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Background: Adenoid hypertrophy (AH) and allergic rhinitis (AR) are common pediatric diseases, seriously affecting the quality of life and growth of children. The recurrence rate of AH is higher for patients with than for those without concurrent AR. Allergen specific immunotherapy (AIT) is the only effective therapy for modifying the course of allergic diseases. This study sought to investigate the efficacy of AIT in preventing AH recurrence in patients with AR who underwent adenoidectomy. Methods: This study included 134 children aged 5– 12 years with concurrent AH and AR. They were separated into the subcutaneous immunotherapy (SCIT) group treated with a double-mite allergen preparation or the non-AIT group treated symptomatically with only medications. The adenoid/nasopharyngeal ratio at one year after adenoidectomy was used to assess AH recurrence. The Obstructive Sleep Apnoea Questionnaire (OSA-18), Paediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), and Visual Analogue Scale (VAS) were used to assess the severity of the sleep disorders and AR. Results: This study included 62 and 72 children with concurrent AH and AR in the SCIT and non-AIT groups, respectively. The rate of recurrence in the SCIT group was significantly lower than that in the non-AIT group (4.84% vs.16.67%; P=0.030). The OSA-18, PRQLQ, and VAS scores were significantly lower for the SCIT than (P< 0.001) for the non-AIT group after one year of treatment. Conclusion: The findings suggest that AIT should be considered the preferred therapy for reducing postoperative recurrence of AH in children with concurrent AR following adenoidectomy, but further research is needed to confirm these findings in a larger population. [ABSTRACT FROM AUTHOR]

Allergen-specific immunotherapy is based on the development of induced tolerance in patients. Natural extracts are most often used as therapeutic allergens worldwide.The article presents new approaches to biological standardization of subcutaneous administered allergens. It is established that own standard allergens have specific allergenic activity, which was determined on sensitized patients-volunteers. The Russian Federation uses its own units — EAA (Units of Allergenic Activity). 100 000 EAA/mL corresponds to the size of wheal in prick test equal to 8 mm. The internal reference material (RM) of allergenic activity of pollen allergens ”Microgen“ have different specific activity depending on the type of allergen. The most common series have allergenic (specific) activity in the range of 150,000 — 200,000 EAA/mL.The control of the specific activity of allergen drugs is carried out in accordance with the current certified standard samples of the company’s standards. A method of competitive enzyme-linked immunosorbent assay using specific sera containing specific IgE antibodies is used for this purpose.In addition, the specific activity of allergen preparations is certified through three additional characteristics: total protein content (using the Bradford method), protein profile (through electrophoresis in a polyacrylamide gel with sodium dodecyl sulfate under reducing conditions), and authenticity through the presence of major specific components, which is determined by the Western blot method using sera containing IgE antibodies specific for the corresponding allergen.Currently, in the Russian Federation, the standardization of therapeutic and diagnostic allergens is conducted simultaneously according to two indicators: protein nitrogen content, expressed in Protein Nitrogen Units (PNU), and allergenic (specific) activity expressed in units of allergenic activity per milliliter (EAA/ml). While the PNU indicator partially reflects the allergenic properties of the drug, it does not fully capture these properties, making it necessary to remove PNU from the list of quality indicators for allergen medicines. This would require changes to regulatory documentation and instructions for allergens.When evaluating the allergenic activity of allergens, it is now recommended to focus on units of EAA. The consistency of the protein composition and presentation in the drug ensures increased safety and efficacy of therapy, as well as allows for comparison between drugs.

Purpose: Symptom control in the long-term with less side effects is important in perennial allergic conjunctivitis, since would improve quality of life. This study aimed to assess the clinical efficacies of topical cyclosporin A and subcutaneous allergen immunotherapy (SCIT) in terms of sign control in perennial allergic conjunctivitis. Methods: This retrospective study included 20 adult patients with perennial allergic conjunctivitis and confirmed sensitization to house dust mites with skin prick test. Patients were assigned to either topical cyclosporine A treatment or SCIT. The participants were followed for 6 months, and signs scores were recorded at 1, 3 and 6 months. Results: Overall, both cyclosporine and immunotherapy groups showed significant improvements in papillary reaction (p = 0.011 and 0.003, respectively), limbal involvement (p = 0.031 and 0.001), and conjunctival hyperemia (p = 0.001 and p < 0.001) scores during the 6-month follow-up. However, only cyclosporine group showed a significant improvement in corneal involvement scores (p = 0.015) during the study period. When scores at different time points were compared, significant improvement in conjunctival hyperemia was evident at 6 months in both groups when compared to baseline (cyclosporine group, 0.7 ± 0.68 vs. 2.4 ± 0.84, 70.8% decrease, p = 0.01; immunotherapy group, 0.3 ± 0.48 vs. 2.3 ± 0.95, 87.0% decrease, p = 0.004), whereas for limbal involvement such an improvement was only evident in the immunotherapy group (0.1 ± 0.32 vs. 1.3 ± 0.95, 92.3% decrease, p = 0.01). Conclusions: Allergen immunotherapy and cyclosporin A treatment may provide effective sign relief in perennial allergic conjunctivitis. It may represent an encouraging treatment option particularly for cases with perennial allergic conjunctivitis refractive to other treatments and positive skin prick test to a specific allergen (house dust in the present study). Long-term relief by SCIT would reduce the side effects of polypharmacotherapy. Larger studies with longer follow-up are warranted to confirm our findings. [ABSTRACT FROM AUTHOR]

Allergic respiratory diseases (ARDs) have been one of the major global health problems of the 21st century with an increasing prevalence. A significant proportion of aerobiological particles in the environment is constituted by fungal structures, including those from Alternaria, Cladosporium, Penicillium , and Aspergillus species which are regarded as the four most common fungal genera associated with allergic fungal airway diseases (AFADs). Allergen specific immunotherapy (AIT) has capacity to promote protection as well as long-term tolerance to the allergen, however there have not been adequate number of studies evaluating the efficacy of against AFADs, up till today. Our review would like to draw more attention to the field by summarizing the current literature regarding the clinical use of the immunotherapy, with special focus on Alternaria , and Cladosporium AITs. The area is considered to be vital to public health due to the potential increase in global AFAD cases because of ongoing air pollution and climate impacts. The review also aims to sum up immunological findings associated with mould-AIT which would help further studies to be performed in order to develop an objective method to identify non-responders early in the course of therapy. [ABSTRACT FROM AUTHOR]

Allergic respiratory diseases (ARDs) have been one of the major global health problems of the 21st century with an increasing prevalence. A significant proportion of aerobiological particles in the environment is constituted by fungal structures, including those from Alternaria, Cladosporium, Penicillium, and Aspergillus species which are regarded as the four most common fungal genera associated with allergic fungal airway diseases (AFADs). Allergen specific immunotherapy (AIT) has capacity to promote protection as well as long-term tolerance to the allergen, however there have not been adequate number of studies evaluating the efficacy of against AFADs, up till today. Our review would like to draw more attention to the field by summarizing the current literature regarding the clinical use of the immunotherapy, with special focus on Alternaria, and Cladosporium AITs. The area is considered to be vital to public health due to the potential increase in global AFAD cases because of ongoing air pollution and climate impacts. The review also aims to sum up immunological findings associated with mould-AIT which would help further studies to be performed in order to develop an objective method to identify non-responders early in the course of therapy., Competing Interests: Declaration of competing interest Authors have no conflicts of interest to declare., (Copyright © 2024 SFMM. Published by Elsevier Masson SAS. All rights reserved.)

Background: The modulations of lymphocyte subsets and cytokine production due to subcutaneous allergen immunotherapy (SCIT) are not fully clarified. Objective: We investigated the changes in T-lymphocyte subsets and serum Dermatophagoides pteronyssinus-specific immunoglobulin G4 (Der-p sIgG4), as well as cytokine production during Der-p SCIT, in patients with allergic asthma. Methods: This study involved 20 patients with allergic asthma who were receiving 156-week Der-p SCIT and 20 patients without SCIT (non-SCIT). We measured symptom and medication scores (SMS), serum Der-p sIgG4 levels, CD4+CD25+Foxp3+ T regulatory (Treg), CD4+IL-4−IFN-γ+ T-helper (Th) 1, and CD4+IL-4+IFN-γ− Th2 lymphocyte percentages in peripheral blood mononuclear cells (PBMCs) with/without Der-p extract stimulation at weeks 0, 4, 12, 16, 52, 104, and 156. Cytokine release inhibition assays were performed by incubation with serum from SCIT and non-SCIT patients, Der-p allergen, and PBMCs. Levels of interleukin (IL)-4, IL-5, IL-10, IL-13, IL-17, interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β1 were evaluated in supernatant. Results: We found that SCIT patients had significantly lower SMS after week 52. Der-p sIgG4 levels in SCIT patients significantly increased at week 16 compared with non-SCIT subjects. CD4+IL-4+IFN-γ− Th2% in SCIT patients showed a significant decrease from weeks 104–156 compared with week 0, while no change was observed in CD4+CD25+Foxp3+ Treg and CD4+IL-4−IFN-γ+ Th1 percentages. IL-5, IL-13, IL-4, IL-17, and TNF-α levels in supernatant of PBMCs cultured with serum of SCIT patients after 16 weeks showed significant lower levels compared with non-SCIT patients, and showed significant reverse associations with Der-p sIgG4 levels. Conclusion: SCIT induced Dep-p sIgG4 may be involved in downregulating Th2 cytokine production in Der-p allergic asthma patients.

IgG4 is a subclass of IgG antibody with a unique molecular feature of (Fragment antigen- binding) Fab-arm exchange, allowing bispecific antigen binding in a mono-valent manner. With low binding affinity to C1q and Fcγreceptors, IgG4 is incapable of forming immune complexes and activating the complement pathway, exhibiting a non-inflammatory feature. IgG4 is produced similarly to IgE and is considered a modified reaction to IgE class-switching response under certain conditions. It could also counteract IgE-activated inflammation. However, the clinical significance of IgG4 in allergic diseases is complex and controversial. Three viewpoints have been suggested to describe the role of IgG4. IgG4 can act as a tolerance–inducer to play a protective role under repeated and rapid incremental dosing of allergen exposure in allergen immunotherapy (AIT), supported by allergies in cat raisers and venom desensitization in beekeepers. Another viewpoint accepted by mainstream specialists and guidelines of Food Allergy and Management in different countries points out that food-specific IgG4 is a bystander in food allergy and should not be used as a diagnostic tool in clinical work. However, eosinophilic esophagitis (EoE) investigation revealed a direct clinical relevance between physiopathology and serum IgG4 in cow milk and wheat. These factors indicate that allergen-specific IgG4 plays a multifaceted role in allergic diseases that is protective or pathogenic depending on different allergens or exposure conditions.

Background: Recently, bacterial components were shown to enhance immune responses by shifting immune cell metabolism towards glycolysis and lactic acid production, also known as the Warburg Effect. Currently, the effect of allergen products for immunotherapy (AIT) and commercial vaccines on immune cell metabolism is mostly unknown. Objective: To investigate the effect of AIT products (adjuvanted with either MPLA or Alum) on myeloid dendritic cell (mDC) metabolism and activation. Methods: Bone marrow-derived mDCs were stimulated with five allergoidbased AIT products (one adjuvanted with MPLA, four adjuvanted with Alum) and two MPLA-adjuvanted vaccines and analyzed for their metabolic activation, expression of cell surface markers, and cytokine secretion by ELISA. mDCs were pre-incubated with either immunological or metabolic inhibitors or cultured in glucose- or glutamine-free culture media and subsequently stimulated with the MPLA-containing AIT product (AIT product 1). mDCs were co-cultured with allergen-specific CD4+ T cells to investigate the contribution of metabolic pathways to the T cell priming capacity of mDCs stimulated with AIT product 1. Results: Both the MPLA-containing AIT product 1 and commercial vaccines, but not the Alum-adjuvanted AIT products, activated Warburg metabolism and TNF-α secretion in mDCs. Further experiments focused on AIT product 1. Metabolic analysis showed that AIT product 1 increased glycolytic activity while also inducing the secretion of IL-1b, IL-10, IL-12, and TNF-a. Both rapamycin (mTOR-inhibitor) and SP600125 (SAP/JNK MAPK-inhibitor) dose-dependently suppressed the AIT product 1-induced Warburg Effect, glucose consumption, IL-10-, and TNF-α secretion. Moreover, both glucose- and glutamine deficiency suppressed secretion of all investigated cytokines (IL-1b, IL-10, and TNF-a). Glucose metabolism in mDCs was also critical for the (Th1- biased) T cell priming capacity of AIT product 1-stimulated mDCs, as inhibition of mTOR signaling abrogated their ability to induce Th1-responses. Conclusion: The AIT product and commercial vaccines containing the adjuvant MPLA were shown to modulate the induction of immune responses by changing the metabolic state of mDCs. Better understanding the mechanisms underlying the interactions between cell metabolism and immune responses will allow us to further improve vaccine development and AIT. [ABSTRACT FROM AUTHOR]

BackgroundRecently, bacterial components were shown to enhance immune responses by shifting immune cell metabolism towards glycolysis and lactic acid production, also known as the Warburg Effect. Currently, the effect of allergen products for immunotherapy (AIT) and commercial vaccines on immune cell metabolism is mostly unknown.ObjectiveTo investigate the effect of AIT products (adjuvanted with either MPLA or Alum) on myeloid dendritic cell (mDC) metabolism and activation.MethodsBone marrow-derived mDCs were stimulated with five allergoid-based AIT products (one adjuvanted with MPLA, four adjuvanted with Alum) and two MPLA-adjuvanted vaccines and analyzed for their metabolic activation, expression of cell surface markers, and cytokine secretion by ELISA. mDCs were pre-incubated with either immunological or metabolic inhibitors or cultured in glucose- or glutamine-free culture media and subsequently stimulated with the MPLA-containing AIT product (AIT product 1). mDCs were co-cultured with allergen-specific CD4+ T cells to investigate the contribution of metabolic pathways to the T cell priming capacity of mDCs stimulated with AIT product 1.ResultsBoth the MPLA-containing AIT product 1 and commercial vaccines, but not the Alum-adjuvanted AIT products, activated Warburg metabolism and TNF-α secretion in mDCs. Further experiments focused on AIT product 1. Metabolic analysis showed that AIT product 1 increased glycolytic activity while also inducing the secretion of IL-1β, IL-10, IL-12, and TNF-α. Both rapamycin (mTOR-inhibitor) and SP600125 (SAP/JNK MAPK-inhibitor) dose-dependently suppressed the AIT product 1-induced Warburg Effect, glucose consumption, IL-10-, and TNF-α secretion. Moreover, both glucose- and glutamine deficiency suppressed secretion of all investigated cytokines (IL-1β, IL-10, and TNF-α). Glucose metabolism in mDCs was also critical for the (Th1-biased) T cell priming capacity of AIT product 1-stimulated mDCs, as inhibition of mTOR signaling abrogated their ability to induce Th1-responses.ConclusionThe AIT product and commercial vaccines containing the adjuvant MPLA were shown to modulate the induction of immune responses by changing the metabolic state of mDCs. Better understanding the mechanisms underlying the interactions between cell metabolism and immune responses will allow us to further improve vaccine development and AIT.

BackgroundAllergen immunotherapy (AIT) can induce immune tolerance to allergens by activating multiple mechanisms, including promoting IgG4 synthesis and blunting IgE production. However, the longitudinal data of sIgE and sIgG4 to allergen components during AIT are limited.ObjectiveWe sought to investigate the persistence and evolution of sIgE and sIgG4 against house dust mite (HDM) components during AIT and explore their correlation with clinical responses.MethodsSixty allergic rhinitis (AR) with/without asthma patients receiving AIT for HDM were enrolled in AIT group. Thirty AR patients without receiving AIT served as control group. Blood samples were collected for sIgE, sIgG4 to HDM components (Derp 1, Derf 1, Derp 2, Derf 2, Derp 7, Derp 10, Derp 21 and Derp 23) assay at baseline, Month 6 and Month 18 of AIT. Combined symptom and medication scores (CSMS) were obtained accordingly.ResultsIn the AIT group, sIgG4 to the HDM components of Derp 1, Derf 1, Derp 2 and Derf 2, Derp 21 significantly increased at Month 18 compared to the baseline (36.2 UA/mL vs 158.8 UA/mL, 46.4 UA/mL vs 94.6 UA/mL, 80.5 UA/mL vs 152.3 UA/mL, 78.3 UA/mL vs 205.1 UA/mL, 42.3 UA/mL vs 59.3 UA/mL, all p0.05).The numbers of positive HDM component sIgE and sIgG4 increased from 4.5 to 5 and 0 to 1.5 respectively (both p0.05).ConclusionAIT can induce the production of sIgG4 to HDM components. However, the increased sIgG4 levels of HDM component do not correlate with the corresponding sIgE levels at baseline or with AIT response. sIgG4 to HDM components do not qualify as a biomarker to evaluate the efficacy of AIT.

Background: Allergen immunotherapy (AIT) can induce immune tolerance to allergens by activating multiple mechanisms, including promoting IgG4 synthesis and blunting IgE production. However, the longitudinal data of sIgE and sIgG4 to allergen components during AIT are limited. Objective: We sought to investigate the persistence and evolution of sIgE and sIgG4 against house dust mite (HDM) components during AIT and explore their correlation with clinical responses. Methods: Sixty allergic rhinitis (AR) with/without asthma patients receiving AIT for HDM were enrolled in AIT group. Thirty AR patients without receiving AIT served as control group. Blood samples were collected for sIgE, sIgG4 to HDM components (Derp 1, Derf 1, Derp 2, Derf 2, Derp 7, Derp 10, Derp 21 and Derp 23) assay at baseline, Month 6 and Month 18 of AIT. Combined symptom and medication scores (CSMS) were obtained accordingly. Results: In the AIT group, sIgG4 to the HDM components of Derp 1, Derf 1, Derp 2 and Derf 2, Derp 21 significantly increased at Month 18 compared to the baseline (36.2 UA/mL vs 158.8 UA/mL, 46.4 UA/mL vs 94.6 UA/mL, 80.5 UA/mL vs 152.3 UA/mL, 78.3 UA/mL vs 205.1 UA/mL, 42.3 UA/mL vs 59.3 UA/mL, all p <0.05), sIgE to HDM components didn't see differences at baseline and at Month 18 (all p >0.05).The numbers of positive HDM component sIgE and sIgG4 increased from 4.5 to 5 and 0 to 1.5 respectively (both p <0.05). However, the changes of sIgE, sIgG4, sIgE/sIgG4 ratio and the numbers of positive HDM components had no correlations with the improvement of CSMS after AIT (all ρ<0.3). For the control group, the sIgE and sIgG4 did not change significantly during the observational period (all p >0.05). Conclusion: AIT can induce the production of sIgG4 to HDM components. However, the increased sIgG4 levels of HDM component do not correlate with the corresponding sIgE levels at baseline or with AIT response. sIgG4 to HDM components do not qualify as a biomarker to evaluate the efficacy of AIT. [ABSTRACT FROM AUTHOR]

Objectives: Allergen-specific immunotherapy (AIT) has been considered the most effective treatment for IgE mediated allergies, especially respiratory allergies. Several biomarkers have been developed to evaluate the clinical efficacy of AIT, yet none of them have been thoroughly validated. So our objective here is to investigate the usefulness of periostin as a biomaker for monitoring the efficacy of allergen immunotherapy. Materials and methods: This study included 46 healthy non-atopic volunteers and 46 patients with allergic rhinitis (AR). They were sensitized only to date palm pollen. The participants were tested by skin prick test and total serum IgE levels were measured. Serum samples were collected from healthy subjects and allergic patients before and after the one-year AIT. Serum levels of periostin, eotaxin, and sIL-2R were estimated by ELISA. Symptom scores in the allergic patients were also evaluated before and after completing one year AIT. Results: There is a significant increase in serum levels of IgE, periostin, sIL-2R, and eotaxin in allergic patients as compared to healthy controls. Symptom scores, sIL-2R and serum periostin levels were significantly decreased after one-year AIT in AR patients. Conclusion: Periostin can be used as a biomarker to evaluate AIT efficacy in AR patients. [ABSTRACT FROM AUTHOR]

Background: The use of ovalbumin as a model allergen in murine models of allergic asthma is controversially discussed since it is not an aeroallergen and sensitization can only be achieved by using strong Th2-inducing adjuvants. Therefore, in this study, a murine model of asthma has been established in which sensitization against the major grass pollen allergen Phl p5b was performed without using aluminum hydroxide (alum). We used this model for specific immunotherapy.Methods: Female, 5–6-week-old mice were sensitized by six subcutaneous (s.c.) injections of 20 μg Phl p5b followed by four provocations to induce allergic airway inflammation. For desensitization, 1 mg of Phl p5b was injected subcutaneously during allergen challenge for one to a maximum of four times. Three days after the last challenge, the allergic immune response was analyzed.Results: Sensitized and challenged animals showed a significant infiltration of eosinophils into the airways, and the production of interleukin-5 (IL-5) by in vitro re-stimulated splenocytes could be detected. Furthermore, hyper-responsiveness of the airways was verified by invasive measurement of airway resistance in methacholine-challenged animals. Desensitized animals showed a significant reduction of all parameters.Conclusion: In this study, a murine model of asthma has successfully been established by sensitization against the clinically relevant allergen Phl p5b without using alum. S.c. injection of allergen dose dependently led to desensitization of sensitized mice. We suggest that this model is useful to study adjuvant effects of immune modulatory substances on immunotherapy without the interference of alum.

Background: Real-world studies on the allergen specific immunotherapy (AIT), omalizumab, and dupilumab associated anaphylactic events are limited. We aimed to analyze the characteristics of drug associated anaphylaxis, and to compare the differences among different drugs.Methods: A disproportionality analysis and Bayesian analysis were used in data mining to identify suspected anaphylaxis associated with AIT, omalizumab, and dupilumab based on the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) from January 2004 to March 2021. Demographic information, time interval to onset, and death rates of AIT, omalizumab, and dupilumab associated anaphylaxis were also analyzed.Results: Totally 9,969 anaphylactic events were identified. Reports of AIT, omalizumab, and dupilumab associated anaphylactic events were 64, 7,784, and 2,121, respectively. AIT had a high reporting odds ratio (ROR) of 5.03 [95%confidental interval (CI) 3.69–6.85], followed by omalizumab (ROR 2.24, 95% CI 2.18–2.29), and dupilumab had a negative signal for anaphylaxis. In children, most anaphylactic reactions (68%) were reported in the 12–17-year-old group. More reports of anaphylaxis related to AIT were in boys (73%), while more reports of anaphylaxis related to omalizumab (63%) and dupilumab (58%) were in girls. Most symptoms occurred on the day of drug initiation. The death rate of AIT related anaphylaxis was the lowest (0%), the death rate of omalizumab was 0.87%, while the death rate of dupilumab was 4.76%. No significant differences were observed among these drugs.Conclusion: AIT and omalizumab had a positive signal for anaphylaxis, while dupilumab had a negative signal for anaphylaxis. Patients should be strictly monitored after administration of AIT and also biologics. It also gives us a suggestion for choosing a combined biologics with AIT when the risk of anaphylaxis was considered.

Background: Real-world studies on the allergen specific immunotherapy (AIT), omalizumab, and dupilumab associated anaphylactic events are limited. We aimed to analyze the characteristics of drug associated anaphylaxis, and to compare the differences among different drugs. Methods: A disproportionality analysis and Bayesian analysis were used in data mining to identify suspected anaphylaxis associated with AIT, omalizumab, and dupilumab based on the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) from January 2004 to March 2021. Demographic information, time interval to onset, and death rates of AIT, omalizumab, and dupilumab associated anaphylaxis were also analyzed. Results: Totally 9,969 anaphylactic events were identified. Reports of AIT, omalizumab, and dupilumab associated anaphylactic events were 64, 7,784, and 2,121, respectively. AIT had a high reporting odds ratio (ROR) of 5.03 [95%confidental interval (CI) 3.69–6.85], followed by omalizumab (ROR 2.24, 95% CI 2.18–2.29), and dupilumab had a negative signal for anaphylaxis. In children, most anaphylactic reactions (68%) were reported in the 12–17-year-old group. More reports of anaphylaxis related to AIT were in boys (73%), while more reports of anaphylaxis related to omalizumab (63%) and dupilumab (58%) were in girls. Most symptoms occurred on the day of drug initiation. The death rate of AIT related anaphylaxis was the lowest (0%), the death rate of omalizumab was 0.87%, while the death rate of dupilumab was 4.76%. No significant differences were observed among these drugs. Conclusion: AIT and omalizumab had a positive signal for anaphylaxis, while dupilumab had a negative signal for anaphylaxis. Patients should be strictly monitored after administration of AIT and also biologics. It also gives us a suggestion for choosing a combined biologics with AIT when the risk of anaphylaxis was considered. [ABSTRACT FROM AUTHOR]

Allergic rhinitis in childhood has been often missed, mistreated and misunderstood. It has significant comorbidities, adverse effects upon quality of life and educational performance and can progress to asthma or worsen control of existing asthma. Accurate diagnosis and effective treatment are important. The new EUFOREA algorithm provides a succinct but wide- ranging guide to management at all levels, based on previous guidelines with updated evidence and has been adjusted and approved by experts worldwide.

Objective: Neosensitizations may be occur during the allergen specific immunotherapy（AIT） due to the differences between allergen vaccine's content and a patient's molecular sensitization profile. This study investigates whether AIT with HDM extract changes the sensitization profile, whether de novo sensitization occurs, and the clinical importance of the neosensitization. Methods: Fifty-three patients with HDM allergic rhinitis ,with/without asthma, patients were received one year HDM subcutaneous AIT . Fourteen patients were recruited as control group and received only necessary medications. Serum samples were collected at baseline, 6thmoths and 12thof AIT, respectively. Serum samples were tested specific IgE against Der p, Der p 1/2/3 and Der f, Der f 1/2/3, as well as IgG4 against Der p, Der p 1/2 and Der f, Der f 1/2. VAS were collected at the time-points as well. Results: In AIT group, Der p, Der p 1/3, and Der f 1/3 specific IgE levels were significantly higher after one-year treatment, especially for Der p 3. There were 69.2%（18/26） patients whose Der p 3 specific IgE below 0.35 kU/L at baseline but became positive（>0.35 kU/L） after treatment, that is, neosensitization occurred. All tested allergen specific IgG4 level significantly increased after one year AIT treatment and the VAS declined dramatically. However, for patients with neosensitization and without neosensitization, there were no significantly changes concerning to IgG4 level and VAS. Conclusion: Patients undergoing AIT might have a risk of neosensitization to the allergen components in the vaccines. However, the clinical importance of the neosensitization remains unclear and warrants further studies., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Background. In the structure of dermatological morbidity, the specific weight of atopic dermatitis (AD) is up to 20.0 %. The severity of AD correlates with the lesion of the gastrointestinal tract. In the opinion of almost all immunology and allergology specialists, allergen specific immunotherapy (ASIT) is the only method that is able to influence all links of the pathological process. The purpose was to determine the effectiveness of the ASIT in children with atopic dermatitis combined with the pathology of the upper gastrointestinal tract. Materials and methods. The paper presents data of clinical observation, clinical laboratory and instrumental examination of 168 children aged 7 to 18 years with AD combined with chronic gastroduodenitis (CGD). A comparative evaluation of the different treatment options was carried out in 50 children: the main group of 25 children with AD and CGD who, along with the traditional therapy as a part of outpatient treatment, underwent ASIT according to the standard schedule during the year, the comparison group consisted of 25 children with combined pathology who received standard therapy. Results. Clinical symptoms in children with CGD combined with AD were characterized by the presence of leading syndromes: pain (98.8 ± 8.9 % of patients), dyspepsia (91.6 ± 11.2 % of persons), intoxication (79.1 ± 7.2 % of patients) and cutaneous (100 %). In the group of children receiving ASIT, the mean levels of the Scoring Atopic Dermatitis index decreased by 61.8 % three months after treatment, and one year after the treatment — by 42.6 %. The corresponding indices in the comparison group decreased by 41.3 and 24.9 %, respectively (р < 0.05). The use of comprehensive treatment in children with AD and CGD reduced by 27.8 % the period of pain relief, by 14.0 % — of dyspepsia and by 25.0 % — of asthenovegetative syndromes. It was found that the relative risk of disease recurrence will decrease by 0.48 times (c2 = 3.96, p < 0.05) when this therapy is included in the treatment regimen. Conclusions. The clinical study demonstrated the positive effect of comprehensive treatment with the inclusion of ASIT on the clinical course of AD combined with CGD. The proposed comprehensive therapy was more effective than traditional treatment even in long-term follow-up.

• Sub lingual Allergen Specific Immunotherapy is a important intervention in the treatment of Mild Allergic Asthmatics. • Long term AIT brings change in the Pulmonary function variable Pre FEV1% and FEV1/FVC ratio. • AIT leads to Inhaled corticosteroid Discontuation (ICS) and hence reduces Systemic side effects of ICS. Allergen immunotherapy (AIT) is a promising treatment for allergic disease that induces immunological tolerance through the administration of specific allergens. The study of AIT is in its early stage and its clinical effects are not well elucidated. The present study was aimed at determining the effect of AIT on pulmonary function and serum variables of mild allergic asthma patients. A total of 80 patients with mild allergic asthma were recruited for the study. Allergen Specific Immunotherapy was administered in the form of Sublingual Immunotherapy and consisted of a build up phase followed by a maintenance phase (six months each respectively). Total serum IgE and vitamin D levels were quantified by ELISA. The percent eosinophill count was determined by cell analyzers. Pulmonary function test was performed at the baseline and after the end of study period. Subjective symptom score was recorded in the form of asthma control questionnaire score. There was a significant increase in the pre FEV1% and pre FEV1/FVC post AIT administration. A significant decrease in the total serum IgE was found post AIT. A decrease in Asthma control Questionnaire (ACQ) scores indicated an improvement in clinical symptoms. Besides there was a significant effect on ICS discontinuation after AIT. The study supports SLIT as an effective treatment for Immunomodulation in mild allergic asthmatics besides it gives us significant information regarding the safety and efficacy of SLIT in such patients. [ABSTRACT FROM AUTHOR]

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Purpose of Review: This paper explores how the Environmental Exposure Unit (EEU) experimental model can be used to further our understanding of pharmacotherapies and immunotherapies for the treatment of allergic rhinitis (AR). Recent Findings: EEUs are used increasingly for the study of combination therapies, immunotherapies, and novel AR treatments. A combined antihistamine/corticosteroid nasal spray formulation was seen to have a faster onset of action relative to the therapies individually in the Environmental Exposure Chamber. House dust mite sublingual immunotherapy tablets are both safe and efficacious as evaluated by the Vienna Challenge Chamber. The Kingston EEU found that a novel peptide-based immunotherapy approach to be effective in reducing grass pollen-induced AR. Lastly, nasal filters were determined to reduce seasonal AR symptoms, given out-of-season in the Denmark Environmental Exposure Unit. Summary: EEUs are controlled, replicable models that provide valuable insight into the efficacy, onset and duration of action, and dose-related impacts of AR therapeutics, with direct clinical relevance. [ABSTRACT FROM AUTHOR]

Determination of protein concentration in Hymenoptera venoms requires an accurate and reproducible assay as the results will be used to support subsequent proteomic techniques employed in their analyses. However, all protein assay techniques have inherent strengths and weaknesses, demanding their assessment before selecting the most suitable platform for sample analysis. In this study, protein profiles of ant, honeybee, and wasp venoms, and bovine serum albumin (BSA) and hyaluronidase standards were qualitatively assessed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Their amino acid and protein concentration were quantitatively determined via Amino Acid Analysis (AAA). Amino acid concentration was determined via hydrolysis, derivatization, and chromatographic quantification. Protein concentration was estimated using four different protein concentration assays. The ratios of protein concentration in venom samples to protein standards were calculated, and the accuracy of the protein concentration assays was analysed relative to the concentration determined from AAA. SDS-PAGE analysis showed that BSA contained several protein bands, while hyaluronidase contained a mixture of peptide and protein bands. Ant and honeybee venoms contained a higher proportion of peptide bands, while wasp venom contained more protein bands. As determined by AAA, the ratio of protein concentration in Hymenoptera venoms varied between 1.01 and 1.11 to BSA, and between 0.96 and 1.06 to hyaluronidase. Overall, the Bradford assay was found to be the least accurate and the BCA assay was the most accurate in estimating protein concentration in Hymenoptera venoms. There was no significant advantage in using hyaluronidase as a standard or increasing incubation temperature of BCA assay when analysing Hymenoptera venoms. Diluent solutions containing phenol and human serum albumin interfered with Lowry-based assays. [Display omitted] • Bradford assay is the most frequently used protein concentration assay in Hymenoptera venom analysis. • Bradford assay produces inaccurate estimation of protein concentration in clinically relevant Hymenoptera venom samples. • BCA assay in combination with bovine serum albumin standard provides accurate estimation of protein concentration. [ABSTRACT FROM AUTHOR]

Abstract Background Allergen-specific immunotherapy (AIT) is the only treatment able to change the natural course of allergic diseases. We aimed at investigating the clinical efficacy of SLITOR (Serbian registered vaccine for sublingual allergen specific immunotherapy). Methods 7–18 years old children with allergic asthma and rhinitis were enrolled and addressed to the active (AIT plus pharmacological treatment) or control (standard pharmacological treatment only) group. Clinical and medications scores, lung function and exhaled FeNO were measured at baseline and at every follow-up. Results There was a significant improvement in both nasal and asthma symptom scores as well as in medication score in SLIT group. SLIT showed an important influence on lung function and airway inflammation. Conclusions Our data showed that SLITOR was effective not only in terms of patient reported outcomes but an improvement of pulmonary function and decrease of lower airway inflammation were also observed.

Purpose: Allergen-specific immunotherapy (AIT) is known to be the only therapeutic modality to alter the natural course of allergic diseases. However, at least 3 years of treatment is recommended for achieving long-term disease modifying effect. This study aimed to investigate factors associated with immunotherapy non-adherence in real practice. Materials and Methods: We retrospectively reviewed medical records of patients who were diagnosed with allergic rhinitis, asthma, or atopic dermatitis, and received AIT to common allergens such as house dust mite and/or pollens from January 2007 to August 2014. In this study, non-adherence was defined as not completing 3 years of AIT. Results: Among 1162 patients enrolled, 228 (19.6%) failed to complete 3 years of AIT. In multivariate analysis, age less than 20 years [odds ratio (OR) 3.11, 95% confidence interval (CI) 1.70-5.69] and 20 to 40 years (OR 2.01, 95% CI 1.17-3.43), cluster buildup (OR 1.78, 95% CI 1.05-3.02) and ultra-rush build-up schedules (OR 5.46, 95% CI 2.40-12.43), and absence of visit to other departments in the same hospital (OR 1.87, 95% CI 1.05-3.32) were independently associated with immunotherapy non-adherence. Disease duration of 5-10 years was negatively associated with non-adherence compared to shorter disease duration of less than 5 years (OR 0.61, 95% CI 0.40-0.94). Although male sex and commercial product of AIT, Tyrosine S®, compared to Novo-Helisen® were non-adherent factors in univariate analysis, no statistical significances were identified in multivariate analysis. Conclusion: Various factors are associated with immunotherapy adherence affecting the utility of immunotherapy. Clinicians should be aware of factors associated with adherence to maximize the utility of allergen-specific subcutaneous immunotherapy. [ABSTRACT FROM AUTHOR]

Since it was introduced by Noon in 1911, allergen-specific immunotherapy or desensitization has been widely prescribed in the management of allergic diseases. Aimed at the etiology, it represents the only effective treatment for allergy. The basic mechanisms of immunotherapy are becoming better understood and allow us to improve this technique in the future. The sublingual immunotherapy as an alternative to subcutaneous route has been widely studied. Several clinical trials confirmed that sublingual immunotherapy is efficient in reducing allergic respiratory symptoms. The sublingual immunotherapy reduces the risk of developing serious side effects due to desensitization. We performed a literature review in order to remind the mechanisms of action and to demonstrate efficacy and tolerability of the sublingual immunotherapy in the treatment of allergic rhinoconjunctivitis and asthma and its impact on the quality of life.

Abstract Allergen specific immunotherapy (AIT) has been the only pathogenetically relevant treatment of IgE-mediated allergic diseases (ADs) for many years. The use of AIT for atopic dermatitis (AD) treatment is dubious and has both followers and opponents. The improvement of subcutaneous AIT (SCIT) and introduction of Sublingual immunotherapy (SLIT) gives prospects of their application both for adults and children suffering from AD. This review presents results of scientific research, system and meta-analyses that confirm the clinical efficacy of AIT for children with AD who has the sensitization to allergens of house dust mite, grass and plant pollen suffering from co-occurring respiratory ADs and with moderate and severe course of allergic AD. There have been analyzed the most advanced achievements in AIT studies as well as there have been specified the unmet needs in AD. The preliminary diagnostics of IgE-mediated AD and pathophysiological disorders, including immune ones, will allow a doctor to develop appropriate comprehensive treatment algorithm for children’s AD aimed at its correction. The including of AIT to the children’s comprehensive therapy program is reasonable only if AD has the allergic form. It is necessary better to design the randomized research studies and to acquire extended clinical practice in children with AD. Use of the successes of molecular-based allergy diagnostics will help to optimize and personalize the process of selecting the necessary allergens to determine the most appropriate vaccines for children considering the results of the allergen component diagnostics. The strategy of treatment of children with AD in future will be based on individual target therapy.

Severe atopic dermatitis, which affects both adults and children, is a debilitating disorder with a significant decline of patients' quality of life. Although aetiopathogenic factors are currently a topic of study and interpretation, the main features of atopic eczema are skin barrier disturbance and immune dysregulation. Severe refractory disease that fails to improve with conventional therapy may benefit from biologic therapy. Progress in understanding immunopathology of atopic dermatitis have allowed identification of therapeutic molecular targets in the field of biological therapy. We reviewed the different biological treatments with a focus on novel targeted agents: Systemic immunotherapy (Omalizumab, Dupilumab, Lebrikizumab, Tralokinumab, Nemolizumab, Ustekinumab, Fezakinumab, Tezepelumab, Apremilast, allergen specific immunotherapy), and topical agents (Tofacitinib, Crisaborole). [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Allergen specific immunotherapy (SIT) is the only specific therapeutic way for house dust mite (HDM) allergy. To improve the efficacy of SIT, hollow mesoporous silica nanoparticles (HMSNs) were used as vehicles for HDM allergen. The HMSNs were prepared and characterized. The major HDM allergen (Der f2) was loaded onto HMSNs, and the drug loading capacity and release profile were determined. Then the Der f2 loaded HMSNs were injected subcutaneously to mouse model of Der f2 induced allergic asthma and the preventive effects were evaluated. Our results showed that HMSNs were spherical (100 nm) with pore diameter of 2.897 nm and successfully loaded with Der f2 protein. The loading capacity is 90 μg Der f2/1 mg HMSNs. The Der f2 loaded on HMSNs released slowly in 72 h. Treatment with Der f2 loaded HMSNs could efficiently decrease Der f2 specific IgE levels, inflammatory cells infiltration in lung tissue, and Th2 cytokine IL4 levels in BALF. In the meanwhile, it could increase the Der f2 specific IgG levels, Th1 cytokine IFN-γ levels, and induce proliferation of splenocytes to Der f2 accompanied by increased IFN-γ levels. These results showed that Der f2 loaded HMSNs were efficient in preventing allergic inflammation, and HMSNs may be potential vehicles for SIT of HDM allergy. [ABSTRACT FROM AUTHOR]

The growing prevalence of allergy and asthma in India has become a major health concern with symptoms ranging from mild rhinitis to severe asthma and even life-threatening anaphylaxis. The "allergen repertoire" of this subcontinent is highly diverse due to the varied climate, flora, and food habits. The proper identification, purification, and molecular characterization of allergy-eliciting molecules are essential in order to facilitate an accurate diagnosis and to design immunotherapeutic vaccines. Although several reports on prevalent allergens are available, most of these studies were based on preliminary detection and identification of the allergens. Only a few of these allergen molecules have been characterized by recombinant technology and structural biology. The present review first describes the composition, distribution pattern, and natural sources of the predominant allergens in India along with the prevalence of sensitization to these allergens across the country. We go on to present a comprehensive report on the biochemical, immunological, and molecular information on the allergens reported so far from India. The review also covers the studies on allergy- related biosafety assessment of transgenic plants. Finally, we discuss the allergen-specific immunotherapy trials performed in India. [ABSTRACT FROM AUTHOR]

Background The treatment of atopic dermatitis is multimodal. When offending environmental allergens are identified, an allergen specific immunotherapy (ASIT) can be combined with other treatments, and it is the only treatment with a potential disease-modifying effect on allergic subjects. Traditionally, ASIT consists of subcutaneous administration of increasing doses of allergens up to a maintenance dose. The major drawback of such a protocol is the escalating phase, which presents a risk of incorrect dosage and lack of compliance from owners. There is a need for simplification of existing protocols to increase compliance and adherence. Objective To report the safety of a protocol of ASIT without an induction phase. Method Medical records of atopic dogs sensitized to common allergens and treated for at least 1 year with monthly subcutaneous injections of calcium phosphate conjugated allergenic extracts at maintenance dose without an escalating phase were reviewed. Signs of adverse reactions at the time of and 30 minutes after each injection were reported. Results One hundred eighty five atopic dogs presenting a positive intradermal skin testing for domestic mites or pollens were included in the study . Each dog received a monthly subcutaneous injection of 0.8 ml of calcium phosphate adjuvanted allergenic extracts (Biogenix®, Ceva Biovac, France) at the following concentrations: mites 1/10000 w/v, pollens 1/1000 w/v. At the first injection, 104 dogs were not receiving any immunomodulating treatment, 41 were receiving oclacitinib, 22 cyclosporine, and 13 cetirizine. Except for one dog that displayed a reversible swelling at the injection site following the first injection, no adverse reactions were observed. Conclusion This protocol is safe. Thanks to the simplification (one vial for 1 year of treatment administered at the same dosage once a month), it could be a significant aid in prescribing ASIT. It may improve compliance, which would be helpful since 1 year is often necessary before ASIT efficacy can be measured on treated dogs. [ABSTRACT FROM AUTHOR]

Copyright of Zdorov'ye Rebenka is the property of Zaslavsky O.Yu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Allergen specific immunotherapy is the only treatment that has the potential to alter the natural course of allergic disease. It modifies the immunological response to alergen which causes the developing of the disease. It is effective in allergic rhinitis, allergic asthma and Hymenoptera venom allergy. It's beneficial effect maintains for years after it has been discontinued and it concerns not only the reduction of symptoms of certain disease, but aslo the prevention of progression of the disease and the onset of new sensitisations. There are two forms of alergen immunotherapy available: subcutaneous and sublingual, the latter beeing more safe and more patient's friendly. [ABSTRACT FROM AUTHOR]

In the present study, we aimed to evaluate the knowledge levels and perspectives about allergen specific immunotherapy (ASI) of parents whose children were diagnosed with asthma and/or allergic rhinitis with positive skin prick test. The study was conducted between September 2014 and January 2015. Surveys that were filled by 198 parents were analyzed. One hundred-ninety-eight parents were included in the study; 42.9% of the parents had knowledge about ASI. Parents obtained information about the ASI from respectively pediatric allergy specialists (25.5%), relatives and friends (17.8%), media (12.9%), and pediatrician (8.2%). There is a strong association between educational level of the mother, atopy background of the family, the monthly per capita income, and having knowledge about the ASI. Multivariate regression analysis revealed that individuals with a monthly income higher than 2,000 TL were more likely to be aware of the ASI application (OR: 4.35, 95% CI: 1.13- 16.71; p<0.05). Eighty-nine percent of the parents stated that they would prefer the sublingual ASI instead of subcutaneous ASI because it is easy to use and its severe side effects risk is low. The awareness of the ASI is at high rates in our patient population. [ABSTRACT FROM AUTHOR]

Background: Allergen-specific immunotherapy (AIT) is the only treatment able to change the natural course of allergic diseases. We aimed at investigating the clinical efficacy of SLITOR (Serbian registered vaccine for sublingual allergen specific immunotherapy). Methods: 7-18 years old children with allergic asthma and rhinitis were enrolled and addressed to the active (AIT plus pharmacological treatment) or control (standard pharmacological treatment only) group. Clinical and medications scores, lung function and exhaled FeNO were measured at baseline and at every follow-up. Results: There was a significant improvement in both nasal and asthma symptom scores as well as in medication score in SLIT group. SLIT showed an important influence on lung function and airway inflammation. Conclusions: Our data showed that SLITOR was effective not only in terms of patient reported outcomes but an improvement of pulmonary function and decrease of lower airway inflammation were also observed. [ABSTRACT FROM AUTHOR]

Because the prevalence of allergic diseases has significantly increased in recent years, understanding the causes and mechanisms of these disorders is of high importance, and intense investigations are ongoing. Current knowledge pinpoints immune tolerance mechanisms as indispensable for healthy immune response to allergens in daily life. It is evident that development and maintenance of allergens-pecific T cell tolerance is of vital importance for a healthy immune response to allergens. Such tolerance can be gained spontaneously by dose-dependent exposures to allergens in nature or by allergen-specific immunotherapy. Allergen-specific immunotherapy induces regulatory T cells with the capacity to secrete interleukin-10 and transforming growth factor-β, limits activation of effector cells of allergic inflammation (such as mast cells and basophils), and switches antibody isotype from IgE to the noninflammatory type IgG4. Although allergen-specific immunotherapy is the only method of tolerance induction in allergic individuals, several factors, such as long duration of treatment, compliance problems, and life-threatening side effects, have limited widespread applicability of this immunomodulatory treatment. To overcome these limitations, current research focuses on the introduction of allergens in more efficient and safer ways. Defining the endotypes and phenotypes of allergic diseases might provide the ability to select ideal patients, and novel biomarkers might ensure new custom-tailored therapy modalities.

Allergen specific immunotherapy (AIT) has been the only pathogenetically relevant treatment of IgE-mediated allergic diseases (ADs) for many years. The use of AIT for atopic dermatitis (AD) treatment is dubious and has both followers and opponents. The improvement of subcutaneous AIT (SCIT) and introduction of Sublingual immunotherapy (SLIT) gives prospects of their application both for adults and children suffering from AD. This review presents results of scientific research, system and meta-analyses that confirm the clinical efficacy of AIT for children with AD who has the sensitization to allergens of house dust mite, grass and plant pollen suffering from co-occurring respiratory ADs and with moderate and severe course of allergic AD. There have been analyzed the most advanced achievements in AIT studies as well as there have been specified the unmet needs in AD. The preliminary diagnostics of IgE-mediated AD and pathophysiological disorders, including immune ones, will allow a doctor to develop appropriate comprehensive treatment algorithm for children's AD aimed at its correction. The including of AIT to the children's comprehensive therapy program is reasonable only if AD has the allergic form. It is necessary better to design the randomized research studies and to acquire extended clinical practice in children with AD. Use of the successes of molecular-based allergy diagnostics will help to optimize and personalize the process of selecting the necessary allergens to determine the most appropriate vaccines for children considering the results of the allergen component diagnostics. The strategy of treatment of children with AD in future will be based on individual target therapy. [ABSTRACT FROM AUTHOR]

Allergy to hen’s (Gallus domesticus) egg white is one of the most common forms of food allergy. Allergy to hen’s yolk also exists however, to a lesser extent when compared to egg white allergy. Two minor allergens from the hen’s egg yolk known as α-livetin (Gal d 5) and YGP42 (Gal d 6) were discovered recently. In this study, we investigated whether sensitization to egg white is associated with reactivity to egg yolk as well. Sera obtained from 25 patients with allergy to egg white were tested for specific IgE binding for egg yolk proteins through western immunoblotting. 36% of patients were found with true IgE-sensitization against egg yolk proteins. It was found that most of the IgE reactive yolk proteins were fragments of major precursor proteins of hen; vitellogenin-1 (VTG-1), vitellogenin-2 (VTG-2) and apolipoprotein B (Apo B). The egg yolk allergen Gal d 6 is the C-terminal part of VTG-1 and was found to be allergenic in significant percentage of egg white allergy patients. These results highlight the significance of Gal d 6 as an important allergen of egg yolk. Therefore, the secondary aim of this study involved developing a recombinant version of YGP42 in an Escherichia coli expression system. Recombinant Gal d 6 (rGal d6) was expressed as a fusion peptide with a 6 × His tag and purified using metal chelating resin. The inhibition ELISA results showed that rYGP42 was IgE reactive and was able to inhibit IgE binding to crude egg yolk (CEY) by up to 30%. Traditionally, it was thought that allergy to egg yolk occurred independently from sensitization to egg white. This study underlies the importance of concomitant sensitization to egg yolk proteins in patients allergic to egg white. Evidence reported in this study strongly suggests that egg yolk has potentially undiscovered allergens and therefore warrants further investigation. Furthermore, IgE reactive Gal d 6 presented in this study has the potential to be used in diagnosis and immunotherapy to treat egg allergy. [ABSTRACT FROM AUTHOR]

The dynamics of the immunologic status parameters in 62 patients with persistent allergic rhinitis (PAR), who received the complete course of allergen specific immunotherapy (ASIT) was studied. Monitoring of the level of immunologic parameters was carried out before immunocorrecting therapy and upon completing ASIT course. ASIT efficiency in patients with PAR is characterized by high initial level of immunological parameters CD3+; CD4+; CD8+ and IgG and change in concentration of IL-4, IL-6, IL-8 in blood at the early stages of treatment. [ABSTRACT FROM AUTHOR]

There are many different treatment options for atopic dermatitis in the dog and cat. Unfortunately, many of the recommendations for therapy are based on anecdotal reports rather than on evidence-based decisions. This review considers the different treatment modalities that may be considered, together with the supporting scientific data for each of them. Therapies that are discussed include antihistamines, glucocorticoids, ciclosporine, Janus kinase inhibitors and allergen-specific immunotherapy. [ABSTRACT FROM AUTHOR]

Japanese cedar (JC) pollinosis is caused by Japanese cedar pollen (JCP) and most common seasonal allergic disease in Japan. Subcutaneous immunotherapy (SCIT) with allergen extract of JCP (JCP-allergen extract) is well established for JC pollinosis treatment with improvement of symptoms. However, major drawbacks for SCIT are repeated painful injections, frequent hospital visits and anaphylactic risk. Currently, sublingual immunotherapy (SLIT) has received much attention as an advanced alternative application with lower incidence of systemic reactions because the liquid or tablet form of allergen is placed under the tongue. The aim of this study was safety evaluation of standardized JCP-allergen extract currently developed for SLIT in JC pollinosis. JCP-allergen extract showed no potential genotoxicity. No systemic effects were observed in rats administered JCP-allergen extract orally for 26 weeks followed by 4-week recovery period. Mild local reactions such as hyperplasia and increased globule leukocytes resulting from vehicle (glycerin)-induced irritation were observed in stomach. No-observed-adverse-effect level was greater than 10,000 JAU/kg/day for systemic toxicity, equivalent to 300-fold the human dose. No local irritation was found in rabbits oral mucosae by 7-day sublingual administration. These results demonstrate the safe profile of standardized JCP-allergen extract, suggesting it is suitable for SLIT in JC pollinosis. [ABSTRACT FROM AUTHOR]

Allergen specific immunotherapy (ASI) is a well-documented treatment for allergic asthma, rhinitis and allergy to bee venoms. Immunotherapy with subcutaneous injections of allergens extracts has proved beneficial in reducing symptoms of allergic rhinitis and asthma. Side effects due to specific immunotherapy in short term have been largely documented. These effects were various but were usually mild. Fatal reactions are less frequent. We reported a case of a woman, with a history of allergic asthma under specific desensitization protocol who developed an acute multi-organ failure (MOF) consecutive to administration of ASI (Alustal Stallergenes SA, France). This fatal reaction has never been described as adverse event of specific immunotherapy. We aimed to describe this dramatic reaction, expose the arguments to define the relationship between the administration of allergen extract and the occurrence of this fatal reaction.