The Multifaceted B Cell Response in Allergen Immunotherapy
AbstractWhile allergen immunotherapy (AIT) for IgE-mediated diseases holds curative potential, the considerable heterogeneity in clinical outcomes may relate to the complex mechanisms of tolerance. The regulation of humoral immunity by AIT contributes to the suppression of allergic responses. Recent findings have revealed novel roles for IgA and IgG antibodies in the induction of tolerance. These mechanisms synergize with their ability to block allergen-IgE binding and mediate inhibitory signaling of effector cells of the allergic response. In addition, the regulatory activity of B cells in AIT extends beyond IL-10 secretion and induction of IgG4. Here, we review the evolution of the B cell response during AIT with special emphasis on the novel protective mechanisms entailing humoral immunity.
ConclusionThe trial demonstrated a favorable safety profile of the SQ HDM SLIT-tablet in Japanese adult patients with AA. The treatment appeared to be efficacious in patients requiring rescue medication (i.e., SABA) at baseline in the efficacy assessment using asthma exacerbation during ICS reduction (JapicCTI number 121847).
Publication date: Available online 12 September 2019Source: The LancetAuthor(s): R Sharon Chinthrajah, Natasha Purington, Sandra Andorf, Andrew Long, Katherine L O'Laughlin, Shu Chen Lyu, Monali Manohar, Scott D Boyd, Robert Tibshirani, Holden Maecker, Marshall Plaut, Kaori Mukai, Mindy Tsai, Manisha Desai, Stephen J Galli, Kari C NadeauSummaryBackgroundDietary avoidance is recommended for peanut allergies. We evaluated the sustained effects of peanut allergy oral immunotherapy (OIT) in a randomised long-term study in adults and children.MethodsIn this randomised, double-blind, placebo-controlled, phase 2 study, we enrolle...
THURSDAY, Sept. 12, 2019 -- Allergy immunotherapy (AIT) is associated with a decreased risk for asthma progression, particularly in younger patients, according to a study published online Aug. 13 in Allergy. Jochen Schmitt, M.P.H., from the...
ConclusionAs new data arise, revisions might soon be needed allowing AIT in the cases of patients treated with ACE inhibitors and beta-blockers, in elderly patients and in patients with concomitant autoimmune diseases and neoplasias in remission. The decision to prescribe AIT is always tailor-made, balancing risk vs benefit. Creating globally accepted guidelines would help Allergologists in their decision making.
CONCLUSIONS: In a simulation of potential SIE prescribing strategies for patients receiving AIT, a universal approach to an epinephrine autoinjector requirement was not cost-effective when compared to an approach in which an SIE is prescribed only to patients with prior SRIT. PMID: 31520771 [PubMed - as supplied by publisher]
Aeroallergen immunotherapy is a safe and effective disease-modifying treatment associated with rare therapy-associated fatality. Significant practice variation surrounds universal or contextual prescription of self-injectable epinephrine (SIE) for patients receiving AIT.Objective: To characterize the cost-effectiveness of a universal vs. contextual SIE requirement for patients receiving AIT.
When I worked at Greenpeace for five years before I attended medical school, a popular slogan was, “think globally, act locally.” As I write this blog about climate change and hay fever, I wonder if wiping off my computer that I’ve just sneezed all over due to my seasonal allergies counts as abiding by this aphorism? (Can you clean a computer screen with a tissue?) Come to think of it, my allergies do seem to be worse in recent years. So do those of my patients. It seems as if I’m prescribing nasal steroids and antihistamines, recommending over-the-counter eye drops, and discussing ways to avoid all...
Recently, a policy decision by ICER (the Institute for Clinical and Economic Research) on the grading of risk-benefit trade offs of investigational peanut immunotherapy regimens was demoted to a “D” (https://icer-review.org/announcements/peanut_evidence_report/), meaning a negative evaluation of the therapy. The report was issued to the public on July 10, 2019.
Conclusion: The case report presented here suggests the effectiveness of an individualized approach and phenotype-specific treatment of patients who cannot receive allergen-specific immunotherapy due to the contraindication uncontrolled asthma and who receive SIT after asthma control is achieved by using target treatments. PMID: 31486698 [PubMed - as supplied by publisher]
The rising incidence of pediatric food allergy results in significant health care burden and family stress. Oral immunotherapy (OIT) has been shown to induce tolerance to peanut, milk and egg. OIT for other foods, particularly multiple foods simultaneously, has not been thoroughly studied.