Molecular approaches to allergen-specific immunotherapy: Are we so far from clinical implementation?

Clin Exp Allergy. 2020 May;50(5):543-557. doi: 10.1111/cea.13588. Epub 2020 Mar 9.

Abstract

Conventional allergen-specific immunotherapy (AIT), based on administrations of allergen extracts, represents up to now the unique protocol for the desensitization of allergic patients. Whereas the effectiveness of AIT was evidenced for the treatment of allergic rhinitis and allergic asthma, such strategy remains experimental for food allergies up to now. However, important issues are commonly associated with AIT as the quality of natural allergen extracts, the long duration and adverse side-effects which negatively affect successful desensitization together with the patient compliance. The rapid progression of molecular allergology made possible the quest of safer, shorter and more effective immunotherapeutic approaches. The aim of this review was to provide an update on these different innovative recombinant derivatives including their efficacy but also their limitations. Despite promising preclinical and early clinical studies, the absence of convincing data in large phase III trials precludes so far the translation of these immunotherapeutic candidates into the clinic.

Keywords: Treg; allergen-specific immunotherapy; blocking antibodies; clinical trial; efficacy; hypoallergenic; recombinant derivatives; safety.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Allergens / immunology
  • Allergens / therapeutic use*
  • Asthma / immunology
  • Asthma / pathology
  • Asthma / therapy*
  • Desensitization, Immunologic*
  • Food Hypersensitivity / immunology
  • Food Hypersensitivity / pathology
  • Food Hypersensitivity / therapy*
  • Humans
  • Rhinitis, Allergic / immunology
  • Rhinitis, Allergic / pathology
  • Rhinitis, Allergic / therapy*

Substances

  • Allergens