Faculty of Medicine, General Hospital, University of Southampton, Southampton, United Kingdom
| | | | - Thomas M Kündig
- Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Monique Vogel
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland
| | - Martin F Bachmann
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland; Nuffield Department of Medicine, Centre for Cellular and Molecular Physiology, The Jenner Institute, University of Oxford, Oxford, United Kingdom.
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Abstract
PURPOSE OF REVIEW The goal of this review is to present an updated summary of the natural history of major childhood and adult food allergies and report recent advances in potential treatments for food allergy. RECENT FINDINGS The most common childhood food allergies are typically outgrown by adolescence or adulthood. However, peanut/tree nut allergies appear to more commonly persist into adulthood. Adults can develop new IgE-mediated food allergies; the most common is oral allergy syndrome. There are multiple different approaches being tried as possible treatments for food allergy. The prevalence of food allergy appears to be increasing but the varied approaches to treatment are being actively pursued such that an approved modality may not be too far in the future.
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The Current State of Epicutaneous Immunotherapy for Food Allergy: a Comprehensive Review. Clin Rev Allergy Immunol 2017; 55:153-161. [DOI: 10.1007/s12016-017-8650-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Advances and highlights in allergen immunotherapy: On the way to sustained clinical and immunologic tolerance. J Allergy Clin Immunol 2017; 140:1250-1267. [PMID: 28941667 DOI: 10.1016/j.jaci.2017.08.025] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/17/2017] [Accepted: 08/21/2017] [Indexed: 12/11/2022]
Abstract
Allergen immunotherapy (AIT) is an effective treatment strategy for allergic diseases and has been used for more than 100 years. In recent years, however, the expectations on concepts, conduct, statistical evaluation, and reporting have developed significantly. Products have undergone dose-response and confirmative studies in adults and children to provide evidence for the optimal dosage, safety, and efficacy of AIT vaccines using subcutaneous and sublingual delivery pathways in large patient cohorts, ensuring solid conclusions to be drawn from them for the advantage of patients and societies alike. Those standards should be followed today, and products answering to them should be preferred over others lacking optimization and proof of efficacy and safety. Molecular and cellular mechanisms of AIT include early mast cell and basophil desensitization effects, regulation of T- and B-cell responses, regulation of IgE and IgG4 production, and inhibition of responses from eosinophils, mast cells, and basophils in the affected tissues. There were many developments to improve vaccination strategies, demonstration of new molecules involved in molecular mechanisms, and demonstration of new biomarkers for AIT during the last few years. The combination of probiotics, vitamins, and biological agents with AIT is highlighting current advances. Development of allergoids and recombinant and hypoallergenic vaccines to skew the immune response from IgE to IgG4 and regulation of dendritic cell, mast cell, basophil, innate lymphoid cell, T-cell, and B-cell responses to allergens are also discussed in detail.
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Hamad A, Burks WA. Emerging Approaches to Food Desensitization in Children. Curr Allergy Asthma Rep 2017; 17:32. [PMID: 28429307 DOI: 10.1007/s11882-017-0700-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight the recent advances in food desensitization in children with food allergy. RECENT FINDINGS Recent advancements in epicutaneous, sublingual, and oral immunotherapy for food allergy in the future may offer children with food allergy and their families a viable option to reduce risk or severity of anaphylaxis with phase III trials ongoing for two of these treatment modalities. Food allergy prevalence in children is estimated to be up to 8%. These children are at risk of significant allergic reactions and anaphylaxis. Food avoidance and use of antihistamines or epinephrine has been the standard of care for these patients. This approach also has a significant socioeconomic effects on patients and their families. Recent advancements in understanding food allergy have allowed for exploring new methods of treatment. There is an increasing interest in oral immunotherapy, epicutaneous immunotherapy, or sublingual immunotherapy for food allergy. There have been also innovative approaches to immunotherapy by modification of food allergens (to make them less allergenic while maintain their immunogenicity) or adding adjunctive treatments (probiotics, anti-IgE, etc.) to increase efficacy or safety.
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Affiliation(s)
- Ahmad Hamad
- Division of Allergy and Immunology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, 27517, USA.
| | - Wesley A Burks
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, USA
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Baumert JL, Taylor SL, Koppelman SJ. Quantitative Assessment of the Safety Benefits Associated with Increasing Clinical Peanut Thresholds Through Immunotherapy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 6:457-465.e4. [PMID: 28669889 DOI: 10.1016/j.jaip.2017.05.006] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 04/20/2017] [Accepted: 05/09/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Peanut immunotherapy studies are conducted with the aim to decrease the sensitivity of patients to peanut exposure with the outcome evaluated by testing the threshold for allergic response in a double-blind placebo-controlled food challenge. The clinical relevance of increasing this threshold is not well characterized. OBJECTIVE We aimed to quantify the clinical benefit of an increased threshold for peanut-allergic patients. METHODS Quantitative risk assessment was performed by matching modeled exposure to peanut protein with individual threshold levels. Exposure was modeled by pairing US consumption data for various food product categories with potential contamination levels of peanut that have been demonstrated to be present on occasion in such food products. Cookies, ice cream, doughnuts/snack cakes, and snack chip mixes were considered in the risk assessment. RESULTS Increasing the baseline threshold before immunotherapy from 100 mg or less peanut protein to 300 mg peanut protein postimmunotherapy reduces the risk of experiencing an allergic reaction by more than 95% for all 4 food product categories that may contain trace levels of peanut residue. Further increase in the threshold to 1000 mg of peanut protein had an additional quantitative benefit in risk reduction for all patients reacting to 300 mg or less at baseline. CONCLUSIONS We conclude that achieving thresholds of 300 mg and 1000 mg of peanut protein by peanut immunotherapy is clinically relevant, and that the risk for peanut-allergic patients who have achieved this increased threshold to experience an allergic reaction is reduced in a clinically meaningful way.
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Affiliation(s)
- Joseph L Baumert
- Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, Neb.
| | - Steve L Taylor
- Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, Neb
| | - Stef J Koppelman
- Food Allergy Research and Resource Program, Department of Food Science and Technology, University of Nebraska, Lincoln, Neb
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Jones SM, Sicherer SH, Burks AW, Leung DYM, Lindblad RW, Dawson P, Henning AK, Berin MC, Chiang D, Vickery BP, Pesek RD, Cho CB, Davidson WF, Plaut M, Sampson HA, Wood RA. Epicutaneous immunotherapy for the treatment of peanut allergy in children and young adults. J Allergy Clin Immunol 2016; 139:1242-1252.e9. [PMID: 28091362 DOI: 10.1016/j.jaci.2016.08.017] [Citation(s) in RCA: 227] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/18/2016] [Accepted: 08/16/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Peanut allergy is common, life-threatening, and without therapeutic options. We evaluated peanut epicutaneous immunotherapy (EPIT) by using Viaskin Peanut for peanut allergy treatment. OBJECTIVE We sought to evaluate the clinical, safety, and immunologic effects of EPIT for the treatment of peanut allergy. METHODS In this multicenter, double-blind, randomized, placebo-controlled study, 74 participants with peanut allergy (ages 4-25 years) were treated with placebo (n = 25), Viaskin Peanut 100 μg (VP100; n = 24) or Viaskin Peanut 250 μg (VP250; n = 25; DBV Technologies, Montrouge, France). The primary outcome was treatment success after 52 weeks, which was defined as passing a 5044-mg protein oral food challenge or achieving a 10-fold or greater increase in successfully consumed dose from baseline to week 52. Adverse reactions and mechanistic changes were assessed. RESULTS At week 52, treatment success was achieved in 3 (12%) placebo-treated participants, 11 (46%) VP100 participants, and 12 (48%) VP250 participants (P = .005 and P = .003, respectively, compared with placebo; VP100 vs VP250, P = .48). Median change in successfully consumed doses were 0, 43, and 130 mg of protein in the placebo, VP100, and VP250 groups, respectively (placebo vs VP100, P = .014; placebo vs VP250, P = .003). Treatment success was higher among younger children (P = .03; age, 4-11 vs >11 years). Overall, 14.4% of placebo doses and 79.8% of VP100 and VP250 doses resulted in reactions, predominantly local patch-site and mild reactions (P = .003). Increases in peanut-specific IgG4 levels and IgG4/IgE ratios were observed in peanut EPIT-treated participants, along with trends toward reduced basophil activation and peanut-specific TH2 cytokines. CONCLUSIONS Peanut EPIT administration was safe and associated with a modest treatment response after 52 weeks, with the highest responses among younger children. This, when coupled with a high adherence and retention rate and significant changes in immune pathways, supports further investigation of this novel therapy.
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Affiliation(s)
- Stacie M Jones
- Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark.
| | - Scott H Sicherer
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Wesley Burks
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | | | | | | | | | - M Cecilia Berin
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David Chiang
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Brian P Vickery
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC
| | - Robbie D Pesek
- Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark
| | | | - Wendy F Davidson
- National Institutes of Health (National Institutes of Allergy and Infectious Diseases), Bethesda, Md
| | - Marshall Plaut
- National Institutes of Health (National Institutes of Allergy and Infectious Diseases), Bethesda, Md
| | - Hugh A Sampson
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Robert A Wood
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Md
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11
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Chambliss JM, Burks AW. The latest on food allergy immunotherapy. Ann Allergy Asthma Immunol 2016; 117:476-478. [PMID: 27788874 DOI: 10.1016/j.anai.2016.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 05/25/2016] [Accepted: 07/19/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Jeffrey M Chambliss
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - A Wesley Burks
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
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12
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Commins SP, Kim EH, Orgel K, Kulis M. Peanut Allergy: New Developments and Clinical Implications. Curr Allergy Asthma Rep 2016; 16:35. [PMID: 27039393 DOI: 10.1007/s11882-016-0613-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Food allergies have increased in prevalence over the past 20 years, now becoming an important public health concern. Although there are no therapies currently available for routine clinical care, recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective. Oral immunotherapy is conducted by administering small, increasing amounts of food allergen; it has shown promise for desensitizing individuals with peanut, egg, or milk allergies. Sublingual immunotherapy also desensitizes allergic patients to foods-two major studies have examined the effects of sublingual immunotherapy in subjects with peanut allergies. We review the complex nature of IgE-mediated food allergies and the therapies being evaluated in clinical trials. We focus on the diagnosis and management of food allergies and investigational therapies.
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Affiliation(s)
- Scott P Commins
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA. .,Thurston Arthritis Research Center, Chapel Hill, NC, USA. .,Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA. .,Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina, 3300 Thurston Building, CB 7280, Chapel Hill, NC, 27599-7280, USA.
| | - Edwin H Kim
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.,Thurston Arthritis Research Center, Chapel Hill, NC, USA.,Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Kelly Orgel
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Mike Kulis
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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13
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Sindher S, Fleischer DM, Spergel JM. Advances in the Treatment of Food Allergy: Sublingual and Epicutaneous Immunotherapy. Immunol Allergy Clin North Am 2016; 36:39-54. [PMID: 26617226 DOI: 10.1016/j.iac.2015.08.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Food allergies continue to increase in prevalence. Standard care is a strict elimination diet, but life-threatening reactions still occur. Allergen immunotherapy has the most potential in treating food allergy. Subcutaneous immunotherapy has not been adopted into food allergy therapy. Oral immunotherapy has a high rate of adverse reactions. Sublingual immunotherapy (SLIT) uses the tolerogenic environment of the oral mucosa and epicutaneous immunotherapy (EPIT) uses the immune cells of the epidermis to transport antigens to afferent lymph nodes to activate immune responses. SLIT and EPIT can successfully desensitize patients. More research is needed to define optimal doses and administration protocols.
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Affiliation(s)
- Sayantani Sindher
- Division of Allergy and Immunology, Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104-4399, USA
| | - David M Fleischer
- Section of Allergy, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Denver School of Medicine, 13123 East 16th Avenue, B518, Aurora, CO 80045, USA
| | - Jonathan M Spergel
- Division of Allergy and Immunology, Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104-4399, USA.
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Senti G, Kündig TM. Novel Delivery Routes for Allergy Immunotherapy: Intralymphatic, Epicutaneous, and Intradermal. Immunol Allergy Clin North Am 2016; 36:25-37. [PMID: 26617225 DOI: 10.1016/j.iac.2015.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Current allergy immunotherapy protocols suffer from two main problems: long treatment duration and systemic allergic side effects of the allergen administrations. The immunologic effects of allergen administration could be enhanced and the number of allergen administrations and treatment duration reduced by choosing a tissue for administration that contains a high density of antigen-presenting cells. Local side effects could be reduced by choosing a route characterized by a low density of mast cells, and systemic side effects could be reduced by administration to nonvascularized tissues, so that inadvertent systemic distribution of the allergen and consequent systemic allergic side effects are minimized.
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Affiliation(s)
- Gabriela Senti
- Clinical Trials Center, University Hospital Zurich, Moussonstrasse 2, Zurich 8044, Switzerland
| | - Thomas M Kündig
- Department of Dermatology, University Hospital Zurich, Gloriatrasse 31, Zurich 8091, Switzerland.
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15
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Jhamnani RD, Frischmeyer-Guerrerio P. Desensitization for Peanut Allergies in Children. CURRENT TREATMENT OPTIONS IN ALLERGY 2016; 3:282-291. [PMID: 28042528 PMCID: PMC5193471 DOI: 10.1007/s40521-016-0091-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Immunotherapy for peanut allergy has been an exploding topic of study within the last few years. Sublingual, epicutaneous, and oral immunotherapy are being investigated and show promise in the treatment of peanut allergy. Oral immunotherapy has shown the most clinical benefit; however, sublingual and epicutaneous immunotherapy appear to have the most favorable safety profiles. Most studies to date suggest that only a minority of subjects achieve sustained unresponsiveness to peanut after discontinuation of immunotherapy. Recent efforts have been focused on identifying adjunct therapies, such as omalizumab, that may assist patients in achieving peanut desensitization more quickly and with greater success. Several underlying immunologic mechanisms, including a switch from IgE to IgG4 production and induction of T regulatory cells, have been studied although more research is needed to identify reliable biomarkers. This article will describe the immunotherapy approaches that are being investigated to induce peanut desensitization, and highlight the benefits and risks of these therapies that need to be considered before they are ready for routine clinical practice.
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Affiliation(s)
- Rekha D Jhamnani
- National Institutes of Health, 10 Clinical Center Drive, Bethesda, MD, 20892, USA
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Trendelenburg V, Blümchen K. [Allergen-specific immunotherapy for food allergies in childhood. Current options and future perspectives]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:855-64. [PMID: 27324376 DOI: 10.1007/s00103-016-2372-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
During recent years increasing research has been conducted on casual treatment options for food allergy, with focus on oral immunotherapy (OIT) for hen's egg, cow's milk and peanut allergy. Several studies could show that OIT leads to desensitization or an increase of threshold. However, severe adverse events during this treatment are not uncommon. Whether OIT leads to a sustained, 'robust' development of tolerance in patients has not yet been thoroughly investigated. Besides OIT, some studies on sublingual (SLIT) and epicutaneous immunotherapy (EPIT) were performed, aiming to improve the safety profile. Furthermore, there are some pilot studies investigating a combined treatment of SLIT and OIT or a combined use of anti-IgE treatment or probiotic supplementation with OIT. Further placebo-controlled trials with larger sample size are needed in order to develop standardized protocols before immunotherapy may be used as a therapeutic option for food allergy outside of clinical trials.
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Affiliation(s)
- Valérie Trendelenburg
- Klinik für Pädiatrie mit Schwerpunkt Pneumologie/Immunologie, Universitätsmedizin Charité, Berlin, Deutschland
| | - Katharina Blümchen
- Klinik für Kinder- und Jugendmedizin, Pädiatrische Allergologie, Pneumologie und Mukoviszidose, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
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Allergenicity attributes of different peanut market types. Food Chem Toxicol 2016; 91:82-90. [DOI: 10.1016/j.fct.2016.02.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/28/2016] [Accepted: 02/19/2016] [Indexed: 11/20/2022]
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Mondoulet L, Dioszeghy V, Thébault C, Benhamou PH, Dupont C. Epicutaneous immunotherapy for food allergy as a novel pathway for oral tolerance induction. Immunotherapy 2015; 7:1293-305. [PMID: 26584421 DOI: 10.2217/imt.15.86] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Epicutaneous immunotherapy is a developing technique, aiming at desensitizing patients with food allergy with less risks that oral ingestion or injection could generate. Several clinical trials have been performed and are currently running, in milk and peanut allergy, assessing the safety of the technique and its efficacy. Preclinical models indicate a major role in the mechanisms of desensitization, for example, Tregs and epigenetic modifications.
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Affiliation(s)
- Lucie Mondoulet
- DBV Technologies, Green Square, 80/84 rue des Meuniers, Bagneux, France
| | - Vincent Dioszeghy
- DBV Technologies, Green Square, 80/84 rue des Meuniers, Bagneux, France
| | - Claude Thébault
- DBV Technologies, Green Square, 80/84 rue des Meuniers, Bagneux, France
| | | | - Christophe Dupont
- Université Paris Descartes - Hôpital Necker-Enfants Malades, 149 Rue de Sèvres, 75015 Paris, France
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An Examination of Clinical and Immunologic Outcomes in Food Allergen Immunotherapy by Route of Administration. Curr Allergy Asthma Rep 2015; 15:35. [PMID: 26141581 DOI: 10.1007/s11882-015-0536-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Allergen immunotherapy for the treatment of food allergy has been a subject of intensive study within the last 10 years. After an unsuccessful attempt with subcutaneous immunotherapy for peanut allergy, other routes with varying degrees of safety and efficacy have been tested for peanut, milk, and egg allergies. In this review, we summarize the results to date with oral immunotherapy, sublingual immunotherapy, and epicutaneous immunotherapy for the treatment of food allergy. While results of immunotherapy trials are promising, increases in efficacy are commonly associated with an increased side effect profile. There is a need for additional research beginning at the preclinical level to develop safe and effective treatments for food allergy.
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Gavillet BM, Mondoulet L, Dhelft V, Eberhardt CS, Auderset F, Pham HT, Petre J, Lambert PH, Benhamou PH, Siegrist CA. Needle-free and adjuvant-free epicutaneous boosting of pertussis immunity: Preclinical proof of concept. Vaccine 2015; 33:3450-5. [PMID: 26067183 DOI: 10.1016/j.vaccine.2015.05.089] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/12/2015] [Accepted: 05/28/2015] [Indexed: 11/27/2022]
Abstract
The limited durability of pertussis vaccine-induced protection requires novel approaches to reactivate immunity and limit pertussis resurgence in older children and adults. We propose that periodic boosters could be delivered using a novel epicutaneous delivery system (Viaskin) to deliver optimized pertussis antigens such as genetically-detoxified pertussis toxin (rPT). To best mimic the human situation in which vaccine-induced memory cells persist, whereas antibodies wane, we developed a novel adoptive transfer murine model of pertussis immunity. This allowed demonstrating that a single application of Viaskin delivering rPT and/or pertactin and filamentous hemagglutinin effectively reactivates vaccine-induced pertussis immunity and protects against Bordetella pertussis challenge. Recalling pertussis immunity without needles nor adjuvant may considerably facilitate the acceptance and application of periodic boosters.
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Affiliation(s)
- Beatris Mastelic Gavillet
- World Health Organization Collaborating Center for Vaccine Immunology, Departments of Pathology-Immunology, University of Geneva, 1211 Geneva, Switzerland.
| | - Lucie Mondoulet
- DBV Technologies, Green Square, 80/84 rue des Meuniers, 92220 Bagneux, France
| | - Véronique Dhelft
- DBV Technologies, Green Square, 80/84 rue des Meuniers, 92220 Bagneux, France
| | - Christiane Sigrid Eberhardt
- World Health Organization Collaborating Center for Vaccine Immunology, Departments of Pathology-Immunology, University of Geneva, 1211 Geneva, Switzerland
| | - Floriane Auderset
- World Health Organization Collaborating Center for Vaccine Immunology, Departments of Pathology-Immunology, University of Geneva, 1211 Geneva, Switzerland
| | - Hong Thai Pham
- BioNet-Asia Co., Ltd., 19 Udomsuk 37, Sukhumvit 103, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Jean Petre
- BioNet-Asia Co., Ltd., 19 Udomsuk 37, Sukhumvit 103, Bangjak, Prakanong, Bangkok 10260, Thailand
| | - Paul-Henri Lambert
- World Health Organization Collaborating Center for Vaccine Immunology, Departments of Pathology-Immunology, University of Geneva, 1211 Geneva, Switzerland
| | | | - Claire-Anne Siegrist
- World Health Organization Collaborating Center for Vaccine Immunology, Departments of Pathology-Immunology, University of Geneva, 1211 Geneva, Switzerland
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