Current advances in house dust mite allergen immunotherapy (AIT): Routes of administration, biomarkers and molecular allergen profiling

Allergy to house dust mites (HDM) is a perennial respiratory disease that affect more than half a billion people worldwide. Dermatophagoides pteronyssinus and D. farinae, two HDM species, are major sources of indoor allergens triggering allergic inflammation. Although symptomatic drugs are widely us...

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Published inMolecular immunology Vol. 155; pp. 124 - 134
Main Authors Batard, Thierry, Canonica, Walter G., Pfaar, Oliver, Shamji, Mohamed H., O’Hehir, Robyn E., van Zelm, Menno C., Mascarell, Laurent
Format Journal Article
LanguageEnglish
Published England Elsevier Ltd 01.03.2023
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Abstract Allergy to house dust mites (HDM) is a perennial respiratory disease that affect more than half a billion people worldwide. Dermatophagoides pteronyssinus and D. farinae, two HDM species, are major sources of indoor allergens triggering allergic inflammation. Although symptomatic drugs are widely used to block the allergic reaction, allergen immunotherapy is the only curative treatment of IgE-mediated type I respiratory allergies. In this article, we review recent advances in various routes of allergen immunotherapy. We particularly focus on subcutaneous (SCIT) and sublingual (SLIT) immunotherapy, used as a reference therapy since they have transformed allergic treatments by improving symptoms (asthma and rhinitis) as well as the quality of life of patients. We also highlight recent data in more exploratory routes (i.e., oral, intralymphatic, epicutaneous and intradermal) and discuss respective advantages of various route, as well as their foreseen modes of action. Finally, we provide an update on biomarkers as well as on the relevance of the molecular profiling of allergic individuals related to treatment efficacy or asthma prediction. •SCIT and SLIT are efficacious in HDM-induced allergic rhinitis (> 5 years) and SLIT in mild to moderate asthma (> 18 years).•Other promising AIT routes and allergen presentation platforms (adjuvants or delivery systems) need to be further explored.•Innate and adaptive immune candidate biomarkers related to regulatory and type-2 responses have been identified during AIT.•Evaluating HDM-specific IgE, IgG2 and IgG4 in serum could help in the decision to continue and/or adapt AIT.•Molecular profile of IgE sensitization should help to establish the risk of asthma and to foster personalized medicine.
AbstractList Allergy to house dust mites (HDM) is a perennial respiratory disease that affect more than half a billion people worldwide. Dermatophagoides pteronyssinus and D. farinae, two HDM species, are major sources of indoor allergens triggering allergic inflammation. Although symptomatic drugs are widely used to block the allergic reaction, allergen immunotherapy is the only curative treatment of IgE-mediated type I respiratory allergies. In this article, we review recent advances in various routes of allergen immunotherapy. We particularly focus on subcutaneous (SCIT) and sublingual (SLIT) immunotherapy, used as a reference therapy since they have transformed allergic treatments by improving symptoms (asthma and rhinitis) as well as the quality of life of patients. We also highlight recent data in more exploratory routes (i.e., oral, intralymphatic, epicutaneous and intradermal) and discuss respective advantages of various route, as well as their foreseen modes of action. Finally, we provide an update on biomarkers as well as on the relevance of the molecular profiling of allergic individuals related to treatment efficacy or asthma prediction.
Allergy to house dust mites (HDM) is a perennial respiratory disease that affect more than half a billion people worldwide. Dermatophagoides pteronyssinus and D. farinae, two HDM species, are major sources of indoor allergens triggering allergic inflammation. Although symptomatic drugs are widely used to block the allergic reaction, allergen immunotherapy is the only curative treatment of IgE-mediated type I respiratory allergies. In this article, we review recent advances in various routes of allergen immunotherapy. We particularly focus on subcutaneous (SCIT) and sublingual (SLIT) immunotherapy, used as a reference therapy since they have transformed allergic treatments by improving symptoms (asthma and rhinitis) as well as the quality of life of patients. We also highlight recent data in more exploratory routes (i.e., oral, intralymphatic, epicutaneous and intradermal) and discuss respective advantages of various route, as well as their foreseen modes of action. Finally, we provide an update on biomarkers as well as on the relevance of the molecular profiling of allergic individuals related to treatment efficacy or asthma prediction. •SCIT and SLIT are efficacious in HDM-induced allergic rhinitis (> 5 years) and SLIT in mild to moderate asthma (> 18 years).•Other promising AIT routes and allergen presentation platforms (adjuvants or delivery systems) need to be further explored.•Innate and adaptive immune candidate biomarkers related to regulatory and type-2 responses have been identified during AIT.•Evaluating HDM-specific IgE, IgG2 and IgG4 in serum could help in the decision to continue and/or adapt AIT.•Molecular profile of IgE sensitization should help to establish the risk of asthma and to foster personalized medicine.
Author Canonica, Walter G.
Shamji, Mohamed H.
Batard, Thierry
van Zelm, Menno C.
Mascarell, Laurent
Pfaar, Oliver
O’Hehir, Robyn E.
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  surname: Mascarell
  fullname: Mascarell, Laurent
  email: laurent.mascarell@stallergenesgreer.com
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/36806944$$D View this record in MEDLINE/PubMed
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Keywords ILC
TU
TRMS
VAS
HDM
SCIT
AASS
SLIT
TE/RAE
AE
Administration routes
IR
House dust mite
AIT
ILIT
DBPC
T(C)RS
BAU
EPIT
Biomarkers
ICS
FEV1
Allergen immunotherapy
TDIT
Molecular reactivity profiling
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Snippet Allergy to house dust mites (HDM) is a perennial respiratory disease that affect more than half a billion people worldwide. Dermatophagoides pteronyssinus and...
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SubjectTerms Administration routes
Allergen immunotherapy
Allergens
Animals
Antigens, Dermatophagoides - therapeutic use
Asthma - drug therapy
Biomarkers
Desensitization, Immunologic
House dust mite
Humans
Hypersensitivity - drug therapy
Molecular reactivity profiling
Pyroglyphidae
Quality of Life
Rhinitis, Allergic - drug therapy
Title Current advances in house dust mite allergen immunotherapy (AIT): Routes of administration, biomarkers and molecular allergen profiling
URI https://dx.doi.org/10.1016/j.molimm.2023.02.004
https://www.ncbi.nlm.nih.gov/pubmed/36806944
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