Inflammation Research

, Volume 58, Issue 9, pp 523–536 | Cite as

Current immunological approaches for management of allergic rhinitis and bronchial asthma

  • Deepsikha Srivastava
  • Naveen Arora
  • Bhanu Pratap Singh
Review

Abstract

A large population world over is affected with allergic diseases and asthma. Pharmacotherapy for allergic diseases and asthma is effective in controlling symptoms but on discontinuation of medication, symptoms reoccur. In contrast, immunotherapy modifies and corrects the underlying pathological immune responses in an antigen-specific manner. Immunotherapy shows an increase in IgG (blocking antibody) that competes with IgE for allergen, inhibiting the release of inflammatory mediators. Recent studies suggest that immunotherapy acts by modifying CD4+ T-cell responses either by immune deviation, T-cell anergy and/or both. Current immunological approaches for management of allergies and asthma involve immunization with native allergen, modified allergen, peptides/cDNA of allergen, anti-IgE, adjuvants coupled allergen, including immunostimulatory DNA sequences, cytokines, and bacterial products. These approaches modulate the immune response and are intended to give long-term benefit.

Keywords

Specific immunotherapy Rhinitis Asthma Allergen IgE IgG THTHCD4+ T-cell anergy 

References

  1. 1.
    Akdis M, Verhagen J, Taylor A, et al. Immune responses in healthy and allergic individuals are characterized by a fine balance between allergen-specific T regulatory 1 and T helper 2 cells. J Exp Med. 2004;199:1567–75.PubMedCrossRefGoogle Scholar
  2. 2.
    Galli SJ, Tsai M, Piliponsky AM. The development of allergic inflammation. Nature. 2008;454:445–54.PubMedCrossRefGoogle Scholar
  3. 3.
    Lund R, Ahlfors H, Kainonen E, Lahesmaa AM, Dixon C, Lahesmaa R. Identification of genes involved in the initiation of human Th1 or Th2 cell commitment. Eur J Immunol. 2005;35:3307–19.PubMedCrossRefGoogle Scholar
  4. 4.
    Dong C, Flavell RA. TH1 and TH2 cells. Curr Opin Hematol. 2001;8:47–51.PubMedCrossRefGoogle Scholar
  5. 5.
    Tavakkol Afshari J, Farid Hosseini R, Hosseini Farahabadi S, et al. Association of the expression of IL-4 and IL-13 genes, IL-4 and IgE serum levels with allergic asthma. Iran J Allergy Asthma Immunol. 2007;6:67–72.PubMedGoogle Scholar
  6. 6.
    Salib RJ, Drake-Lee A, Howarth PH. Allergic rhinitis: past, present and the future. Clin Otolaryngol Allied Sci. 2003;28:291–303.PubMedCrossRefGoogle Scholar
  7. 7.
    Gaur SN, Rajpal S, Rohatgi A. Prevalence of bronchial asthma and allergic rhinitis among school children in Delhi. Intern Med J Thai. 2004;20:8–13.Google Scholar
  8. 8.
    Chhabra SK, Gupta CK, Chhabra P, Rajpal S. Prevalence of bronchial asthma in schoolchildren in Delhi. J Asthma. 1998;35:291–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Vishwanathan R. Definition, incidence, etiology and natural history of asthma. Ind J Chest Dis. 1964;6:108–24.Google Scholar
  10. 10.
    Ariano R, Berto P, Tracci D, Incorvaia C, Frati F. Pharmacoeconomics of allergen immunotherapy compared with symptomatic drug treatment in patients with allergic rhinitis and asthma. Allergy Asthma Proc. 2006;27:159–63.PubMedGoogle Scholar
  11. 11.
    Chan-Yeung M, Dimich-Ward H, Becker A. Atopy in early life and effect of a primary prevention program for asthma in a high-risk cohort. J Allergy Clin Immunol. 2007;120:1221–3.PubMedCrossRefGoogle Scholar
  12. 12.
    Tonnel AB. Specific immunotherapy and therapeutic strategies in allergic diseases. What’s new? Bull Acad Natl Med. 2005;189:1475–87.PubMedGoogle Scholar
  13. 13.
    Moller C, Dreborg S, Ferdousi HA, et al. Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis. J Allergy Clin Immunol. 2002;109:251–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Adkinson NF Jr, Eggleston PA, Eney D, et al. A controlled trial of immunotherapy for asthma in allergic children. N Engl J Med. 1997;336:324–31.PubMedCrossRefGoogle Scholar
  15. 15.
    Dam Petersen K, Gyrd-Hansen D, Kjaergaard S, Dahl R. Clinical and patient based evaluation of immunotherapy for grass pollen and mite allergy. Allergol Immunopathol (Madr). 2005;33:264–9.CrossRefGoogle Scholar
  16. 16.
    Casimir G, Cuvelier P, Allard S, Duchateau J. Life-threatening fish allergy successfully treated with immunotherapy. Pediatr Allergy Immunol. 1997;8:103–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Gaur SN, Gupta S. Clinical response of immunotherapy in cases of nasobronchial allergy. Indian J Allergy Appl Immunol. 1996;10:65–8.Google Scholar
  18. 18.
    Karmakar PR, Das A, Chatterjee BP. Placebo-controlled immunotherapy with Cocos nucifera pollen extract. Int Arch Allergy Immunol. 1994;103:194–201.PubMedGoogle Scholar
  19. 19.
    Sheikh WA. Immunotherapy vs. inhaled budesonide in bronchial asthma: an open, parallel, comparative trial. Clin Exp Allergy. 1997;27:1279–84.CrossRefGoogle Scholar
  20. 20.
    Srivastava D, Singh BP, Sudha VT, Arora N, Gaur SN. Immunotherapy with mosquito (Culex quinquefasciatus) extract: a double-blind, placebo-controlled study. Ann Allergy Asthma Immunol. 2007;99:273–80.PubMedGoogle Scholar
  21. 21.
    Anonymus (2007) Clinico-immunologic studies on allergen specific immunotherapy in patients of respiratory allergy (2004–2007). Project report Department of Science and Technology, New Delhi.Google Scholar
  22. 22.
    Young-Min Y, Soo-Keol L, Seung-Hyun K, Dong-Ho N, Chang-Hee S, Hae-Sim P. Changes of serum cytokines after the long-term immunotherapy with Japanese Hop pollen extracts. J Korean Med Sci. 2006;21:805–10.CrossRefGoogle Scholar
  23. 23.
    Ohashi Y, Nakai Y, Tanaka A, et al. Ten-year follow-up study of allergen-specific immunoglobulin E and immunoglobulin G4, soluble interleukin-2 receptor, interleukin-4, soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1 in serum of patients on immunotherapy for perennial allergic rhinitis. Scand J Immunol. 1998;47:167–78.PubMedCrossRefGoogle Scholar
  24. 24.
    Pajno GB, Barberio G, De Luca F, Morabito L, Parmiani S. Prevention of new sensitizations in asthmatic children monosensitized to house dust mite by specific immunotherapy. A six-year follow-up study. Clin Exp Allergy. 2001;31:1392–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Marcucci F, Sensi L, Allocca G, et al. Sublingual immunotherapy: from safety to mechanism of action. Eur Ann Allergy Clin Immunol. 2007;39:101–3.PubMedGoogle Scholar
  26. 26.
    Di Gioacchino M, Perrone A, Petrarca C, et al. Early cytokine modulation after the rapid induction phase of sublingual immunotherapy with mite monomeric allergoids. Int J Immunopathol Pharmacol. 2008;21:969–76.PubMedGoogle Scholar
  27. 27.
    Savolainen J, Jacobsen L, Valovirta E. Sublingual immunotherapy in children modulates allergen-induced in vitro expression of cytokine mRNA in PBMC. Allergy. 2006;61:1184–90.PubMedCrossRefGoogle Scholar
  28. 28.
    Akdis CA, Barlan IB, Bahceciler N, Akdis M. Immunological mechanisms of sublingual immunotherapy. Allergy. 2006;S 81:11–4.CrossRefGoogle Scholar
  29. 29.
    Antunez C, Mayorga C, Corzo JL, Jurado A, Torres MJ. Two year follow-up of immunological response in mite-allergic children treated with sublingual immunotherapy. Comparison with subcutaneous administration. Pediatr Allergy Immunol. 2008;19:210–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Silvestri M, Spallarosa D, Battistini E, et al. Changes in inflammatory and clinical parameters and in bronchial hyperreactivity asthmatic children sensitized to house dust mites following sublingual immunotherapy. J Investig Allergol Clin Immunol. 2002;12:52–9.PubMedGoogle Scholar
  31. 31.
    Mortemousque B, Bertel F, De Casamayor J, Verin P, Colin J. House dust mite sublingual swallow immunotherapy in perennial conjunctivitis: a double blind placebo controlled study. Clin Exp Allergy. 2003;33:464–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Sun JB, Cuburu N, Blomquist M, Li BL, Czerkinsky C, Holmgren J. Sublingual tolerance induction with antigen conjugated to cholera toxin B subunit induces Foxp3+ CD25+ CD4+ regulatory T cells and suppresses delayed-type hypersensitivity reactions. Scand J Immunol. 2006;64:251–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Bagnasco M, Mariani G, Passalacqua G, et al. Absorption and distribution kinetics of the major Parietaria judaica allergen (Par j 1) administered by noninjectable routes in healthy human beings. J Allergy Clin Immunol. 1997;100:122–9.PubMedCrossRefGoogle Scholar
  34. 34.
    Moller C, Dreborg S, Lanner A, Bjorksten B. Oral immunotherapy of children with rhinoconjuctivitis due to birch pollen allergy. Allergy. 1986;41:271–7.PubMedCrossRefGoogle Scholar
  35. 35.
    Giovane A, Bardare M, Passalacqua G. A three year double blind placebo controlled study with oral immunotherapy to pediatric patients. Clin Exp Allergy. 1994;24:53–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Miller A, Lider O, Roberts AB, Sporn MB, Weiner HL. Suppressor T cells generated by oral tolerance to myelin basic protein suppress both in vitro and in vivo immune response by release of TGF β following antigen specific triggering. Proc Nal Acad Sci USA. 1992;89:421–5.CrossRefGoogle Scholar
  37. 37.
    Mosbech H, Dreberg S, Madsenn F. High dose grass pollen tablets used for hyposensitization in hay fever patients. A 1 year double blind placebo controlled study. Allergy. 1987;42:451–5.PubMedCrossRefGoogle Scholar
  38. 38.
    Litwin A, Flanazan M, Eritis G. Oral immunotherapy with short ragweed in a novel encapsulated preparation: a double blind study. J Allergy Clin Immunol. 1997;100:30–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Tari MG, Mancino M, Monti G. Immunotherapy by inhalation of allergen in powder in house dust allergic asthma: a double blind study. J Invest Allergol Clin Immunol. 1992;2:59–67.Google Scholar
  40. 40.
    Schumacher MJ, Pain MC. Intranasal immunotherapy with polymerized grass pollen allergens. Allergy. 1982;37:241–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Loveless MH. Immunological studies of pollinosis: I. The presence of two antibodies related to the same pollen antigen in the serum of treated hay-fever patients. J Immunol. 1940;38:25–50.Google Scholar
  42. 42.
    Pilette C, Nouri-Aria KT, Jacobson MR, et al. Grass pollen immunotherapy induces an allergen-specific IgA2 antibody response associated with mucosal TGF-β expression. J Immunol. 2007;178:4658–66.PubMedGoogle Scholar
  43. 43.
    Flicker S, Steinberger P, Norderhaug L, et al. Conversion of grass pollen allergen specific human IgE into a protective IgG1 antibody. Eur J Immunol. 2002;32:2156–62.PubMedCrossRefGoogle Scholar
  44. 44.
    Kawakami A, Koketsu R, Suzukawa M, et al. Blocking antibody is generated in allergic rhinitis patients during specific immunotherapy using standardized Japanese cedar pollen extract. Int Arch Allergy Immunol. 2008;146(S1):54–60.PubMedCrossRefGoogle Scholar
  45. 45.
    Rabinovitch N, Gelfand EW. Expression of functional activating and inhibitory Fcgamma receptors on human B cells. Int Arch Allergy Immunol. 2004;133:285–94.PubMedCrossRefGoogle Scholar
  46. 46.
    Larche M, Akdis CA, Valenta R. Immunological mechanisms of allergen-specific immunotherapy. Nat Rev Immunol. 2006;6:761–71.PubMedCrossRefGoogle Scholar
  47. 47.
    Wachholz PA, Soni NK, Till SJ, Durham SR. Inhibition of allergen-IgE binding to B cells by IgG antibodies after grass pollen immunotherapy. J Allergy Clin Immunol. 2003;112:915–22.PubMedCrossRefGoogle Scholar
  48. 48.
    Zhuang Q, Bisotto S, Fixman ED, Mazer B. Suppression of IL-4- and CD40-induced B-lymphocyte activation by intravenous immunoglobulin is not mediated through the inhibitory IgG receptor FcgammaRIIb. J Allergy Clin Immunol. 2002;110:480–3.PubMedCrossRefGoogle Scholar
  49. 49.
    Jeannin P, Delneste Y, Tillie-Leblond I, et al. Abnormal IgG4 antibody response to aeroallergens in allergic patients. Int Arch Allergy Immunol. 1994;104:191–8.PubMedCrossRefGoogle Scholar
  50. 50.
    Ball T, Sperr WR, Valent P, et al. Induction of antibody responses to new B-cell epitopes indicates vaccination character of allergen immunotherapy. Eur J Immunol. 1999;29:2026–36.PubMedCrossRefGoogle Scholar
  51. 51.
    Durham SR, Walker SM, Varga EM, et al. Long-term clinical efficacy of grass pollen immunotherapy. N Engl J Med. 1999;341:468–75.PubMedCrossRefGoogle Scholar
  52. 52.
    Akdis M, Akdis CA. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol. 2007;119:780–9.PubMedCrossRefGoogle Scholar
  53. 53.
    Van Neerven RJ, Wikborg T, Lund G, et al. Blocking antibodies induced by specific allergy vaccination prevents the activation of CD4+ T cells by inhibiting serum-IgE-facilitated allergen presentation. J Immunol. 1999;163:2944–52.PubMedGoogle Scholar
  54. 54.
    McHugh SM, Deighton J, Stewart AG, Lachmann PJ, Ewan PW. Bee venom immunotherapy induces a shift in cytokine response from a TH2 to a TH1 dominant pattern: comparison of rush and conventional immunotherapy. Clin Exp Allergy. 1995;25:828–33.PubMedCrossRefGoogle Scholar
  55. 55.
    Gardner LM, Thien FC, Douglass JA, Rolland JM, O’Hehir RE. Induction of T regulatory cells by standardized house dust mite immunotherapy: an increase in CD4+ CD25+ interleukin-10+ T cells expressing peripheral tissue trafficking markers. Clin Exp Allergy. 2004;34:1209–19.PubMedCrossRefGoogle Scholar
  56. 56.
    Presser K, Schwinge D, Wegmann M, et al. Coexpression of TGF-beta1 and IL-10 enables regulatory T cells to completely suppress airway hyperreactivity. J Immunol. 2008;181:7751–8.PubMedGoogle Scholar
  57. 57.
    Borish L, Aarons A, Rumbyrt J, Cvietusa P, Negri J, Wenzel S. Interleukin-10 regulation in normal subjects and patients with asthma. J Allergy Clin Immunol. 1996;97:1288–96.PubMedCrossRefGoogle Scholar
  58. 58.
    Koning H, Neijens HJ, Baert MR, Oranje AP, Savelkoul HF. T cells subsets and cytokines in allergic and non-allergic children. II. Analysis and IL-5 and IL-10 mRNA expression and protein production. Cytokine. 1997;9:427–36.PubMedCrossRefGoogle Scholar
  59. 59.
    Jutel M, Akdis M, Budak F, et al. IL-10 and TGF-β cooperate in the regulatory T cell response to mucosal allergens in normal immunity and specific immunotherapy. Eur J Immunol. 2003;33:1205–14.PubMedCrossRefGoogle Scholar
  60. 60.
    Francis JN, Till SJ, Durham SR. Induction of IL-10 CD4+ CD25+ T cells by grass pollen immunotherapy. J Allergy Clin Immunol. 2003;111:1255–61.PubMedCrossRefGoogle Scholar
  61. 61.
    Schandene L, Alonso-Vega C, Willems F, et al. B7/CD28-dependent IL-5 production by human resting T cells is inhibited by IL-10. J Immunol. 1994;152:4368–74.PubMedGoogle Scholar
  62. 62.
    Akdis CA, Joss A, Akdis M, Faith A, Blaser K. A molecular basis for T cell suppression by IL-10: CD28-associated IL-10 receptor inhibits CD28 tyrosine phosphorylation and phosphatidylinositol. 3-kinase binding. FASEB J. 2000;14:1666–8.PubMedGoogle Scholar
  63. 63.
    Abramson MJ, Puy RM, Weiner JM. Allergen immunotherapy for asthma. Cochrane Database Syst Rev. 2003;4:CD001186.PubMedGoogle Scholar
  64. 64.
    Tseng SH, Fu LS, Nong BR, Weng JD, Shyur SD. Changes in serum specific IgG4 and IgG4/IgE ratio in mite-sensitized Taiwanese children with allergic rhinitis receiving short-term sublingual-swallow immunotherapy: a multicenter, randomized, placebo-controlled trial. Asian Pac J Allergy Immunol. 2008;26:105–12.PubMedGoogle Scholar
  65. 65.
    Moingeon P, Batard T, Fadel R, Frati F, Sieber J, Van Overtvelt L. Immune mechanisms of allergen-specific sublingual immunotherapy. Allergy. 2006;61:151–65.PubMedCrossRefGoogle Scholar
  66. 66.
    Bohle B, Kinaciyan T, Gerstmayr M, Radakovics A, Jahn-Schmid B, Ebner C. Sublingual immunotherapy induces IL-10-producing T regulatory cells, allergen-specific T-cell tolerance, and immune deviation. J Allergy Clin Immunol. 2007;120:707–13.PubMedCrossRefGoogle Scholar
  67. 67.
    Cosmi L, Santarlasci V, Angeli R, et al. Sublingual immunotherapy with Dermatophagoides monomeric allergoid down-regulates allergen-specific immunoglobulin E and increases both interferon-gamma- and interleukin-10-production. Clin Exp Allergy. 2006;36:261–72.PubMedCrossRefGoogle Scholar
  68. 68.
    Allam JP, Novak N, Fuchs C, et al. Characterization of dendritic cells from human oral mucosa: a new Langerhans cell type with high constitutive FcepsilonRI expression. J Allergy Clin Immunol. 2003;112:141–8.PubMedCrossRefGoogle Scholar
  69. 69.
    Allam JP, Niederhagen B, Bücheler M, et al. Comparative analysis of nasal and oral mucosa dendritic cells. Allergy. 2006;61:166–72.PubMedCrossRefGoogle Scholar
  70. 70.
    Rank MA, Oslie CL, Krogman JL, Park MA, Li JT. Allergen immunotherapy safety: characterizing systemic reactions and identifying risk factors. Allergy Asthma Proc. 2008;29:400–5.PubMedCrossRefGoogle Scholar
  71. 71.
    Karaayvaz M, Erel F, Caliskaner Z, Ozanguc N. Systemic reactions due to allergen immunotherapy. J Investig Allergol Clin Immunol. 1999;9:39–44.PubMedGoogle Scholar
  72. 72.
    Martin Munoz MF. Efficacy of immunotherapy in the treatment of asthma. Allergol Immunopathol. 2004;32:133–41.CrossRefGoogle Scholar
  73. 73.
    Gonzalez EM, Villalba M, Rodriguez R. Allergenic cross-reactivity of Olive pollen. Allergy. 2000;55:658–63.PubMedCrossRefGoogle Scholar
  74. 74.
    Di Felice G, Barletta B, Tingho R, Pini C. Cupressaceae pollinosis: identification, purification and cloning of relevant allergens. Int Arch Allergy Immunol. 2001;125:280–9.PubMedCrossRefGoogle Scholar
  75. 75.
    Chakraborty P, Gupta-Bhattacharya S, Roy I, Chanda S. Identification of shared allergenic components from four common and dominant pollen taxa of Arecaceae. Curr Science. 2004;86:1539–43.Google Scholar
  76. 76.
    Moingeon P, Hrabina M, Bergmann KC, et al. Specific immunotherapy for common grass pollen allergies: pertinence of a five grass pollen vaccine. Int Arch Allergy Immunol. 2008;146:338–42.PubMedCrossRefGoogle Scholar
  77. 77.
    Chaudhry S, Jhamb S, Chauhan UP, Gaur SN, Agarwal HC, Agarwal MK. Shared and specific allergenic and antigenic components in the two sexes of American cockroach Periplaneta americana. Clin Exp Allergy. 1990;20:59–65.PubMedCrossRefGoogle Scholar
  78. 78.
    Grier TJ, LeFevre DM, Duncan EA, Esch RE. Stability of standardized grass, dust mite, cat, and short ragweed allergens after mixing with mold or cockroach extracts. Ann Allergy Asthma Immunol. 2007;99:151–60.PubMedGoogle Scholar
  79. 79.
    Pauli G. Evolution in the understanding of cross-reactivities of respiratory allergens: the role of recombinant allergens. Int Arch Allergy Immunol. 2000;123:183–95.PubMedCrossRefGoogle Scholar
  80. 80.
    Van der Veen MJ, Mulder M, Witteman AM, Van Ree R, Aalberse RC, Jansen HM. False-positive skin prick test responses to commercially available dog dander extracts caused by contamination with house dust mite (Dermatophagoides pteronyssinus) allergens. J Allergy Clin Immunol. 1996;98:1028–34.PubMedCrossRefGoogle Scholar
  81. 81.
    Singh BP, Gangal SV. Defined allergen extracts; need for efficient diagnosis of allergy and immunotherapy. Indian J Allergy Asthma Immunol. 2001;15:67–74.Google Scholar
  82. 82.
    Sudha VT, Srivastava D, Arora N, Gaur SN, Singh BP. Stability of protease rich Periplaneta americana allergen extracts during storage: formulating preservatives to enhance shelf life. J Clin Immunol. 2007;27:294–301.PubMedCrossRefGoogle Scholar
  83. 83.
    Ruiz Reyes H, Rodriguez Orozco AR. Allergic fungi: importance of the standardization of fungal extracts and their application on clinical practice. Rev Alerg Mex. 2006;53:144–9.PubMedGoogle Scholar
  84. 84.
    Bijli KM, Singh BP, Sridhara S, Gaur SN, Arora N. Standardizing Imperata cylindrica source material for quality allergen preparations. Immunol Methods. 2002;260:91–6.CrossRefGoogle Scholar
  85. 85.
    Kurup VP. Fungal allergens. Curr Allergy Asthma Rep. 2003;3:416–23.PubMedCrossRefGoogle Scholar
  86. 86.
    Bisht V, Arora N, Singh BP, Gaur SN, Sridhara S. Purification and characterization of a major cross-reactive allergen from Epicoccum purpurascens. Int Arch Allergy Immunol. 2004;133:217–24.PubMedCrossRefGoogle Scholar
  87. 87.
    Dhyani A, Arora N, Gaur SN, Jain VK, Sridhara S, Singh BP. Analysis of IgE binding proteins of mesquite (Prosopis juliflora) pollen and cross-reactivity with predominant tree pollens. Immunobiology. 2006;211:733–40.PubMedCrossRefGoogle Scholar
  88. 88.
    Sudha VT, Arora N, Sridhara S, Gaur SN, Singh BP. Biopotency and identification of allergenic proteins in Periplaneta americana extract for clinical applications. Biologicals. 2006;35:131–7.Google Scholar
  89. 89.
    Patil SP, Niphadkar PV, Bapat MM. Chickpea: a major food allergen in the Indian subcontinent and its clinical and immunochemical correlation. Ann Allergy Asthma Immunol. 2001;87:140–5.PubMedGoogle Scholar
  90. 90.
    Kumari D, Kumar R, Sridhara S, Arora N, Gaur SN, Singh BP. Sensitization to black gram in patients with bronchial asthma and rhinitis: clinical evaluation and characterization of allergens. Allergy. 2006;61:104–10.PubMedCrossRefGoogle Scholar
  91. 91.
    Kumar R, Srivastava P, Kumari D, et al. Rice (Oryza sativa) allergy in rhinitis and asthma patients: a clinico-immunological study. Immunobiology. 2007;212:141–7.PubMedCrossRefGoogle Scholar
  92. 92.
    Ito M, Kato T, Matsuda T. Rice allergenic proteins, 14–16 kDa albumin and alpha-globulin, remain insoluble in rice grains recovered from rice miso (rice-containing fermented soybean paste). Biosci Biotechnol Biochem. 2005;69:1137–44.PubMedCrossRefGoogle Scholar
  93. 93.
    Scurlock AM, Burks AW. Peanut allergenicity. Ann Allergy Asthma Immunol. 2004;93:S12–8.PubMedGoogle Scholar
  94. 94.
    Lin J, Shewry PR, Archer DB, et al. Potential allergenicity of two 2S albumins from soybean (Glycine max): a protein microarray approach. Int Arch Allergy Immunol. 2006;141:91–102.PubMedCrossRefGoogle Scholar
  95. 95.
    Secrist H, DeKruyff RH, Umetsu DT. Interleukin 4 production by CD4+ cells from allergic individuals is modulated by allergen concentration and antigen-presenting cell type. J Exp Med. 1995;181:1081–90.PubMedCrossRefGoogle Scholar
  96. 96.
    HayGlass KT, Stefura BP. Anti-interferon gamma treatment blocks the ability of glutaraldehyde-polymerized allergens to inhibit specific IgE responses. J Exp Med. 1991;173:279–85.PubMedCrossRefGoogle Scholar
  97. 97.
    Ohman S, Bjorkander J, Dreborg S, Lanner A, Malling HJ, Weeke B. A preliminary study of immunotherapy with a monomethoxy polyethylene glycol modified honey bee venom preparation. Allergy. 1986;41:81–8.PubMedCrossRefGoogle Scholar
  98. 98.
    Malet A, Lluch M, Valero AL, Casanovas M. Clinical and immunological effects of immunotherapy with glutaraldehyde modified house dust mite extract. Allergol Immunopathol (Madr). 1994;22:226–32.Google Scholar
  99. 99.
    Pollock KG, Conacher M, Wei XQ, Alexander J, Brewer JM. Interleukin-18 plays a role in both the alum-induced T helper 2 response and the T helper 1 response induced by alum-adsorbed interleukin-12. Immunology. 2003;108:137–43.PubMedCrossRefGoogle Scholar
  100. 100.
    Arora N, Gangal SV. Efficacy of liposome entrapped allergen in regulation of IgE response in mice. Clin Exp Allergy. 1992;22:35–42.PubMedCrossRefGoogle Scholar
  101. 101.
    Gangal SV, Arora N, Chugh L, Sehra S, Singh B, Malik BK (1999) Immunomodulation and immunotherapy using liposome entrapped allergens. Arb Paul Ehrlich Inst Bundesamt Sera Impfstoffe Frankf A M 93: 267–73Google Scholar
  102. 102.
    Sehra S, Chug L, Gangal SV. Polarized TH1 responses by liposome entrapped allergen and its potential in immunotherapy of allergic disorders. Clin Exp Allergy. 1998;28:1530–7.PubMedCrossRefGoogle Scholar
  103. 103.
    Cevc G, Gebauer D, Stieber J, Schaltzein A, Blume G. Ultraflexible vesicles, transfersomes, have an extremely pore penetration resistant and transport therapeutic amount of insulin across the intact mammalian skin. Biochim Biophys Acta. 1998;1368:201–15.PubMedCrossRefGoogle Scholar
  104. 104.
    Chapman MD, Smith AM, Vailes LD, Arruda LK, Dhanaraj V, Pomes A. Recombinant allergens for diagnosis and therapy of allergic diseases. J Allergy Clin Immunol. 2000;106:409–18.PubMedCrossRefGoogle Scholar
  105. 105.
    Shankar J, Singh BP, Gaur SN, Arora N. Recombinant glutathione-S-transferase, a major allergen from Alternaria alternata for clinical use in allergy patients. Mol Immunol. 2006;43:1927–32.PubMedCrossRefGoogle Scholar
  106. 106.
    Tresch S, Holzmann D, Baumann S, et al. In vitro and in vivo allergenicity of recombinant Bet v 1 compared to the reactivity of natural birch pollen extract. Clin Exp Allergy. 2003;33:1153–8.PubMedCrossRefGoogle Scholar
  107. 107.
    Jutel M, Jaeger L, Suck R, Meyer H, Fiebig H, Cromwell O. Allergen-specific immunotherapy with recombinant grass pollen allergens. J Allergy Clin Immunol. 2005;116:608–13.PubMedCrossRefGoogle Scholar
  108. 108.
    Pauli G, Larsen TH, Rak S, et al. Efficacy of recombinant birch pollen vaccine for the treatment of birch-allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2008;122:951–60.PubMedCrossRefGoogle Scholar
  109. 109.
    Niederberger V, Horak F, Vrtala S, et al. Vaccination with genetically engineered allergens prevents progression of allergic disease. Proc Natl Acad Sci USA. 2004;101:14677–82.PubMedCrossRefGoogle Scholar
  110. 110.
    Von Garnier C, Astori M, Kettner A, et al. Allergen-derived long peptide immunotherapy down-regulates specific IgE response and protects from anaphylaxis. Eur J Immunol. 2000;30:1638–45.CrossRefGoogle Scholar
  111. 111.
    Kammerer R, Chvatchko Y, Kettner A, Dufour N, Corradin G, Spertini F. Modulation of T-cell response to phospholipase A2 and phospholipase A2-derived peptides by conventional bee venom immunotherapy. J Allergy Clin Immunol. 1997;100:96–103.PubMedCrossRefGoogle Scholar
  112. 112.
    Fellrath JM, Kettner A, Dufour N, et al. Allergen-specific T-cell tolerance induction with allergen-derived long synthetic peptides: results of a phase I trial. J Allergy Clin Immunol. 2003;111:854–61.PubMedCrossRefGoogle Scholar
  113. 113.
    Pene J, Desroches A, Paradis L, et al. Immunotherapy with Fel d 1 peptides decreases IL-4 release by peripheral blood T cells of patients allergic to cats. J Allergy Clin Immunol. 1998;102:571–8.PubMedCrossRefGoogle Scholar
  114. 114.
    Muller U, Akdis CA, Fricker M, et al. Successful immunotherapy with T-cell epitope peptides of bee venom phospholipase A 2 induces specific T-cell anergy in patients allergic to bee venom. J Allergy Clin Immunol. 1998;101:747–54.PubMedCrossRefGoogle Scholar
  115. 115.
    Oldfield W, Larche M, Kay A. Effect of T cell peptides derived from Fel d 1 on allergic reactions and cytokine production in patients sensitive to cats: a randomized controlled trial. Lancet. 2002;360:47–53.PubMedCrossRefGoogle Scholar
  116. 116.
    Maguire P, Nicodemus C, Aaronson D, Robinson D, Umetsu DT. The safety and efficacy of ALLERVAX CAT in cat allergic patients. Clin Immunol. 1999;93:222–31.PubMedCrossRefGoogle Scholar
  117. 117.
    Akdis CA, Akdis M, Blesken T, et al. Epitope-specific T cell tolerance to phospholipase A2 in bee venom immunotherapy and recovery by IL-2 and IL-15 in vitro. J Clin Invest. 1996;98:1676–83.PubMedCrossRefGoogle Scholar
  118. 118.
    Helm BA, Spivey AC, Padlan EA. Peptide blocking of IgE/receptors interaction: possibilities and pitfalls. Allergy. 1997;52:1155–69.PubMedCrossRefGoogle Scholar
  119. 119.
    Prussin C, Griffith DT, Boesel KM, Lin H, Foster B, Casale TB. Omalizumab treatment down regulates dendritic cell FcepsilonRI expression. J Allergy Clin Immunol. 2003;112:1147–54.PubMedCrossRefGoogle Scholar
  120. 120.
    Kopp MV, Brauburger J, Riedinger F, et al. The effect of anti-IgE treatment on in vitro leukotriene release in children with seasonal allergic rhinitis. J Allergy Clin Immunol. 2002;110:728–35.PubMedCrossRefGoogle Scholar
  121. 121.
    Djukanovi R, Wilson SJ, Kraft M, Jarjour NN, Steel M, Chung KF et al. Effects of treatment with anti-immunoglobulin E antibody omalizumab on airway inflammation in allergic asthma. Am J Respir Crit Care Med. (2004); 170: 583–93.Google Scholar
  122. 122.
    Walker S, Monteil M, Phelan K, Lasserson TJ, Walters EH. Anti-IgE for chronic asthma in adults and children. Cochrane Database Syst Rev. 2006;19(2):CD003559.Google Scholar
  123. 123.
    Casale TB, Busse WW, Kline JN, et al. Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis. J. Allergy Clin Immunol. 2006;117:134–40.PubMedCrossRefGoogle Scholar
  124. 124.
    Bez C, Schubert R, Kopp M, et al. Effect of anti-immunoglobulin E on nasal inflammation in patients with seasonal allergic rhino conjunctivitis. Clin Exp Allergy. 2004;34:1079–85.PubMedCrossRefGoogle Scholar
  125. 125.
    Rolinck-Werninghaus C, Hamelmann E, Keil T, et al. The co-seasonal application of anti-IgE after preseasonal specific immunotherapy decreases ocular and nasal symptom scores and rescue medication use in grass pollen allergic children. Allergy. 2004;59:973–9.PubMedCrossRefGoogle Scholar
  126. 126.
    Kuehr J, Brauburger J, Zielen S, et al. Efficacy of combination treatment with anti-IgE plus specific immunotherapy in polysensitized children and adolescents with seasonal allergic rhinitis. J Allergy Clin Immunol. 2002;109:274–80.PubMedCrossRefGoogle Scholar
  127. 127.
    Tournoy KG, Kips JC, Pauwels RA. The allergen-induced airway hyperresponsiveness in a human-mouse chimera model of asthma is T cell and IL-4 and IL-5 dependent. J Immunol. 2001;166:6982–91.PubMedGoogle Scholar
  128. 128.
    Borish LC, Nelson HS, Corren J, et al. Efficacy of soluble IL-4 receptor for the treatment of adults with asthma. J Allergy Clin Immunol. 2001;107:963–70.PubMedCrossRefGoogle Scholar
  129. 129.
    Borish LC, Nelson HS, Lanz MJ, et al. Interleukin-4 receptor in moderate atopic asthma. A phase I/II randomized, placebo-controlled trial. Am J Respir Crit Care Med. 1999;160:1816–23.PubMedGoogle Scholar
  130. 130.
    Kips JC, O’Connor BJ, Langley SJ, et al. Effect of SCH55700, a humanized anti-human interleukin-5 antibody, in severe persistent asthma: a pilot study. Am J Respir Crit Care Med. 2003;167:1655–9.PubMedCrossRefGoogle Scholar
  131. 131.
    Leckie MJ, ten Brinke A, Khan J, et al. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic response. Lancet. 2000;356:2144–8.PubMedCrossRefGoogle Scholar
  132. 132.
    Boushey HA, Fahy JV. Targeting cytokines in asthma therapy: round one. Lancet. 2000;356:2114–6.PubMedCrossRefGoogle Scholar
  133. 133.
    Flood-Page PT, Menzies-Gow AN, Kay AB, Robinson DS. Eosinophil’s role remains uncertain as anti-interleukin-5 only partially depletes numbers in asthmatic airway. Am J Respir Crit Care Med. 2003;167:199–204.PubMedCrossRefGoogle Scholar
  134. 134.
    Terada T, Zhang K, Belperio J, Londhe V, Saxon A. A chimeric human-cat Fcgamma-Fel d 1 fusion protein inhibits systemic, pulmonary and cutaneous allergic reactivity to intratracheal challenge in mice sensitized to Fel d 1, the major cat allergen. Clin Immunol. 2006;120:45–56.PubMedCrossRefGoogle Scholar
  135. 135.
    Bryan SA, O’Connor BJ, Matti S, et al. Effects of recombinant human interleukin-12 on eosinophils, airway hyper-responsiveness, and the late asthmatic response. Lancet. 2000;356:2149–53.PubMedCrossRefGoogle Scholar
  136. 136.
    Kim TS, DeKruyff RH, Rupper R, Maecker HT, Levy S, Umetsu DT. An ova-IL-12 fusion protein is more effective than OVA plus rIL-12 in inducing a Th1-dominated immune response and inhibiting antigen-specific IgE production. J Immunol. 1997;158:4137–44.PubMedGoogle Scholar
  137. 137.
    Walter DM, Wong CP, DeKruyff RH, Berry GJ, Levy S, Umetsu DT. IL-18 gene transfer by adenovirus prevents the development of and reverses established allergen induced airway hyper reactivity. J Immunol. 2001;166:6392–8.PubMedGoogle Scholar
  138. 138.
    Revets H, Pynaert G, Grooten J, De Baetselier P. Lipoprotein I, a TLR2/4 ligand modulates TH2-driven allergic immune responses. J Immunol. 2005;174:1097–103.PubMedGoogle Scholar
  139. 139.
    Taylor RC, Richmond P, Upham JW. Toll-like receptor 2 ligands inhibit TH2 responses to mite allergen. J Allergy Clin Immunol. 2006;117:1148–54.PubMedCrossRefGoogle Scholar
  140. 140.
    Takeda K, Akira S. Toll-like receptors in innate immunity. Int Immunol. 2005;17:1–14.PubMedCrossRefGoogle Scholar
  141. 141.
    Krieg AM. Therapeutic potential of Toll-like receptor 9 activation. Nat Rev Drug Discov. 2006;5:471–84.PubMedCrossRefGoogle Scholar
  142. 142.
    Klinman DM. Immunotherapeutic uses of CpG oligodeoxynucleotides. Nat Rev Immunol. 2004;4:249–58.PubMedCrossRefGoogle Scholar
  143. 143.
    Krieg AM, Wagner H. Causing a commotion in the blood: immunotherapy progresses from bacteria to bacterial DNA. Immunol Today. 2000;21:521–6.PubMedCrossRefGoogle Scholar
  144. 144.
    Zuany-Amorim C, Hastewell J, Walker C. Toll-like receptors as potential therapeutic targets for multiple diseases. Nat Rev Drug Discov. 2002;1:797–807.PubMedCrossRefGoogle Scholar
  145. 145.
    Creticos PS, Schroeder JT, Hamilton RG, et al. Immunotherapy with a ragweed-toll-like receptor 9 agonist vaccine for allergic rhinitis. N Engl J Med. 2006;355:1445–55.PubMedCrossRefGoogle Scholar
  146. 146.
    Shirota H, Sano K, Kikuchi T, Tamura G, Shirato K. Regulation of murine airway eosinophilia and TH2 cells by antigen-conjugated CpG oligodeoxynucleotides as a novel antigen-specific immunomodulator. J Immunol. 2000;164:5575–82.PubMedGoogle Scholar
  147. 147.
    Tighe H, Takabayashi K, Schwartz D, et al. Conjugation of immunostimulatory DNA to the short ragweed allergen Amb a 1 enhances its immunogenicity and reduces its allergenicity. J Allergy Clin Immunol. 2000;106:124–34.PubMedCrossRefGoogle Scholar
  148. 148.
    Tulic MK, Fiset PO, Christodoulopoulos P, et al. Amb a 1-immunostimulatory oligodeoxynucleotide conjugate immunotherapy decreases the nasal inflammatory response. J Allergy Clin Immunol. 2004;113:235–41.PubMedCrossRefGoogle Scholar
  149. 149.
    Kerzl R, Mempel M, Ring J. Allergen-specific immunotherapy in food anaphylaxis. WAO J. (2008); 1:47–50.Google Scholar
  150. 150.
    Mansfield L. Successful oral desensitization for systemic peanut allergy. Ann Allergy Asthma Immunol. 2006;97:266–7.PubMedCrossRefGoogle Scholar
  151. 151.
    Oppenheimer JJ, Nelson HS, Bock SA, Christensen F, Leung DY. Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol. 1992;90:256–62.PubMedCrossRefGoogle Scholar
  152. 152.
    Patriarca G, Nucera E, Pollastrini E, et al. Oral rush desensitization in peanut allergy: a case report. Dig Dis Sci. 2006;51:471–3.PubMedCrossRefGoogle Scholar
  153. 153.
    Bjorksten B. The intrauterine and post natal environments. J Allergy Clin Immunol. 1999;104:1119–27.PubMedCrossRefGoogle Scholar
  154. 154.
    Arshad SH, Bateman B, Sadeghnejad A, Gant C, Matthews SM. Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study. J Allergy Clin Immunol. 2007;119:307–13.PubMedCrossRefGoogle Scholar
  155. 155.
    Sicherer SH, Leung DY. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects in 2007. J Allergy Clin Immunol. 2008;121:1351–8.PubMedCrossRefGoogle Scholar
  156. 156.
    Wheeler JG, Shema SJ, Bogle ML, et al. Immune and clinical impact of Lactobacillus acidophilus on asthma. Ann Allergy Asthma Immunol. 1997;79:229–33.PubMedCrossRefGoogle Scholar
  157. 157.
    Helin T, Haahtela S, Haahtela T. No effect of oral treatment with an intestinal bacterial strain, Lactobacillus rhamnosus (ATCC 53103), on birch-pollen allergy: a placebo-controlled double-blind study. Allergy. 2002;57:243–6.PubMedCrossRefGoogle Scholar
  158. 158.
    Wang MF, Lin HC, Wang YY, Hsu CH. Treatment of perennial allergic rhinitis with lactic acid bacteria. Pediatr Allergy Immunol. 2004;15:152–8.PubMedCrossRefGoogle Scholar
  159. 159.
    Guo YJ, Wu D, Wang KY, Sun SH. Adjuvant effects of Bacillus Calmette-Guerin DNA or CpG-oligonucleotide in the immune response to Taenia solium cysticercosis vaccine in porcine. Scand J Immunol. 2007;66:619–27.PubMedCrossRefGoogle Scholar
  160. 160.
    Stelmach I, Smejda K, Jerzynska J, et al. Decreased markers of atopy in children with presumed early exposure to allergens, unhygienic conditions, and infections. Ann Allergy Asthma Immunol. 2007;99:170–7.PubMedGoogle Scholar
  161. 161.
    Holt PG. A potential vaccine strategy for asthma and allied atopic diseases during early childhood. The Lancet. 1994;344:456–8.CrossRefGoogle Scholar

Copyright information

© Birkhäuser Verlag, Basel/Switzerland 2009

Authors and Affiliations

  • Deepsikha Srivastava
    • 1
  • Naveen Arora
    • 1
  • Bhanu Pratap Singh
    • 1
  1. 1.Allergy and Immunology Section, Room no. 509Institute of Genomics and Integrative Biology (CSIR)DelhiIndia

Personalised recommendations