Asia Pac Allergy.  2018 Apr;8(2):e14. 10.5415/apallergy.2018.8.e14.

Novel strategies in immunotherapy for allergic diseases

Affiliations
  • 1Khoo Teck Puat – National University Children's Medical Institute, National University Health System, Singapore 119229. mohana_rajakulendran@nuhs.edu.sg
  • 2Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119229.

Abstract

Conventional immunotherapy (IT) for optimal control of respiratory and food allergies has been fraught with concerns of efficacy, safety, and tolerability. The development of adjuvants to conventional IT has potentially increased the effectiveness and safety of allergen IT, which may translate into improved clinical outcomes and sustained unresponsiveness even after cessation of therapy. Novel strategies incorporating the successful use of adjuvants such as allergoids, immunostimulatory DNA sequences, monoclonal antibodies, carriers, recombinant proteins, and probiotics have now been described in clinical and murine studies. Future approaches may include fungal compounds, parasitic molecules, vitamin D, and traditional Chinese herbs. More robust comparative clinical trials are needed to evaluate the safety, clinical efficacy, and cost effectiveness of various adjuvants in order to determine ideal candidates in disease-specific and allergen-specific models. Other suggested approaches to further optimize outcomes of IT include early introduction of IT during an optimal window period. Alternative routes of administration of IT to optimize delivery and yet minimize potential side effects require further evaluation for safety and efficacy before they can be recommended.

Keyword

Immunotherapy; Allergy immunology; Allergoid; Immunologic stimulation; Monoclonal antibody; Probiotics

MeSH Terms

Antibodies, Monoclonal
Asian Continental Ancestry Group
Base Sequence
Cost-Benefit Analysis
Food Hypersensitivity
Humans
Immunization
Immunotherapy*
Probiotics
Recombinant Proteins
Treatment Outcome
Vitamin D
Antibodies, Monoclonal
Recombinant Proteins
Vitamin D
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