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Allergy Vaccines

A Review of Developments

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  • Research Perspective
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Summary

Immunotherapy by vaccination (hyposensitisation) has been used since the beginning of this century for the treatment of atopic diseases. Immunotherapy is still widely used and in the hands of specialists is quite safe. However, the use of crude allergen extracts, doubts about its efficacy for many allergens and the risk of severe adverse effects when not properly administered have raised questions about the place of hyposensitisation as part of modern immunotherapy. The relatively efficient pharmacotherapy of allergic diseases has also reduced the need for traditional high dose immunotherapy. However, progress in the understanding of the basic immune mechanisms of allergy and in the characterisation of dominant allergens has stimulated the development of several novel strategies for immunotherapy. A few of these have the potential of reaching the clinic in the near future. The most promising areas of this rapidly developing field will be covered in this article. The 4 main areas which will be discussed in more detail are: (i) progress in the area of modifications of allergen extracts or purified recombinant allergens by allergen cross-linking, monomethoxy-polyethylene glycol coupling or immune complex formation, with the aim of reducing the allergenicity of the antigen or to tolerise or redirect the immune response to a mainly T helper 1 response; (ii) oral administration of allergens or allergen extracts, possibly by using bacteria as live vaccines; (iii) treatment with immunodominant peptides from major allergens, with the aim of inducing unresponsiveness in allergen-specific T cells; and (iv) immune intervention directly targeting the IgE molecule, to deplete circulating and mast cell bound IgE, by treatment with monoclonal antibodies or by vaccination against IgE using parts of the IgE molecule covalently coupled to a foreign carrier protein.

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  1. Department of Medical Immunology and Microbiology, Biomedical Centre, University of Uppsala, Box 582, S-751 23, Uppsala, Sweden

    Lars Hellman

  2. Department of Pathology, Biomedical Centre, University of Uppsala, Uppsala, Sweden

    Mats Carlsson

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Hellman, L., Carlsson, M. Allergy Vaccines. Clin. Immunother. 6, 130–142 (1996). https://doi.org/10.1007/BF03259509

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