BOOK
Aeroallergen and Food Immunotherapy, An Issue of Immunology and Allergy Clinics of North America, E-Book
Linda S. Cox | Anna H. Nowak-Wegrzyn
(2016)
Additional Information
Book Details
Abstract
This issue of Immunology and Allergy Clinics, guest edited by Drs. Linda S. Cox and Anna H. Nowak-Wegrzyn, is devoted to Aeroallergen and Food Immunotherapy. Articles in this issue include History of AIT and the future direction of CRD/molecular allergy; Mechanisms of aeroallergen allergen immunotherapy: SCIT and SLIT; Mechanisms underlying induction of tolerance to foods; Biomarkers for allergen immunotherapy; SCIT and SLIT; Novel delivery routes for allergy immunotherapy; Oral immunotherapy for food allergy; SLIT and EPIT for food allergy; The use of adjuvants for enhancing allergen immunotherapy efficacy; Allergen immunotherapy vaccine modification; Allergen immunotherapy outcome assessment in clinical trials and real life; Component resolved diagnosis: can it make specific AIT more specific?; Baked milk and egg diets for milk and egg allergy management; and Allergen immunotherapy practical considerations: adherence and strategies to improve.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Aeroallergen and FoodImmunotherapy\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: Allergen Immunotherapy—An Old Friend Coming of Age\r | vii | ||
| Preface: Allergen-specific Immunotherapy—Turning the Tables on the Immune System\r | vii | ||
| Allergen Immunotherapy: History and Future Developments\r | vii | ||
| Subcutaneous Immunotherapy and Sublingual Immunotherapy: Comparative\rEfficacy, Current and Potential Indications, and Warnings—United States Versus\rEurope\r | vii | ||
| Novel Delivery Routes for Allergy Immunotherapy: Intralymphatic, Epicutaneous, and Intradermal \r | vii | ||
| Advances in the Treatment of Food Allergy: Sublingual and Epicutaneous Immunotherapy\r | viii | ||
| Oral Immunotherapy for Food Allergy\r | viii | ||
| Mechanisms of Aeroallergen Immunotherapy: Subcutaneous Immunotherapy and Sublingual Immunotherapy\r | viii | ||
| Mechanisms Underlying Induction of Tolerance to Foods\r | ix | ||
| Allergen Immunotherapy: Vaccine Modification\r | ix | ||
| The Use of Adjuvants for Enhancing Allergen Immunotherapy Efficacy\r | ix | ||
| Baked Milk and Egg Diets for Milk and Egg Allergy Management\r | ix | ||
| Biomarkers for Allergen Immunotherapy: A “Panoromic” View\r | x | ||
| Allergen Immunotherapy Outcomes and Unmet Needs: A Critical Review\r | x | ||
| Allergy Work-Up Including Component-Resolved Diagnosis: How to Make Allergen-Specific Immunotherapy More Specific\r | x | ||
| Solving the Problem of Nonadherence to Immunotherapy\r | x | ||
| IMMUNOLOGYAND ALLERGY\rCLINICS OF NORTH AMERICA\r | xii | ||
| FORTHCOMING ISSUES | xii | ||
| RECENT ISSUES | xii | ||
| Foreword: Allergen Immunotherapy—An Old Friend Coming of Age \r | xiii | ||
| Preface: Allergen-specific Immunotherapy—Turning the Tables on the Immune System \r | xv | ||
| REFERENCES | xviii | ||
| Allergen Immunotherapy | 1 | ||
| Key points | 1 | ||
| THE HISTORICAL PERSPECTIVE | 1 | ||
| THE PRESENT SITUATION | 3 | ||
| Practical Aspects | 3 | ||
| The Role of Molecular Diagnosis | 5 | ||
| Regulatory Aspects | 5 | ||
| THE NEAR FUTURE: PERSPECTIVES | 6 | ||
| UNMET NEEDS AND CONCLUDING REMARKS | 7 | ||
| REFERENCES | 8 | ||
| Subcutaneous Immunotherapy and Sublingual Immunotherapy | 13 | ||
| Key points | 13 | ||
| INTRODUCTION | 14 | ||
| CLINICAL EFFICACY | 15 | ||
| THE IMMUNOLOGIC RESPONSE | 16 | ||
| DISEASE MODIFICATION | 16 | ||
| DEFINED OPTIMAL DOSES | 17 | ||
| MULTIALLERGEN ALLERGY IMMUNOTHERAPY | 17 | ||
| SAFETY | 18 | ||
| Local Reactions | 18 | ||
| Systemic Reactions | 18 | ||
| COMPARATIVE EFFICACY OF SUBCUTANEOUS IMMUNOTHERAPY AND SUBLINGUAL IMMUNOTHERAPY | 18 | ||
| WARNINGS | 20 | ||
| REFERENCES | 20 | ||
| Novel Delivery Routes for Allergy Immunotherapy | 25 | ||
| Key points | 25 | ||
| INTRODUCTION | 25 | ||
| Measures to Reduce the Number of Allergen Administrations in Allergy Immunotherapy | 26 | ||
| Measures to Improve Allergy Immunotherapy Safety | 26 | ||
| INTRALYMPHATIC ALLERGEN-SPECIFIC IMMUNOTHERAPY | 26 | ||
| Time Interval Between Injections in Intralymphatic Immunotherapy | 27 | ||
| ALLERGEN-SPECIFIC EPICUTANEOUS IMMUNOTHERAPY | 28 | ||
| History of Epicutaneous Immunotherapy in Allergy | 28 | ||
| Epicutaneous Immunotherapy with Aeroallergens | 29 | ||
| Epicutaneous Immunotherapy with Food Allergens | 30 | ||
| Methods for Enhancing Penetration | 30 | ||
| Adjuvants in Epicutaneous Immunotherapy | 31 | ||
| Outlook for Allergen Epicutaneous Immunotherapy in Humans | 31 | ||
| INTRADERMAL ALLERGEN IMMUNOTHERAPY | 32 | ||
| SUMMARY AND FUTURE DIRECTIONS | 32 | ||
| REFERENCES | 32 | ||
| Advances in the Treatment of Food Allergy | 39 | ||
| Key points | 39 | ||
| INTRODUCTION | 39 | ||
| SUBLINGUAL IMMUNOTHERAPY | 40 | ||
| Kiwi | 41 | ||
| Hazelnut | 41 | ||
| Milk | 41 | ||
| Peach | 41 | ||
| Peanut | 45 | ||
| SUBLINGUAL IMMUNOTHERAPY VERSUS ORAL IMMUNOTHERAPY | 45 | ||
| Safety | 46 | ||
| Immune Mechanisms | 47 | ||
| EPICUTANEOUS IMMUNOTHERAPY | 47 | ||
| Milk | 48 | ||
| Peanut | 48 | ||
| Safety | 49 | ||
| Immune Mechanisms | 50 | ||
| SUMMARY | 50 | ||
| REFERENCES | 51 | ||
| Oral Immunotherapy for Food Allergy | 55 | ||
| Key points | 55 | ||
| INTRODUCTION | 55 | ||
| WHAT IS ORAL IMMUNOTHERAPY? | 56 | ||
| EFFICACY OF ORAL IMMUNOTHERAPY | 56 | ||
| SUMMARY OF CLINICAL TRIALS | 57 | ||
| Peanut Oral Immunotherapy | 57 | ||
| Egg Oral Immunotherapy | 58 | ||
| Milk Oral Immunotherapy | 60 | ||
| MULTIPLE FOODS | 63 | ||
| IMMUNOLOGIC CHANGES WITH ORAL IMMUNOTHERAPY | 63 | ||
| SAFETY OF ORAL IMMUNOTHERAPY | 63 | ||
| ADJUNCTIVE THERAPIES | 64 | ||
| LIMITATIONS | 65 | ||
| FUTURE CONSIDERATIONS/SUMMARY | 65 | ||
| REFERENCES | 65 | ||
| Mechanisms of Aeroallergen Immunotherapy | 71 | ||
| Key points | 71 | ||
| INTRODUCTION | 72 | ||
| ALLERGIC IMMUNE RESPONSE | 72 | ||
| ANTIGEN PRESENTATION, CELLULAR INTERACTIONS, AND ANTIBODY RESPONSES IN ALLERGIC IMMUNE RESPONSE | 72 | ||
| IMMUNE TOLERANCE TO ALLERGENS IN HEALTHY IMMUNE RESPONSE | 74 | ||
| REGULATORY CELLS OF THE IMMUNE SYSTEM | 75 | ||
| MECHANISMS OF ALLERGEN-SPECIFIC IMMUNOTHERAPY | 76 | ||
| INNATE IMMUNE RESPONSES IN SUBLINGUAL IMMUNOTHERAPY AND SUBCUTANEOUS IMMUNOTHERAPY | 77 | ||
| INFLUENCE OF SUBLINGUAL IMMUNOTHERAPY AND SUBCUTANEOUS IMMUNOTHERAPY ON T-CELL RESPONSES | 78 | ||
| INFLUENCE OF SUBLINGUAL IMMUNOTHERAPY AND SUBCUTANEOUS IMMUNOTHERAPY ON ANTIBODY RESPONSES | 79 | ||
| INFLUENCE OF SUBLINGUAL IMMUNOTHERAPY AND SUBCUTANEOUS IMMUNOTHERAPY ON EFFECTOR CELLS | 79 | ||
| SUMMARY | 80 | ||
| REFERENCES | 80 | ||
| Mechanisms Underlying Induction of Tolerance to Foods | 87 | ||
| Key points | 87 | ||
| IMMUNE MECHANISMS OF ORAL TOLERANCE | 87 | ||
| Role of Regulatory T Cells | 88 | ||
| Site of Initiation of Tolerance | 88 | ||
| Role of Gastrointestinal Dendritic Cell Subsets | 89 | ||
| Unique Regulatory Milieu of the Gastrointestinal Tract | 89 | ||
| Role of the Commensal Microbiota in Oral Tolerance to Foods | 90 | ||
| Impaired Regulatory Responses and Food Allergy | 90 | ||
| Therapeutic Oral Tolerance for Food Allergy | 91 | ||
| EVIDENCE OF ORAL TOLERANCE IN HUMANS | 92 | ||
| B-Cell Response to Dietary Antigens in Healthy Versus Allergic Individuals | 93 | ||
| T-Cell Response to Dietary Antigens in Healthy Versus Allergic Individuals | 95 | ||
| Responses to Diet Allergens During Immunotherapy | 96 | ||
| SUMMARY | 98 | ||
| REFERENCES | 98 | ||
| Allergen Immunotherapy | 103 | ||
| Key points | 103 | ||
| OVERVIEW | 103 | ||
| MODIFIED ALLERGEN APPROACHES | 104 | ||
| Background | 104 | ||
| Immunostimulatory Adjuvants | 105 | ||
| CpG oligonucleotide conjugated to ragweed Amb a 1 | 105 | ||
| Monophosphoryl lipid A adjuvant | 107 | ||
| Nanoparticle-based immunomodulation with viral-like particles | 108 | ||
| Lysosomal-associated membrane protein | 109 | ||
| Synthetic Peptides | 110 | ||
| T-cell–tolerizing peptides | 110 | ||
| Synthetic peptide immunoregulatory epitopes | 110 | ||
| CAT–SYNTHETIC PEPTIDE IMMUNOREGULATORY EPITOPES | 110 | ||
| Cat–Synthetic Peptide Immunoregulatory Epitopes Clinical Studies | 111 | ||
| Phase 1/2a safety and efficacy trial | 111 | ||
| Phase 2b environmental chamber study | 111 | ||
| Phase 2b Cat–synthetic peptide immunoregulatory epitopes clinical trial: 2-year environmental exposure chamber follow-up | 114 | ||
| Other Peptide Constructs | 115 | ||
| Summary | 115 | ||
| OVERLAPPING PEPTIDES | 115 | ||
| Intralymphatic Immunotherapy | 116 | ||
| Epicutaneous Immunotherapy | 117 | ||
| Recombinant Vaccines | 117 | ||
| SUMMARY | 118 | ||
| REFERENCES | 118 | ||
| The Use of Adjuvants for Enhancing Allergen Immunotherapy Efficacy | 125 | ||
| Key points | 125 | ||
| INTRODUCTION | 125 | ||
| IMMUNOLOGIC MECHANISMS OF SUCCESSFUL ALLERGEN-SPECIFIC IMMUNOTHERAPY | 127 | ||
| Rapid Treatment Response | 128 | ||
| Intermediate Treatment Response | 128 | ||
| Late Treatment Response | 129 | ||
| ADJUVANTS AS MEANS TO OVERCOME LIMITATIONS OF ALLERGEN-SPECIFIC IMMUNOTHERAPY | 129 | ||
| CURRENT ADJUVANTS AND THEIR EFFECTS ON ALLERGEN-SPECIFIC IMMUNOTHERAPY | 129 | ||
| Immunopotentiators | 132 | ||
| Aluminium-based adjuvants | 132 | ||
| Toll-like receptor agonists | 132 | ||
| Probiotics | 134 | ||
| Attenuated mycobacteria, bacterial products | 134 | ||
| Vitamin D | 135 | ||
| Nanoparticle Delivery Systems | 135 | ||
| Liposomes | 135 | ||
| Viruslike particles | 136 | ||
| Immunostimulating complex | 136 | ||
| Polymeric nanoparticles | 136 | ||
| SUMMARY AND FUTURE OUTCOMES | 137 | ||
| REFERENCES | 139 | ||
| Baked Milk and Egg Diets for Milk and Egg Allergy Management | 147 | ||
| Key points | 147 | ||
| INTRODUCTION | 147 | ||
| PREVALENCE OF BAKED MILK AND EGG TOLERANCE | 148 | ||
| FOOD PROCESSING | 148 | ||
| PREDICTIVE BIOMARKERS | 153 | ||
| INFLUENCE ON REGULAR COW’S MILK AND EGG TOLERANCE | 155 | ||
| SAFETY | 155 | ||
| DIETARY GUIDELINES | 156 | ||
| SUMMARY | 157 | ||
| REFERENCES | 157 | ||
| Biomarkers for Allergen Immunotherapy | 161 | ||
| Key points | 161 | ||
| INTRODUCTION | 161 | ||
| THE IDEAL BIOMARKER | 162 | ||
| OPPORTUNITIES FOR THE IDENTIFICATION OF BIOMARKERS FOR ALLERGEN IMMUNOTHERAPY | 164 | ||
| A Better Understanding of Allergic Diseases | 164 | ||
| A Better Understanding of Allergen Immunotherapy Mechanisms | 164 | ||
| Harnessing the Power of Omics Technologies | 165 | ||
| CHALLENGES FOR THE IDENTIFICATION OF BIOMARKERS FOR ALLERGEN IMMUNOTHERAPY | 165 | ||
| Heterogeneity of Allergic Diseases | 165 | ||
| Clinical Development Issues | 165 | ||
| Handling of Biological Samples | 166 | ||
| Big Data Management | 166 | ||
| Regulatory Issues | 166 | ||
| DIAGNOSTIC BIOMARKERS IN SUPPORT OF ALLERGEN IMMUNOTHERAPY | 167 | ||
| PREDICTIVE BIOMARKERS OF ALLERGEN IMMUNOTHERAPY EFFICACY | 167 | ||
| FOLLOW-UP BIOMARKERS OF ALLERGEN IMMUNOTHERAPY EFFICACY | 170 | ||
| Changes in the Polarization of Allergen-Specific CD4+ T Cells | 170 | ||
| Changes in Allergen-Specific Antibody Responses | 171 | ||
| Changes at the Level of the Innate Immune System | 171 | ||
| BIOMARKERS FOR ALLERGEN IMMUNOTHERAPY SAFETY | 172 | ||
| FUTURE CONSIDERATIONS | 173 | ||
| Characterization of Patients’ Microbiota | 173 | ||
| New Players in the Regulation of Allergen-Specific Immune Responses | 173 | ||
| REFERENCES | 174 | ||
| Allergen Immunotherapy Outcomes and Unmet Needs | 181 | ||
| Key points | 181 | ||
| INTRODUCTION | 181 | ||
| PRIMARY OUTCOMES | 182 | ||
| SECONDARY OUTCOMES | 184 | ||
| COST-EFFECTIVENESS OF ALLERGEN IMMUNOTHERAPY | 184 | ||
| UNMET NEEDS | 185 | ||
| SUMMARY | 186 | ||
| DISCLOSURE | 187 | ||
| REFERENCES | 187 | ||
| Allergy Work-Up Including Component-Resolved Diagnosis | 191 | ||
| Key points | 191 | ||
| INTRODUCTION | 192 | ||
| CLINICAL INFORMATION WHEN ALLERGY IS SUSPECTED | 192 | ||
| PRINCIPLES FOR THE DEMONSTRATION OF IMMUNOGLOBULIN E SENSITIZATION | 194 | ||
| Skin Prick Test Reagents Are Considered Drugs in European Law | 194 | ||
| Serologic Immunoglobulin E Diagnostics with Aeroallergens | 194 | ||
| Basophil Activation Test for Sera with Extremely Low Total Immunoglobulin E Levels | 195 | ||
| Concordance and Interpretation of Sensitization Tests | 195 | ||
| ALLERGEN SOURCES FOR DEMONSTRATING SENSITIZATION BEFORE ALLERGEN-SPECIFIC IMMUNOTHERAPY | 195 | ||
| DIAGNOSTIC HURDLES AS A RESULT OF MULTISENSITIZATION TO UNRELATED POLLEN SPECIES | 196 | ||
| Sensitization to Pollen Pan-allergens | 196 | ||
| Diagnostic Approach in the Case of Pollen Pan-allergen Sensitization | 196 | ||
| The Evolution of the Immunoglobulin E Response to Grass Pollen and its Impact on Allergen-Specific Immunotherapy | 197 | ||
| Clinical Consequences of Pollen Pan-allergen Sensitizations | 199 | ||
| INTERPRETATION OF SENSITIZATION TESTS | 199 | ||
| CHALLENGE TESTS IN THE CASE OF UNRESOLVED CLINICAL RELEVANCE | 199 | ||
| SUMMARY | 201 | ||
| REFERENCES | 202 | ||
| Solving the Problem of Nonadherence to Immunotherapy | 205 | ||
| Key points | 205 | ||
| INTRODUCTION | 205 | ||
| ADHERENCE TO ALLERGEN IMMUNOTHERAPY | 206 | ||
| COST VERSUS BENEFIT | 207 | ||
| IDENTIFYING PATIENTS LIKELY TO BE NONADHERENT | 208 | ||
| COMMUNICATION STRATEGIES TO MAXIMIZE ADHERENCE TO ALLERGEN IMMUNOTHERAPY | 209 | ||
| Patient-Centered Care | 209 | ||
| Motivational Interviewing | 209 | ||
| Shared Decision Making | 210 | ||
| SUMMARY AND FUTURE CONSIDERATIONS | 210 | ||
| REFERENCES | 211 |