Journal of Investigational Allergology and Clinical Immunology最新文献

Food allergy has emerged as a significant global health concern, impacting quality of life and contributing to rising health care costs. Severe allergic reactions can be life-threatening and, in some cases, require hospitalization. Standard care typically involves elimination diets and epinephrine injections upon accidental exposure. In the past decade, oral immunotherapy has proven to be effective in reducing symptoms of severe food allergies. However, it also has limitations, including long treatment durations and risk of severe adverse effects. Therefore, alternative therapies are being explored. These include intradermal and subcutaneous injections of novel hypoallergenic allergen immunotherapy (AIT) formulations, such as chemically modified allergens, T-cell epitope-based therapies, particulate-based strategies, and DNA vaccines. The present review will examine the potential of intradermal and subcutaneous AIT applications and provide an overview of current developments in these innovative AIT strategies.

Background and objective: The retrospective study EfficAPSI explored the real-world impact of liquid sublingual allergen immunotherapy (AIT; Staloral® SLIT-liquid) on health care resource utilization (HCRU) in allergic rhinitis (AR) patients with/without asthma.

Methods: In the EfficAPSI cohort, patients dispensed SLIT-liquid and AIT-naïve controls taking symptomatic drug treatment (SDT) were compared using propensity score weighting. A total of 5 periods were analyzed, namely, the historical pre-SLIT period (HP, 2 years before the index dose of SLIT/SDT [first dispensation]) and four 2-year follow-up periods (FUPs) after the index dose, with the latter 2 periods corresponding to post-treatment years. HCRU was analyzed using a Poisson model with generalized estimating equations.

Results: The study population comprised 112 492 SLIT and 333 082 control patients. Dispensations of antihistamines and intranasal corticosteroids decreased by 28% to 49% during the FUPs (IRR from 0.51 [0.50-0.52] to 0.69 [0.67-0.71]) and after treatment (IRR from 0.62 [0.59-0.65] to 0.72 [0.69-0.74]), favoring SLIT-exposed patients. In patients with asthma, a 17%-29% reduction in asthma medication dispensations also favored SLIT-liquid (IRR, 0.83 [0.78-0.88] to 0.71 [0.68-0.74] during treatment; 0.82 [0.77-0.88] to 0.78 [0.72-0.85] after treatment). For oral corticosteroids, the between-group difference in change from the HP was in favor of SLIT-liquid for all FUPs (IRR for doses, 0.66 [0.64-0.69] to 0.79 [0.73-0.85]). The decrease in medical consultations and hospitalizations was consistently more frequent over time in SLIT patients than in controls.

Conclusions: In this national real-world study involving the largest number of person-years followed in the field of AIT to date, SLIT-liquid was associated with a reduction in AR and dispensation of asthma medication, including systemic corticosteroids, and medical consultations. The results recorded in the last 2 post-treatment FUPs suggest a sustained effect of SLIT-liquid.

Background and objective: Honeybee venom (HBV) allergy is a serious, potentially life-threatening, and highly prevalent immediate-type hypersensitivity reaction in humans. It can be treated with allergen-specific immunotherapy (AIT). Api m 10 is one of the major allergens in HBV and is thought to be under-represented in HBV AIT products. Objective: We used a mouse model to investigate whether the Api m 10 amounts contained in marketed HBV AIT products are sufficient to induce humoral immune responses in vivo.

Methods: BALB/c mice were immunized subcutaneously with either (1) increasing amounts of untagged recombinant (r) Api m 10 (0.1-50 µg), with or without aluminum hydroxide or (2) 4 aqueous HBV AIT products (0.001-50 µg total HBV protein). Levels of antibody against rApi m 10 and other HBV allergens were investigated using indirect ELISA.

Results: Administration of isolated rApi m 10 induced humoral immune responses (allergen-specific pan-IgG, IgG1, IgG2a, IgG2b, IgG3, and IgE; cumulative threshold dose, 1.5-3.1 µg) in BALB/c mice, which were able to block human IgE. HBV AIT products induced production of antibody towards rApi m 1, nApi m 4, and, albeit inconsistently, rApi m 3. By contrast, no prominent humoral immune responses to rApi m 10 were observed in mice repeatedly immunized with HBV AIT products.

Conclusions: While isolated rApi m 10 is immunogenic in BALB/c mice, the amount of Api m 10 in complex HBV AIT products is insufficient to induce prominent antibody responses.

Background: The objective of this study was to assess inflammatory and immune responses in patients with asthma and healthy controls exposed to a polluted and a nonpolluted environment over a short period.

Material and methods: We performed a randomized crossover study in patients with asthma (n=20) and in healthy controls (n=15). Participants were exposed for 2 hours to a polluted environment and, after 14 days, to a nonpolluted environment. Pollution levels were assessed at each exposure. Subsequently, serum levels of 8-isoprostane and glutathione peroxidase were measured as markers of oxidative stress, as were 48 cytokines involved in inflammation and the immune response.

Results: In the polluted environment, significantly higher levels of PM1, PM10, NO2, NO, and CO were observed (P=.0026, .0337, <.0001, <.0001, and .0004, respectively) than in the nonpolluted environment. After exposure to a polluted environment, both groups (healthy controls and asthma patients) presented higher values of IL-17F (P=.0285 and .0348, respectively) and CSF2 (P=.0425 and 0.0305, respectively). After exposure to high levels of pollution, healthy controls presented reductions in glutathione peroxidase (with antioxidant activity), CSF3, HGF, and OSM (P=.0038, P=.0123, 0.0353, and 0.0256, respectively) and increased levels of IL-7, CXCL8, and CCL2 (P=.0015, 0.0119 and 0.0215, respectively). Asthma patients had higher serum levels of IL-1ß and IL-15 (P=.0232 and 0.0497, respectively).

Conclusion: Healthy individuals and asthma patients respond differently to exposure to pollutants. Healthy individuals are characterized by adaptive suppression of immune activity, whereas asthma patients present a more marked inflammatory response.