Allergen specific immunotherapy (AIT) is an effective treatment for of allergic diseases. However, due to the fear of side effects and the high expense, it is currently only used by less than ten percent of patients. Adjuvants can make AIT more effective with fewer side effects.
In a recent study, a team of scientists from the Department of Dermatology, University Hospital Zurich and University of Zurich, and the Allergy Center Wiesbaden (D) compared the early immune response to specific immunotherapies with three different adjuvants. They enrolled patients for sensitization to grass and birch pollen and a planned first subcutaneous AIT session and administered aluminum hydroxide (Alum, n=8), microcrystalline tyrosine (MCT, n=6), or MCT and monophosphoryl lipid A (MCT-MPLA, n=8). At baseline and on days 1 and 7 after AIT, the investigator conducted a patient survey by questionnaire with analysis. Blood was drawn for analysis of leukocytes, IL-6, CRP, ASAT, ALAT, and GGT, IgG, IgE, and tryptase at baseline and days 1, 7, and 42 after AIT.
No strong side effects
The course of the concentrations of leukocytes, CRP, IL-6, ASAT, ALAT, and GGT at day 0, 1, and 7 showed no significant difference in the change of concentrations among the three AIT groups (p>0.05). Adverse reactions within the first 24 hours were local reactions in all groups; overall, there were more abnormalities in the MCT-MPLA arm (mainly swelling, redness, pain). However, all adjuvants showed a good safety profile, laboratory chemical changes were comparatively low in all groups, and there were never severe systemic side effects. Additional serological tests will follow in the future to detect early changes in secreted cytokines and allergen-specific IgM antibodies.
Take-Home Messages
- AIT is effective against allergic diseases, but is used <10% of patients.
- Adjuvants can make AIT more effective.
- All adjuvants have a good safety profile.
- There were no severe systemic side effects.
Source: German Allergy Congress, Wiesbaden (D)
Literature:
- Müller A, Leuthard D, Nordmann T, et al: Comparison of the early immune response to specific immunotherapies with three different adjuvants. German Allergy Congress 2020, P4.04
InFo PNEUMOLOGY & ALLERGOLOGY 2020; 2(4): 23 (published 12/4/20, ahead of print).
DERMATOLOGY PRACTICE 2021; 31(1): 23
