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Allergen Immunotherapy in Allergic Diseases
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Allergen Immunotherapy in Allergic Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: closed (25 August 2023) | Viewed by 10515

Special Issue Editor

Dr. Takao Fujisawa

E-Mail Website
Guest Editor
Division of Allergy, National Hospital Organization Mie National Hospital, Tsu, Japan
Interests: clinical immunology; allergy; pediatrics; eosinophils; food allergy; asthma; atopic dermatitis

Special Issue Information

Dear Colleagues,

Allergen immunotherapy is the only disease-modifying therapy for allergic diseases. However, despite being a promising therapy, it has not been well administered in clinical practice. There may be several obstacles: firstly, primary care physicians dealing with very prevalent allergic diseases might not fully understand the efficacy and safety of allergen immunotherapy; secondly, adherence is not easily maintained due to the long-term nature of the treatment; thirdly, there are no good biomarkers to reflect to monitor the treatment; fourthly, there is still a limited number of therapeutic agents available for a wide variety of allergens; lastly, the efficacy of the treatment is not yet sufficient to lead to a cure of the disease.

In this Special Issue, we will discuss 1) the mechanisms of allergen immunotherapy, which should be delivered in a well understandable fashion for clinicians; 2) evidence of efficacy and safety; 3) measures to improve/maintain adherence, and 4) future approaches to “curable” immunotherapy.

To cover the scopes, we would like to publish the latest original research papers in addition to reviews by the world's top researchers.

We welcome the submission of papers related to:

  • immunological mechanism of allergen immunotherapy
  • clinical pearls on allergen immunotherapy in practice
  • allergen immunotherapy for asthma
  • allergen immunotherapy for allergic rhinitis
  • allergen immunotherapy for food allergy
  • new allergen immunotherapy

Dr. Takao Fujisawa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • allergen immunotherapy
  • asthma
  • allergic rhinitis
  • food allergy
  • atopic dermatitis

Published Papers (6 papers)

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Research

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12 pages, 944 KiB  
Article
Tolerability and Safety of Sublingual Immunotherapy in Patients with Tree Pollen Allergy in Daily Practice—An Open, Prospective, Non-Interventional Study
by Christoph Owenier, Cornelia Barnowski, Margret Leineweber, Donghui Yu, Marjan Verhagen and Andreas Distler
J. Clin. Med. 2023, 12(17), 5517; https://doi.org/10.3390/jcm12175517 - 25 Aug 2023
Cited by 1 | Viewed by 744
Abstract
To investigate the tolerability and safety of two sublingual tree pollen extracts approved in 2018, a non-interventional study (NIS) was performed. This NIS was an 8-month observational study conducted at 84 sites throughout Germany. Study participants received either a sublingual liquid allergen extract [...] Read more.
To investigate the tolerability and safety of two sublingual tree pollen extracts approved in 2018, a non-interventional study (NIS) was performed. This NIS was an 8-month observational study conducted at 84 sites throughout Germany. Study participants received either a sublingual liquid allergen extract of birch pollen (SBPE) or a liquid allergen extract consisting of a mixture of birch, hazel, and alder tree pollen (STPE). Data from 432 patients were analyzed for the occurrence of adverse events and patient compliance. At least one local reaction occurred in 69 (22.2%) patients, whereas systemic reactions were only observed in 27 (6.3%) patients. STPE-treated patients developed systemic reactions more frequently than SBPE-treated patients (SBPE: 9 (4.3%) vs. STPE: 18 (8.0%)). Only one patient developed a systemic grade III reaction. Severe systemic grade IV reactions were not observed. A total of 348 (98.6%) of the patients who completed all visits were satisfied or very satisfied with the sublingual immunotherapy (SLIT), and 322 (71%) patients completed all visits. Both investigated products were well tolerated by the patients and demonstrated a good safety profile. AEs were observed less frequently than in the preceding clinical phase III trial, and no new safety concerns were identified. Full article
(This article belongs to the Special Issue Allergen Immunotherapy in Allergic Diseases)
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12 pages, 2050 KiB  
Article
Combined LTP Sublingual and Oral Immunotherapy in LTP Syndrome: Efficacy and Safety
by Maria Aranzazu Martin Iglesias, Rosa Garcia Rodriguez, Alberto Palacios Cañas, Jaime Vinicio Meneses Sotomayor, Miriam Clar Castello and Francisco Feo Brito
J. Clin. Med. 2023, 12(5), 1823; https://doi.org/10.3390/jcm12051823 - 24 Feb 2023
Viewed by 2301
Abstract
Introduction: SLIT for the treatment of plant food allergies has been demonstrated to be safe but less effective than OIT, but the latter is associated with more adverse reactions. The aim of the study was to evaluate the efficacy and safety of a [...] Read more.
Introduction: SLIT for the treatment of plant food allergies has been demonstrated to be safe but less effective than OIT, but the latter is associated with more adverse reactions. The aim of the study was to evaluate the efficacy and safety of a new protocol starting with SLIT-peach followed by OIT with commercial peach juice in patients with LTP syndrome. Methods: This was a prospective, noncontrolled, open study on patients with LTP syndrome who are not sensitized to storage proteins. SLIT peach ALK was followed by OIT with Granini® peach juice after 40 days of the SLIT maintenance phase. At home, the Granini® juice dose was progressively increased during the 42 days until reaching 200 ml. After achieving the maximum dose, an open oral food challenge was carried out with the food that had caused the most severe reaction. If negative, the patient was instructed to progressively introduce the foods that were avoided before starting immunotherapy at home. Patients were reviewed 1 month later. The quality-of-life questionnaire FAQLQ-AF was completed at the beginning of the study and one month after the final challenge. Results: Forty-five patients were included, most of them with LTP anaphylaxis. Peach SLIT was well tolerated in 80.5%, and OIT with Granini® was well tolerated in 85%, with no severe adverse reactions. The final provocation was successful in 39/45 (86.6%). One month after the final provocation, 42/45 (93.3%) patients had no dietary restrictions. FAQLA-AF was significantly reduced. Conclusions: This combination of peach SLIT and OIT with commercial peach juice provides a new, fast, effective, and safe immunotherapy option for selected patients with LTP syndrome who are not allergic to storage proteins, improving their quality of life. This study suggests that cross-desensitization relative to the nsLTPs of several plant foods can be achieved by using Prup3. Full article
(This article belongs to the Special Issue Allergen Immunotherapy in Allergic Diseases)
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12 pages, 2005 KiB  
Article
Salivary IgG4 Levels Contribute to Assessing the Efficacy of Dermatophagoides pteronyssinus Subcutaneous Immunotherapy in Children with Asthma or Allergic Rhinitis
by Jinling Liu, Minfei Hu, Xiaofen Tao, Jing He, Jianhua Wang, Zhenghong Song, Lei Wu, Lanfang Tang, Zhimin Chen and Xuefeng Xu
J. Clin. Med. 2023, 12(4), 1665; https://doi.org/10.3390/jcm12041665 - 19 Feb 2023
Cited by 2 | Viewed by 1481
Abstract
At present, there are no effective, non-invasive, and objective indicators to evaluate the efficacy of pediatric house dust mite (HDM)-specific allergen immunotherapy (AIT). A prospective, observational study was performed in children with Dermatophagoides pteronyssinus (Der p) asthma and/or allergic rhinitis (AR). [...] Read more.
At present, there are no effective, non-invasive, and objective indicators to evaluate the efficacy of pediatric house dust mite (HDM)-specific allergen immunotherapy (AIT). A prospective, observational study was performed in children with Dermatophagoides pteronyssinus (Der p) asthma and/or allergic rhinitis (AR). Forty-four patients received subcutaneous Der p-AIT for 2 years, and eleven patients received only symptomatic treatment. The patients needed to finish their questionnaires at each visit. Serum and salivary Der p-specific IgE, IgG4, and IgE-blocking factors (IgE-BFs) were measured at 0, 4, 12, and 24 months during AIT. A correlation between them was also evaluated. Subcutaneous Der p-specific AIT improved the clinical symptoms of children with asthma and/or AR. The Der p-specific IgE-BF significantly increased at 4, 12, and 24 months after AIT treatment. Serum and salivary Der p-specific IgG4 significantly increased with the time of the AIT treatment, and significant correlations between them at different time points were observed (p < 0.05). Furthermore, there were significant correlations (R = 0.31–0.62) between the serum Der p-specific IgE-BF and Der p-specific IgG4 at the baseline, 4, 12, and 24 months after the AIT (p < 0.01). The salivary Der p-specific IgG4 levels also demonstrated a certain correlation with the Der p-specific IgE-BF. Der p-specific AIT is an effective treatment for children with asthma and/or AR. Its effect was associated with increased serum and salivary-specific IgG4 levels, as well as an increased IgE-BF. Non-invasive salivary-specific IgG4 may be useful for monitoring the efficacy of AIT in children. Full article
(This article belongs to the Special Issue Allergen Immunotherapy in Allergic Diseases)
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13 pages, 1318 KiB  
Article
Real-Life Effectiveness of Subcutaneous Immune Therapy with Carbamylated Monomeric Allergoids on Mite, Grass, and Pellitory Respiratory Allergy: A Retrospective Study
by Mario Di Gioacchino, Loredana Della Valle, Rocco Mangifesta, Arianna Lumaca, Francesco Cipollone, Franco Frati, Enrico Compalati, Eralda Lekli, Etleva Qirco Loloci and Francesca Santilli
J. Clin. Med. 2022, 11(24), 7384; https://doi.org/10.3390/jcm11247384 - 12 Dec 2022
Viewed by 1335
Abstract
Background: real-life studies are encouraged to evaluate the effectiveness and safety of allergen immunotherapy (AIT). In this context, a retrospective cohort study was conducted to assess the effectiveness and safety of carbamylated monomeric allergoid subcutaneous immunotherapy (MA-SCIT), along with patient satisfaction. Methods: a [...] Read more.
Background: real-life studies are encouraged to evaluate the effectiveness and safety of allergen immunotherapy (AIT). In this context, a retrospective cohort study was conducted to assess the effectiveness and safety of carbamylated monomeric allergoid subcutaneous immunotherapy (MA-SCIT), along with patient satisfaction. Methods: a total of 291 patients with rhinoconjunctivitis with or without asthma with inhalant (house dust mite, grass, and pellitory) allergies were enrolled in this study. Perceived efficacy and perceived satisfaction with MA-SCIT, symptom score by VAS, ARIA classification of rhinitis, drug consumption, number of asthma worsening episodes, and asthma symptom control were evaluated by questionnaires before, after one year, at the end of treatment, and after one or two years of MA-SCIT. Results: the overall symptom score significantly decreased over the years of MA-SCIT, irrespective of specific sensitization (p < 0.01). There was a substantial amelioration of rhinitis severity, with a significant reduction (p < 0.01) in drug use. A significant reduction was observed in the asthma symptom VAS score and asthma-worsening episodes requiring systemic steroids. None of the patients reported any severe adverse reactions. Finally, 90% of the patients reported full satisfaction with the treatment. Conclusions: the study showed that AIT with carbamylated monomeric allergoids of grass, pellitory, and mites was effective and well tolerated by patients. Full article
(This article belongs to the Special Issue Allergen Immunotherapy in Allergic Diseases)
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Review

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9 pages, 744 KiB  
Review
Potential Effects of AIT on Nonspecific Allergic Immune Responses or Symptoms
by Kazuyuki Nakagome, Keishi Fujio and Makoto Nagata
J. Clin. Med. 2023, 12(11), 3776; https://doi.org/10.3390/jcm12113776 - 31 May 2023
Cited by 1 | Viewed by 1503
Abstract
Allergen immunotherapy (AIT) is a treatment in which clinically corresponding allergens are administered to patients with allergic diseases, either by subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT), or by oral immunotherapy (OIT) in the case of food allergy. Since etiological allergens are administered [...] Read more.
Allergen immunotherapy (AIT) is a treatment in which clinically corresponding allergens are administered to patients with allergic diseases, either by subcutaneous immunotherapy (SCIT) or sublingual immunotherapy (SLIT), or by oral immunotherapy (OIT) in the case of food allergy. Since etiological allergens are administered to patients, AIT is presumed to modify mainly allergen-specific immune responses. In bronchial asthma, AIT with house dust mites (HDM) alleviates clinical symptoms, suppresses airway hyperresponsiveness, and reduces medication doses of HDM-sensitive asthmatics. Moreover, AIT can suppress the symptoms of other allergic diseases associated with asthma including allergic rhinitis. However, AIT sometimes reduces allergic symptoms not induced by the responsible allergens, such as non-targeted allergens, in clinical settings. Furthermore, AIT can suppress the spread of sensitization to new allergens that are not targeted allergens by AIT, suggesting the suppression of allergic immune responses in an allergen-nonspecific manner. In this review, the nonspecific suppression of allergic immune responses by AIT is discussed. AIT has been reported to increase regulatory T cells that produce IL-10, transforming growth factor-β, and IL-35, IL-10-producing regulatory B cells, and IL-10-producing innate lymphoid cells. These cells can suppress type-2 mediated immune responses mainly through the production of anti-inflammatory cytokines or a cell–cell contact mechanism, which may be involved in the nonspecific suppression of allergic immune responses by AIT. Full article
(This article belongs to the Special Issue Allergen Immunotherapy in Allergic Diseases)
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12 pages, 541 KiB  
Review
Malaysian Society of Allergy and Immunology Consensus Statement on Sublingual Immunotherapy in Allergic Rhinitis
by Baharudin Abdullah, Ruby Pawankar, Amir Hamzah Abdul Latiff, Kent Chee Keen Woo, Eike Wüstenberg, Mohamad Azizul Fitri Khalid, Yeoh Zhi Xiang, Salina Husain, Nurashikin Mohammad and Norasnieda Md Shukri
J. Clin. Med. 2023, 12(3), 1151; https://doi.org/10.3390/jcm12031151 - 01 Feb 2023
Cited by 3 | Viewed by 2471
Abstract
Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the upper airway. AR affects the patients’ quality of life, is a known risk factor for asthma and a socio-economic burden. Allergen-specific immunotherapy (AIT), comprising sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT), involves administering [...] Read more.
Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the upper airway. AR affects the patients’ quality of life, is a known risk factor for asthma and a socio-economic burden. Allergen-specific immunotherapy (AIT), comprising sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT), involves administering increasing doses of the causative allergen to induce clinical and immunologic tolerance to the allergens. It is the only currently available treatment for AR that has been proven to induce disease-modifying effects (i.e., long-term remission of allergic symptoms or potential prevention of asthma and new sensitizations). Although AIT is conventionally recommended for patients who are non-responsive to symptom-relieving pharmacotherapy, it is presently recommended as a first-line treatment for patients with moderate to severe AR who prefer a treatment with the potential for long-term remission. In light of the relatively recent implementation of AIT in Malaysia, guidelines on its appropriate indication and application are important to attain optimal outcomes. This consensus statement was developed by an expert group formed by the Malaysian Society of Allergy and Immunology to provide evidence-based recommendations for the practice of AIT in Malaysia. Patient and product selection, choice of AIT, and strategy towards an effective treatment outcome in AIT are presented. Full article
(This article belongs to the Special Issue Allergen Immunotherapy in Allergic Diseases)
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