Role of Allergen Immunotherapy and Biologics in Allergic Diseases

Overview

Journal Curr Opin Immunol

Publisher Elsevier

Specialty Allergy & Immunology

Date 2024 Oct 2

PMID 39357079

Authors

Xiaoying Zhou

Elisabeth M Simonin

Youn S Jung

Stephen J Galli

Kari C Nadeau

Affiliations

Soon will be listed here.

Abstract

The rise in the prevalence of allergic diseases has become a global health burden. Allergic diseases are a group of immune-mediated disorders characterized by IgE-mediated conditions resulting from a type 2 helper T cell (Th2)-skewed immune response. This review aims to comprehensively summarize recent research on the roles of allergen immunotherapy (AIT) and biologics in allergic diseases. Specifically, we review the mechanisms of AIT and biologics in modulating innate and adaptive immunity involved in allergic disease pathogenesis, as well as their safety and efficacy in the treatment of allergic diseases. We also discuss current new AIT strategies such as recombinant allergen-based vaccines and allergen extract nanoencapsulation. Further research is needed to understand immune tolerance mechanisms beyond the Th2 pathway and to characterize immunological changes in responders and nonresponders to AIT or biologics. This additional research may uncover new targets for monitoring treatment responses and developing personalized treatment strategies for allergic diseases.

References

Barshow S, Tirumalasetty J, Sampath V, Zhou X, Seastedt H, Schuetz J . The Immunobiology and Treatment of Food Allergy. Annu Rev Immunol. 2024; 42(1):401-425. DOI: 10.1146/annurev-immunol-090122-043501. View

Fritzsching B, Contoli M, Porsbjerg C, Buchs S, Larsen J, Elliott L . Long-term real-world effectiveness of allergy immunotherapy in patients with allergic rhinitis and asthma: Results from the REACT study, a retrospective cohort study. Lancet Reg Health Eur. 2021; 13:100275. PMC: 8640513. DOI: 10.1016/j.lanepe.2021.100275. View

Morita H, Matsumoto K, Saito H . Biologics for allergic and immunologic diseases. J Allergy Clin Immunol. 2022; 150(4):766-777. DOI: 10.1016/j.jaci.2022.08.009. View

Lozano-Ojalvo D, Tyler S, Aranda C, Wang J, Sicherer S, Sampson H . Allergen recognition by specific effector Th2 cells enables IL-2-dependent activation of regulatory T-cell responses in humans. Allergy. 2022; 78(3):697-713. PMC: 10111618. DOI: 10.1111/all.15512. View

Bacher P, Heinrich F, Stervbo U, Nienen M, Vahldieck M, Iwert C . Regulatory T Cell Specificity Directs Tolerance versus Allergy against Aeroantigens in Humans. Cell. 2016; 167(4):1067-1078.e16. DOI: 10.1016/j.cell.2016.09.050. View

Corren J, Menzies-Gow A, Chupp G, Israel E, Korn S, Cook B . Efficacy of Tezepelumab in Severe, Uncontrolled Asthma: Pooled Analysis of the PATHWAY and NAVIGATOR Clinical Trials. Am J Respir Crit Care Med. 2023; 208(1):13-24. PMC: 10870853. DOI: 10.1164/rccm.202210-2005OC. View

Brightling C, Nair P, Cousins D, Louis R, Singh D . Risankizumab in Severe Asthma - A Phase 2a, Placebo-Controlled Trial. N Engl J Med. 2021; 385(18):1669-1679. DOI: 10.1056/NEJMoa2030880. View

Boonpiyathad T, Celebi Sozener Z, Akdis M, Akdis C . The role of Treg cell subsets in allergic disease. Asian Pac J Allergy Immunol. 2020; 38(3):139-149. DOI: 10.12932/AP-030220-0754. View

Nur Husna S, Tan H, Md Shukri N, Mohd Ashari N, Wong K . Allergic Rhinitis: A Clinical and Pathophysiological Overview. Front Med (Lausanne). 2022; 9:874114. PMC: 9021509. DOI: 10.3389/fmed.2022.874114. View

10.

Mikhaylov D, Ungar B, Renert-Yuval Y, Guttman-Yassky E . Oral Janus kinase inhibitors for atopic dermatitis. Ann Allergy Asthma Immunol. 2023; 130(5):577-592. DOI: 10.1016/j.anai.2023.01.020. View

11.

Agache I, Rocha C, Beltran J, Song Y, Posso M, Sola I . Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines - recommendations on the use of biologicals in severe asthma. Allergy. 2020; 75(5):1043-1057. DOI: 10.1111/all.14235. View

12.

Voskamp A, Khosa S, Phan T, DeBerg H, Bingham J, Hew M . Phase 1 trial supports safety and mechanism of action of peptide immunotherapy for peanut allergy. Allergy. 2023; 79(2):485-498. DOI: 10.1111/all.15966. View

13.

Sahiner U, Giovannini M, Escribese M, Paoletti G, Heffler E, Lozano M . Mechanisms of Allergen Immunotherapy and Potential Biomarkers for Clinical Evaluation. J Pers Med. 2023; 13(5). PMC: 10223594. DOI: 10.3390/jpm13050845. View

14.

Santos A, James L, Bahnson H, Shamji M, Couto-Francisco N, Islam S . IgG4 inhibits peanut-induced basophil and mast cell activation in peanut-tolerant children sensitized to peanut major allergens. J Allergy Clin Immunol. 2015; 135(5):1249-56. PMC: 4418748. DOI: 10.1016/j.jaci.2015.01.012. View

15.

Wright B, Kulis M, Orgel K, Burks A, Dawson P, Henning A . Component-resolved analysis of IgA, IgE, and IgG4 during egg OIT identifies markers associated with sustained unresponsiveness. Allergy. 2016; 71(11):1552-1560. PMC: 5035709. DOI: 10.1111/all.12895. View

16.

Durham S, Shamji M . Allergen immunotherapy: past, present and future. Nat Rev Immunol. 2022; 23(5):317-328. PMC: 9575636. DOI: 10.1038/s41577-022-00786-1. View

17.

Hofmann M, Fluhr J, Ruwwe-Glosenkamp C, Stevanovic K, Bergmann K, Zuberbier T . Role of IL-17 in atopy-A systematic review. Clin Transl Allergy. 2021; 11(6):e12047. PMC: 8361814. DOI: 10.1002/clt2.12047. View

18.

Varshney P, Jones S, Scurlock A, Perry T, Kemper A, Steele P . A randomized controlled study of peanut oral immunotherapy: clinical desensitization and modulation of the allergic response. J Allergy Clin Immunol. 2011; 127(3):654-60. PMC: 3060783. DOI: 10.1016/j.jaci.2010.12.1111. View

19.

Satitsuksanoa P, Jansen K, Globinska A, Veen W, Akdis M . Regulatory Immune Mechanisms in Tolerance to Food Allergy. Front Immunol. 2019; 9:2939. PMC: 6299021. DOI: 10.3389/fimmu.2018.02939. View

20.

Castro M, Corren J, Pavord I, Maspero J, Wenzel S, Rabe K . Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. N Engl J Med. 2018; 378(26):2486-2496. DOI: 10.1056/NEJMoa1804092. View