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State‐of‐the‐art in marketed adjuvants and formulations in Allergen Immunotherapy: A position paper of the European Academy of Allergy and Clinical Immunology (EAACI)
- Source :
- Allergy (2019). doi:10.1111/all.14134, info:cnr-pdr/source/autori:Jensen-Jarolim E1, Bachmann M2, Bonini S3, Jacobsen L4, Jutel M5,6, Klimek L7, Mahler V8, Mösges R9, Moingeon P10, O Hehir RE11, Palomares O12, Pfaar O13, Renz H14, Rhyner C15, Roth-Walter F16, Rudenko M17, Savolainen J18, Schmidt-Weber C19, Traidl-Hoffmann C20, Kündig T21./titolo:State-of-the-art in marketed adjuvants and formulations in Allergen Immunotherapy: a position paper of the European Academy of Allergy and Clinical Immunology (EAACI)/doi:10.1111%2Fall.14134/rivista:Allergy/anno:2019/pagina_da:/pagina_a:/intervallo_pagine:/volume, Allergy 75, 746-760 (2020)
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Since the introduction of allergen immunotherapy (AIT) over 100 years ago, focus has been on standardization of allergen extracts, with reliable molecular composition of allergens receiving the highest attention. While adjuvants play a major role in European AIT, they have been less well studied. In this Position Paper, we summarize current unmet needs of adjuvants in AIT citing current evidence. Four adjuvants are used in products marketed in Europe: aluminium hydroxide (Al(OH)(3)) is the most frequently used adjuvant, with microcrystalline tyrosine (MCT), monophosphoryl lipid A (MPLA) and calcium phosphate (CaP) used less frequently. Recent studies on humans, and using mouse models, have characterized in part the mechanisms of action of adjuvants on pre-existing immune responses. AIT differs from prophylactic vaccines that provoke immunity to infectious agents, as in allergy the patient is presensitized to the antigen. The intended mode of action of adjuvants is to simultaneously enhance the immunogenicity of the allergen, while precipitating the allergen at the injection site to reduce the risk of anaphylaxis. Contrasting immune effects are seen with different adjuvants. Aluminium hydroxide initially boosts Th2 responses, while the other adjuvants utilized in AIT redirect the Th2 immune response towards Th1 immunity. After varying lengths of time, each of the adjuvants supports tolerance. Further studies of the mechanisms of action of adjuvants may advise shorter treatment periods than the current three-to-five-year regimens, enhancing patient adherence. Improved lead compounds from the adjuvant pipeline are under development and are explored for their capacity to fill this unmet need.
- Subjects :
- Allergen immunotherapy
Allergy
medicine.medical_treatment
Immunology
Monophosphoryl Lipid A
610 Medicine & health
Adjuvants
allergen immunotherapy
aluminium
microcrystalline tyrosine
monophosphoryl-lipid A (MPLA)
medicine.disease_cause
03 medical and health sciences
0302 clinical medicine
Allergen
Immune system
Adjuvants, Immunologic
10183 Swiss Institute of Allergy and Asthma Research
Immunity
Hypersensitivity
medicine
Humans
Immunology and Allergy
Allergen Immunotherapy
Aluminium
Microcrystalline Tyrosine
Monophosphoryl Lipid A (mpla)
ddc:610
2403 Immunology
business.industry
Immunogenicity
10177 Dermatology Clinic
Allergens
medicine.disease
Europe
030228 respiratory system
Desensitization, Immunologic
2723 Immunology and Allergy
business
Adjuvant
030215 immunology
Subjects
Details
- ISSN :
- 13989995 and 01054538
- Volume :
- 75
- Database :
- OpenAIRE
- Journal :
- Allergy
- Accession number :
- edsair.doi.dedup.....47d8a0d03f6d2e945d42f3422a40a00d