New opportunities for allergen immunotherapy using synthetic peptide immuno-regulatory epitopes (SPIREs)

ABSTRACT

Introduction: Allergen immunotherapy (AIT) reduces allergic rhinoconjunctivitis (ARC) symptoms, but long-term efficacy requires treatment for 3–5 years. Synthetic peptide immuno-regulatory epitopes, a new class of AIT, are allergen peptides with a shorter, more convenient treatment regimen that could potentially have benefits on adherence and outcomes.

Areas covered: Phase 2 trials of therapies derived from cat, house dust mite, grass, and ragweed allergen peptides demonstrated significant reduction in ARC symptoms after short-course treatment; improvement was sustained for 18–24 months posttreatment. We conducted a PubMed literature search for clinical publications using the search terms AIT; allergen peptides; ARC; cat, grass, house dust mite, and ragweed allergy; SCIT; SLIT; and synthetic peptides.

Expert commentary: Long-term disease modification is a realistic goal of AIT. The inconvenience of conventional AIT regimens negatively impacts long-term persistence and, thus, efficacy. In comparison, SPIREs have a more convenient treatment regimen that could potentially have benefits on adherence and outcomes.

KEYWORDS:

• Allergen immunotherapy
• allergen peptides
• cat allergy
• Der p 1
• Fel d 1
• grass allergy
• house dust mite allergy
• intradermal immunotherapy
• ragweed allergy
• synthetic peptide immuno-regulatory epitopes
• SPIREs

Acknowledgments

The authors acknowledge writing assistance from Karl Torbey, MD, and editorial assistance from Patricia C. Abramo of Adelphi Communications, New York, NY. This assistance was funded by Circassia Inc., Chicago, Illinois.

Declaration of interest

L Klimek has received research grants for his institution and/or personal fees for lecturing, consultancy or traveling from ALK-Abelló, Denmark; Allergopharma, Germany; Bionorica, Germany; Stallergenes, France; HAL, The Netherlands; Allergy Therapeutics/Bencard, Great Britain/Germany; Biomay, Austria; Circassia, USA; Cytos, Switzerland; Curalogic, Denmark; Lofarma, Italy; MEDA, Sweden; MSD, USA; Novartis Switzerland; Leti, Spain; Roxall, Germany; GlaxoSmithKline (GSK), Great Britain; and has served on the speaker’s bureau for the above mentioned pharmaceutical companies. O Pfaar has received grants from ALK Abello, Allergopharma, Stallergenes, HAL Allergy, Allergy Therapeutics/Bencard, Lofarma, Novartis/Leti, Biomay, Nuvo, Circassia, Biotech Tools s.a. for his institution and personal fees from HAL Allergy, Allergy Therapeutics/Bencard, Lofarma, Novartis/Leti, MEDA, ALK Abello, Allergopharma, Anergis, Biotech Tools s.a., Sanofi, Mobile Chamber Experts (a GA2LEN Partner), Pohl-Boskamp, and Stallergenes for consulting/advisory board services and/or as speaker and/or for (coordinating) investigator services and/or for educational material and non-financial support from HAL Allergy (travel support) for the last three years. O Pfaar is the current chairman of the Immunotherapy Interest Group (IT IG) of the European Academy of Allergy and Clinical Immunology (EAACI) and the secretary of the ENT section of the German Society for Allergology and Clinical Immunology (DGAKI); M Worm received consulting fees and was a principal investigator from Circassia. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.