Highlights
- •Allergen immunotherapy (AIT) is so far the only causal treatment of allergic diseases including asthma which has also been proven to be cost-effective.
- •The key benefits of AIT consist of disease modifying effects as well as protective (preventive) properties against the allergic march in allergic diseases including asthma.
- •Recently, real-life data underscored long-term effectiveness (disease remission/modification) of HDM-AIT across 9–10 years of follow-up in a large cohort of >14,000 patients with HDM-driven asthma.
- •Promising clinical benefits have previously also been achieved with pollen allergen extracts (both SCIT and SLIT), but more real-life data over longer periods of time including larger numbers of patients (including asthma) are of utmost interest to confirm the persistence of clinical effectiveness of pollen AIT.
- •Predictive biomarkers identifying responders to AIT represent an unmet need while research is ongoing.
Keywords
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References
- Allergen immunotherapy: past, present and future.Nat. Rev. Immunol. 2022 Oct 17; : 1-12https://doi.org/10.1038/s41577-022-00786-1
- Prophylactic inoculation against hay fever.Lancet. 1911; 177: 1572-1573https://doi.org/10.1016/S0140-6736(00)78276-6
- 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; 13100275https://doi.org/10.1016/j.lanepe.2021.100275
- Biomarkers in asthma and allergic rhinitis.Pulm. Pharmacol. Ther. 2010; 23: 468-481https://doi.org/10.1016/j.pupt.2010.06.006
- Inhaled allergen bronchoprovocation tests.J. Allergy Clin. Immunol. 2013; 132: 1045-1055.e6https://doi.org/10.1016/j.jaci.2013.08.023
- Allergen Provocation Tests in Respiratory Research: Building on 50 Years of Experience. 60. 2022 Aug 252102782https://doi.org/10.1183/13993003.02782-2021 (2)
- Diverse immune mechanisms of allergen immunotherapy for allergic rhinitis with and without asthma.J. Allergy Clin. Immunol. 2022; 149: 791-801
- Cytokine networking of innate immunity cells: a potential target of therapy.Clin. Sci. 2014; 126: 593-612
- Targeting downstream type 2 cytokines or upstream epithelial alarmins for severe asthma.J. Allergy Clin. Immunol. Pract. 2022 Jun; 10: 1497-1505https://doi.org/10.1016/j.jaip.2022.01.040
- Immunoglobulin E response in health and disease beyond allergic disorders.Allergy. 2022; 77: 1700-1718
- Anti-inflammatory mechanisms of leukotriene modulators.Editorial. Clin. Exp. Allergy. 1999 Nov; 29: 1449-1453https://doi.org/10.1046/j.1365-2222.1999.00711.x
- The effect of inhaled leukotriene D4 and methacholine on sputum cell differentials in asthma.Am. J. Respir. Crit. Care Med. 1997; 155: 1247-1253https://doi.org/10.1164/ajrccm.155.4.9105062
- Mechanisms of airway hyperresponsiveness.J. Allergy Clin. Immunol. 2006; 118: 551-559
- Effects of allergen-specific immunotherapy on functions of helper and regulatory T cells in patients with seasonal allergic rhinitis.Eur. Cytokine Netw. 2011; 22: 15-23
- A novel approach in allergen-specific immunotherapy: combination of sublingual and subcutaneous routes.J. Allergy Clin. Immunol. 2011 Oct; 128: 808-815.e7https://doi.org/10.1016/j.jaci.2011.04.033
- How does B cell antigen presentation affect memory CD4 T cell differentiation and longevity?.Front. Immunol. 2021; 10677036https://doi.org/10.3389/fimmu.2021.677036
- The cost-effectiveness of allergen immunotherapy compared with pharmacotherapy for treatment of allergic rhinitis and asthma, Immuno.l allergy clin.. North Am. 2020 Feb; 40: 69-85https://doi.org/10.1016/j.iac.2019.09.003
- Allergen immunotherapy in allergic respiratory diseases: from mechanisms to meta-analyses.Chest. 2012 May; 141: 1303-1314https://doi.org/10.1378/chest.11-2800
- Allergen immunotherapy: a practice parameter third update.J. Allergy Clin. Immunol. 2011; 127: S1-S5
- Sublingual immunotherapy: a focused allergen immunotherapy practice parameter update.Ann. Allergy Asthma Immunol. 2017; 118: 276-282.e2
- 2020 updated asthma guidelines: allergen immunotherapy.J. Allergy Clin. Immunol. 2020; 146: 1286-1287
- Predicting success of allergen-specific immunotherapy.Front. Immunol. 2020 Aug 25; 11: 1826https://doi.org/10.3389/fimmu.2020.01826
- Allergen immunotherapy for long-term tolerance and prevention.J. Allergy Clin. Immunol. 2022; 149: 802-811
- Immunological responses and biomarkers for allergen-specific immunotherapy against inhaled allergens.J. Allergy Clin. Immunol. Pract. 2021 May; 9: 1769-1778https://doi.org/10.1016/j.jaip.2021.03.029
- Biomarkers of AIT: models of prediction of efficacy.Allergol Select. 2022; 6: 267-275https://doi.org/10.5414/ALX02333E
- EAACI guidelines on allergen immunotherapy: executive statement.Allergy. 2018; 73: 739-743
- Efficacy of a house dust mite sublingual allergen immunotherapy tablet in adults with allergic asthma: a randomized clinical trial.JAMA. 2016; 315: 1715-1725
- Global strategy for asthma management and prevention.
- Real-life compliance and persistence among users of subcutaneous and sublingual allergen immunotherapy.J. Allergy Clin. Immunol. 2013; 132 (e2): 353-360https://doi.org/10.1016/j.jaci.2013.03.013
- Stepwise approach towards adoption of allergen immunotherapy for allergic rhinitis and asthma patients in daily practice in Belgium: a BelSACI-Abeforcal-EUFOREA statement.Clin. Transl. Allergy. 2019 Feb 4; 9: 1https://doi.org/10.1186/s13601-019-0243-1
- Allergen immunotherapy effectively reduces the risk of exacerbations and lower respiratory tract infections in both seasonal and perennial allergic asthma: a nationwide epidemiological study.Eur. Respir. J. 2022 Nov 17; 602200446https://doi.org/10.1183/13993003.00446-2022
- Grass pollen immunotherapy as an effective therapy for childhood seasonal allergic asthma.J. Allergy Clin. Immunol. 2006 Feb; 117: 263-268https://doi.org/10.1016/j.jaci.2005.09.054
- Metaanalysis of the efficacy of sublingual immunotherapy in the treatment of allergic asthma in pediatric patients, 3 to 18 years of age.Chest. 2008 Mar; 133: 599-609https://doi.org/10.1378/chest.06-1425
- Injection allergen immunotherapy for asthma.Cochrane Database Syst. Rev. 2010 Aug 4; : CD001186https://doi.org/10.1002/14651858.CD001186.pub2
- Allergen immunotherapy for allergic asthma: a systematic review and meta-analysis.Allergy. 2017 Dec; 72 (Allergy. 2017 Dec;72(12):1825-1848. doi: 10.1111/all.13208): 1825-1848https://doi.org/10.1111/all.13208
- Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study).J. Allergy Clin. Immunol. 2002 Feb; 109: 251-256https://doi.org/10.1067/mai.2002.121317
- Impact of sublingual immunotherapy on seasonal asthma and skin reactivity in children allergic to Parietaria pollen treated with inhaled fluticasone propionate.Clin. Exp. Allergy. 2003 Dec; 33: 1641-1647https://doi.org/10.1111/j.1365-2222.2003.01809.x
- Effect of immunotherapy on asthma progression, BHR and sputum eosinophils in allergic rhinitis.Allergy. 2004 Nov; 59: 1224-1228https://doi.org/10.1111/j.1398-9995.2004.00537.x
- The PAT investigator group). Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study.Allergy. 2007 Aug; 62: 943-948https://doi.org/10.1111/j.1398-9995.2007.01451.x
- GAP investigators, Results from the 5-year SQ grass sublignual immunotherapy tablet asthma prevention (GAP) trial in children with grass pollen allergy.J. Allergy Clin. Immunol. 2018; 141: 529-538.e13
- Real-world benefits of allergen immunotherapy for birch pollen-associated allergic rhinitis and asthma.Allergy. 2019 Mar; 74: 594-604https://doi.org/10.1111/all.13598
- Does allergen immunotherapy for allergic rhinitis prevent asthma?.Ann. Allergy Asthma Immunol. 2022 Sep; 129: 286-291https://doi.org/10.1016/j.anai.2022.04.028
- Preventive effect of allergen immunotherapy on asthma and new sensitizations.J. Allergy Clin. Immunol. Pract. 2021 May; 9: 1813-1817https://doi.org/10.1016/j.jaip.2021.03.010
- Allergy immunotherapy for allergic rhinitis effectively prevents asthma: results from a large retrospective cohort study.J. Allergy Clin. Immunol. 2015 Dec; 136: 1511-1516https://doi.org/10.1016/j.jaci.2015.07.038
- Immunotherapy in allergic rhinitis and lower airway outcomes.Allergy. 2017 Jan; 72: 35-42https://doi.org/10.1111/all.12989
- Clinical contraindications to allergen immunotherapy : an EAACI position paper.Allergy. 2015; 70: 897-909
- Patient characteristics associated with allergen immunotherapy initiation and adherence.J. Allergy Clin. Immunol. 2011; 127 (e1-3): 46-48
- Children's compliance with allergen immunotherapy according to administration routes.J. Allergy Clin. Immunol. 2005; 116: 1380-1381
- Importance of patients' education in favouring compliance with sublingual immunotherapy.Allergy. 2010; 65: 1341-1342
- Causes of SLIT discontinuation and strategies to improve the adherence: a pragmatic approach.Allergy. 2013; 68: 1193-1195
- Sublingual immunotherapy: adherence based on timing and monitoring control visits.Allergy. 2010; 65: 668-669
- Digital tolls in allergy and respiratory care.World Allergy Organ. J. 2022; 15100661
- Allergen extracts for in vivo diagnosis and treatment of allergy: is there a future?.J. Allergy Clin. Immunol. Pract. 2018; 6: 1845-1855.e2
- Allergens and adjuvants in allergen immunotherapy for immune activation, tolerance, and resilience.J. Allergy Clin. Immunol. Pract. 2021; 9: 1780-1789
- Immune Tolerance Network Group, Immunotherapy with a ragweed-toll-like receptor 9 agonist vaccine for allergic rhinitis.N. Engl. J. Med. 2006; 355: 1445-1455
- The cloning and expression of human monoclonal antibodies: implications for allergen immunotherapy.Curr. Allergy Asthma Rep. 2016; 16: 15
- Dupilumab efficacy in patients with uncontrolled, moderate-to-severe allergic asthma.J. Allergy Clin. Immunol. Pract. 2020; 8: 516-626
- Recent advances in the use of nanoparticles for allergen-specific immunotherapy.Allergy. 2017; 72: 1461-1474
- Intralymphatic immunotherapy: update and unmet needs.Int. Arch. Allergy Immunol. 2019; 178: 141-149
- Epicutaneous allergen administration as a novel method of allergen-specific immunotherapy.J. Allergy Clin. Immunol. 2009; 124: 997-1002
- Epicutaneous immunotherapy in rhino-conjunctivitis and food allergies: a review of the literature.J. Transl. Med. 2018; 16: 329
- EAACI Allergen Immunotherapy Guidelines Group, EAACI guidelines on allergen immunotherapy: IgE-mediated food allergy.Allergy. 2018; 73: 799-815
- Local nasal immunotherapy for allergic rhinitis: a systematic review and meta-analysis.Int. Forum Allergy Rhinol. 2022; https://doi.org/10.1002/alr.23011
- British society for allergy and clinical immunology, immunotherapy for allergic rhinitis.Clin. Exp. Allergy. 2011; 41: 1177-1200
- Standardized quality (SQ) house dus tmite sublingual immunotherapy tablet (ALK) reduces inhaled corticosteroid use while maintaining asthma control: a randomized, double-blind, placebo-controlled trial.J. Allergy Clin. Immunol. 2014; 134: 568-575.e7
- Burden and socioeconomics of asthma, allergic rhinitis, atopic dermatitis and food allergy.Expert Rev. Pharmacoecon. Outcomes Res. 2020; 20: 437-453
- Mechanisms of allergen-specific immunotherapy.J. Allergy Clin. Immunol. 2011; 127: 18-27
- Mechanisms of allergen immunotherapy in allergic rhinitis.Curr. Allergy Asthma Rep. 2021; 21: 2
- Allergen immunotherapy for allergic airway diseases: use lessons from the past to design a brighter future.Pharmacol. Ther. 2022; 237108115
- Mechanisms of allergen-specific immunotherapy and allergen tolerance.Allergol. Int. 2020; 69: 549-560
Article info
Publication history
Accepted:
January 13,
2023
Received in revised form:
January 12,
2023
Received:
October 24,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.