Allergen immunotherapy (AIT) is the only effective treatment for allergic diseases that induces immune tolerance while reducing symptoms in patients with asthma and allergic rhinitis (AR). The principle of this therapy is to reduce the symptoms of allergic diseases by inducing tolerance to allergens. By repeated long-term exposure to a designated dose of allergen, immune responses can be changed, protective immunity can be induced, and patients can tolerate future allergen exposure. Common applications of AIT for respiratory allergies include subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). SCIT involves repeated subcutaneous injections of increasing doses of allergen, starting with a low initial dose, and gradually increasing to a higher dose. SLIT is a non-invasive and well-tolerated therapy that is effective in treating respiratory allergies.
Application of AIT in Allergic Diseases
Immune dysfunction is a key factor in the pathogenesis of allergic diseases, and the concept of inducing immune tolerance is increasingly becoming one of the goals in the prevention and treatment of allergic diseases. AIT can be used to treat adolescents and adults with moderate to severe rhinitis and moderate asthma. In children, AIT can prevent further asthma symptoms in patients with rhinitis. AIT can significantly reduce the patient's symptoms, modify the disease process and improve the quality of life of allergic individuals. the therapeutic effect of AIT requires a three-year course of treatment. the therapeutic principle of AIT for allergic diseases is the induction of immune tolerance, which is related to the amount of specific IgE and IgA antibodies. Studies have shown that AIT modulates the balance of follicular helper T (TFH) cells and follicular regulatory T (TFR) cells in allergic patients, and that defective TFR cell numbers and function are associated with allergic rhinitis. In addition, AIT reduces the expression of CD23 on transformed memory B cells in AR patients, which positively correlates with the clinical efficacy of AIT in AR.
Fig.1 Basic principles of AIT.1
Effect of Drug Delivery Route on AIT Efficacy
In AIT, different routes of drug delivery exhibit different side effects and ultimate efficacy. Traditional AIT includes SCIT and SLIT. SCIT requires frequent medical treatment and multiple injections, and in some rare cases, life-threatening allergic reactions and adverse events may occur. Typical local reactions to SCIT are redness and swelling at the injection site, and more serious systemic reactions include sneezing, nasal congestion, and hives. Intralymphatic immunotherapy (ILIT) is another option for SCIT. This method involves intralymphatic administration since the lymph nodes contain large numbers of immune cells, so they come into direct contact with the allergen more quickly than in SCIT and produce both stronger protective IgG antibodies and immunomodulation. SLIT, in which the drug is placed under the tongue instead of being injected subcutaneously, is a particularly attractive alternative to AIT because of its relatively easy administration. Typical localized reactions to SLIT are mild swelling and itching of the lips, tongue, and throat. However, it shows outstanding therapeutic efficacy, with success rates exceeding 80% from the first year of treatment.
In conclusion, the current goal of improving AIT is to increase efficiency to shorten the duration of treatment, reduce side effects, improve patient compliance, and ultimately increase the utilization of this therapy. In addition, other therapies for the treatment of allergies are being improved and optimized, such as traditional pharmacological treatments for allergic diseases that are still in mainstream use and biologics for allergy treatment that have emerged in recent years. Experienced scientists at Creative Biolabs have built a professional non-IgG antibody research platform to provide non-IgG therapeutic antibodies services for allergic diseases therapy. If you have any related needs, please feel free to contact us for more information and a detailed quote.
Reference
- Komlósi, Zsolt István, et al. "Mechanisms of subcutaneous and sublingual aeroallergen immunotherapy: what is new?." Immunology and Allergy Clinics 40.1 (2020): 1-14
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