Allergen extracts for immunotherapy: to mix or not to mix?

References

• Khinchi MS, Poulsen LK, Carat F, et al. Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study. Allergy. 2004;59(1):45–53.
   PubMed Web of Science ®Google Scholar
• Dahl R, Kapp A, Colombo G, et al. Efficacy and safety of sublingual immunotherapy with grass allergen tablets for seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2006;118(2):434–440.
   PubMed Web of Science ®Google Scholar
• Frew AJ, Powell RJ, Corrigan CJ, et al. Efficacy and safety of specific immunotherapy with SQ allergen extract in treatment-resistant seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2006;117(2):319–325.
   PubMed Web of Science ®Google Scholar
• Didier A, Malling HJ, Worm M, et al. Optimal dose, efficacy, and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol. 2007;120(6):1338–1345.
   PubMed Web of Science ®Google Scholar
• Powell RJ, Frew AJ, Corrigan CJ, et al. Effect of grass pollen immunotherapy with Alutard SQ on quality of life in seasonal allergic rhinoconjunctivitis. Allergy. 2007;62(11):1335–1338.
   PubMed Web of Science ®Google Scholar
• Dahl R, Kapp A, Colombo G, et al. Sublingual grass allergen tablet immunotherapy provides sustained clinical benefit with progressive immunologic changes over 2 years. J Allergy Clin Immunol. 2008;121(2):512–518. e512.
   PubMed Web of Science ®Google Scholar
• Cox LS, Casale TB, Nayak AS, et al. Clinical efficacy of 300IR 5-grass pollen sublingual tablet in a US study: the importance of allergen-specific serum IgE. J Allergy Clin Immunol. 2012;130(6):1327–1334. e1321.
   PubMed Web of Science ®Google Scholar
• Worm M, Rak S, De Blay F, et al. Sustained efficacy and safety of a 300IR daily dose of a sublingual solution of birch pollen allergen extract in adults with allergic rhinoconjunctivitis: results of a double-blind, placebo-controlled study. Clin Trans Allergy. 2014;4(1):7.
   PubMed Web of Science ®Google Scholar
• Nelson HS. Multiallergen immunotherapy for allergic rhinitis and asthma. J Allergy Clin Immunol. 2009;123(4):763–769.
   PubMed Web of Science ®Google Scholar
• Calderon MA, Cox L, Casale TB, et al. Multiple-allergen and single-allergen immunotherapy strategies in polysensitized patients: looking at the published evidence. J Allergy Clin Immunol. 2012;129(4):929–934.
   PubMed Web of Science ®Google Scholar
• Migueres M, Fontaine JF, Haddad T, et al. Characteristics of patients with respiratory allergy in France and factors influencing immunotherapy prescription: a prospective observational study (REALIS). Int J Immunopath Pharmacol. 2011;24(2):387–400.
   PubMed Web of Science ®Google Scholar
• Moingeon P. Update on immune mechanisms associated with sublingual immunotherapy: practical implications for the clinician. J Allergy Clin Immunol: In Pract. 2013;1(3):228–241.
   PubMed Web of Science ®Google Scholar
• Cox L, Jacobsen L. Comparison of allergen immunotherapy practice patterns in the United States and Europe. Ann Allergy Asthma Immunol. 2009;103(6):451-459;. quiz 459-461, 495.
   Web of Science ®Google Scholar
• Cox L, Calderon MA. Subcutaneous specific immunotherapy for seasonal allergic rhinitis: a review of treatment practices in the US and Europe. Curr Med Res Op. 2010;26(12):2723–2733.
   PubMed Web of Science ®Google Scholar
• Migueres M, Davila I, Frati F, et al. Types of sensitization to aeroallergens: definitions, prevalences and impact on the diagnosis and treatment of allergic respiratory disease. Clin Trans Allergy. 2014;4:16.
   PubMed Web of Science ®Google Scholar
• Amar SM, Harbeck RJ, Sills M, et al. Response to sublingual immunotherapy with grass pollen extract: monotherapy versus combination in a multiallergen extract. J Allergy Clin Immunol. 2009;124(1):150-156. e151-155.
   PubMed Web of Science ®Google Scholar
• Meltzer EO, Blaiss MS, Naclerio RM, et al. Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys. Allergy Asthma Proc. 2012;33(Suppl 1):S113–141.
   PubMedGoogle Scholar
• Calderon MA, Simons FE, Malling HJ, et al. Sublingual allergen immunotherapy: mode of action and its relationship with the safety profile. Allergy. 2012;67(3):302–311.
   PubMed Web of Science ®Google Scholar
• Esch RE, Grier TJ. Allergen compatibilities in extract mixtures. Immunol Allergy Clin North Am. 2011;31(2):227–239, viii.
   PubMed Web of Science ®Google Scholar
• Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011;127(1 Suppl):S1–55.
   PubMed Web of Science ®Google Scholar
• Esch RE, Plunkett GA. Immunotherapy preparation guidelines, rules, and regulation. Curr Allergy Asthma Rep. 2013;13(4):406–413.
   PubMed Web of Science ®Google Scholar
• Lorenz AR, Luttkopf D, May S, et al. The principle of homologous groups in regulatory affairs of allergen products–a proposal. Int Arch Allergy Immunol. 2009;148(1):1–17.
   PubMed Web of Science ®Google Scholar
• Zuberbier T, Bachert C, Bousquet PJ, et al. GA(2) LEN/EAACI pocket guide for allergen-specific immunotherapy for allergic rhinitis and asthma. Allergy. 2010;65(12):1525–1530.
   PubMed Web of Science ®Google Scholar
• Nelson HS, Ikle D, Buchmeier A. Studies of allergen extract stability: the effects of dilution and mixing. J Allergy Clin Immunol. 1996;98(2):382–388.
   PubMed Web of Science ®Google Scholar
• Esch RE. Allergen immunotherapy: what can and cannot be mixed?. J Allergy Clin Immunol. 2008;122(3):659–660.
   PubMed Web of Science ®Google Scholar
• Grier TJ, Hall DM, Duncan EA, et al. Allergen stabilities and compatibilities in immunotherapy mixtures that contain cat, dog, dust mite, and cockroach extracts. Ann Allergy Asthma Immunol. 2015;115(6):496–502.
   Web of Science ®Google Scholar
• Grier TJ, LeFevre DM, Duncan EA, et al. Stability and mixing compatibility of dog epithelia and dog dander allergens. Ann Allergy Asthma Immunol. 2009;103(5):411–417.
   PubMed Web of Science ®Google Scholar
• Esch RE. Role of proteases on the stability of allergenic extracts. Arb Paul-Ehrlich-Institut. 1992;(85):171–177. discussion 177-179.
   Google Scholar
• Kordash TR, Amend MJ, Williamson SL, et al. Effect of mixing allergenic extracts containing Helminthosporium, D. farinae, and cockroach with perennial ryegrass. Ann Allergy. 1993;71(3):240–246.
   PubMedGoogle Scholar
• Batard T, Baron-Bodo V, Martelet A, et al. Patterns of IgE sensitization in house dust mite-allergic patients: implications for allergen immunotherapy. Allergy. 2015. doi:10.1111/all.12796. [Epub ahead of print].
   Web of Science ®Google Scholar
• Helm RM, Squillace DL, Jones RT, et al. Shared allergenic activity in Asian (Blattella asahinai), German (Blattella germanica), American (Periplaneta americana), and Oriental (Blatta orientalis) cockroach species. Int Arch Allergy App Immunol. 1990;92(2):154–161.
   PubMedGoogle Scholar
• Jeong KY, Lee J, Lee IY, et al. Allergenicity of recombinant Bla g 7, German cockroach tropomyosin. Allergy. 2003;58(10):1059–1063.
   PubMed Web of Science ®Google Scholar
• Hong J, Bielory L. Oralair(R): sublingual immunotherapy for the treatment of grass pollen allergic rhinoconjunctivitis. Expert Rev Clin Immunol. 2011;7(4):437–444.
   PubMed Web of Science ®Google Scholar
• Creticos PS, Marsh DG, Proud D, et al. Responses to ragweed-pollen nasal challenge before and after immunotherapy. J Allergy Clin Immunol. 1989;84(2):197–205.
   PubMed Web of Science ®Google Scholar
• Grier TJ. How’s my dosing? A one-step, math-free guide for comparing your clinic’s maintenance immunotherapy doses to current practice parameter recommendations. Ann Allergy Asthma Immunol. 2012;108(3):201–205.
   PubMed Web of Science ®Google Scholar
• Koberlein J, Mosges R. Oralair((R)): a causal treatment for grass pollen-induced allergic rhinoconjunctivitis. Immunotherapy. 2013;5(1):13–21.
   PubMed Web of Science ®Google Scholar
• Bahceciler NN, Babayigit Hocaoglu A, Galip N. A milestone in house dust-mite-allergen immunotherapy: the new sublingual tablet S-524101 (actair). Expert Rev Vaccine. 2014;13(12):1427–1438.
   PubMed Web of Science ®Google Scholar
• Demoly P, Emminger W, Rehm D, et al. Effective treatment of house dust mite-induced allergic rhinitis with 2 doses of the SQ HDM SLIT-tablet: results from a randomized double-blind, placebo-controlled phase III trial. J Allergy Clin Immunol. 2015. pii: S0091-6749(15)00935-5. doi:10.1016/j.jaci.2015.06.036. [Epub ahead of print].
   Web of Science ®Google Scholar
• 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(4):338–342.
   PubMed Web of Science ®Google Scholar
• Chabre H, Gouyon B, Huet A, et al. Molecular variability of group 1 and 5 grass pollen allergens between Pooideae species: implications for immunotherapy. Clin Exp Allergy. 2010;40(3):505–519.
   PubMed Web of Science ®Google Scholar
• Moingeon P. Progress in the development of specific immunotherapies for house dust mite allergies. Expert Rev Vaccines. 2014;13(12):1463–1473.
   PubMed Web of Science ®Google Scholar
• Archila LD, DeLong JH, Wambre E, et al. Grass-specific CD4+T-cells exhibit varying degrees of cross-reactivity, implications for allergen-specific immunotherapy. Clin Exp Allergy. 2014;44(7):986–998.
   PubMed Web of Science ®Google Scholar
• Grier TJ, LeFevre DM, Duncan EA, et al. Allergen stabilities and compatibilities in mixtures of high-protease fungal and insect extracts. Ann Allergy Asthma Immunol. 2012;108(6):439–447.
   PubMed Web of Science ®Google Scholar
• Grier TJ, Hall DM, Duncan EA, et al. Mixing compatibilities of Aspergillus and American cockroach allergens with other high-protease fungal and insect extracts. Ann Allergy Asthma Immunol. 2015;114(3):233–239.
   PubMed Web of Science ®Google Scholar
• Fernandez-Caldas E. Towards a More Complete Standardization of Mite Allergen Extracts. Int Arch Allergy Immunol. 2012;160(1):1–3.
   PubMed Web of Science ®Google Scholar
• Cromwell O, Hafner D, Nandy A. Recombinant allergens for specific immunotherapy. J Allergy Clin Immunol. 2011;127(4):865–872.
   PubMed Web of Science ®Google Scholar
• Valenta R, Niespodziana K, Focke-Tejkl M, et al. Recombinant allergens: what does the future hold?. J Allergy Clin Immunol. 2011;127(4):860–864.
   PubMed Web of Science ®Google Scholar
• Tuppo L, Spadaccini R, Alessandri C, et al. Structure, stability, and IgE binding of the peach allergen Peamaclein (Pru p 7). Biopolymers. 2014;102(5):416–425.
   PubMed Web of Science ®Google Scholar
• Badalyan V, Thompson R, Addo K, et al. TNF-alpha/IL-17 synergy inhibits IL-13 bioactivity via IL-13Ralpha2 induction. J Allergy Clin Immunol. 2014;134(4):975–978 e975.
   PubMed Web of Science ®Google Scholar
• Nony E, Bouley J, Le Mignon M, et al. Development and evaluation of a sublingual tablet based on recombinant Bet v 1 in birch pollen-allergic patients. Allergy. 2015;70(7):795–804.
   PubMed Web of Science ®Google Scholar
• 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(Suppl 2):14677–14682.
   PubMed Web of Science ®Google Scholar
• Jutel M, Jaeger L, Suck R, et al. Allergen-specific immunotherapy with recombinant grass pollen allergens. J Allergy Clin Immunol. 2005;116(3):608–613.
   PubMed Web of Science ®Google Scholar
• 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(5):951–960.
   PubMed Web of Science ®Google Scholar
• Klimek L, Schendzielorz P, Pinol R, et al. Specific subcutaneous immunotherapy with recombinant grass pollen allergens: first randomized dose-ranging safety study. Clin Exp Allergy. 2012;42(6):936–945.
   PubMed Web of Science ®Google Scholar
• Meyer W, Narkus A, Salapatek AM, et al. Double-blind, placebo-controlled, dose-ranging study of new recombinant hypoallergenic Bet v 1 in an environmental exposure chamber. Allergy. 2013;68(6):724–731.
   PubMed Web of Science ®Google Scholar
• Konstantinou GN, Bencharitiwong R, Grishin A, et al. The role of casein-specific IgA and TGF-beta in children with food protein-induced enterocolitis syndrome to milk. Pediatr Allergy Immunol. 2014;25(7):651–656.
   PubMed Web of Science ®Google Scholar
• Van Hage-Hamsten M, Kronqvist M, Zetterstrom O, et al. Skin test evaluation of genetically engineered hypoallergenic derivatives of the major birch pollen allergen, Bet v 1: results obtained with a mix of two recombinant Bet v 1 fragments and recombinant Bet v 1 trimer in a Swedish population before the birch pollen season. J Allergy Clin Immunol. 1999;104(5):969–977.
   PubMed Web of Science ®Google Scholar
• Purohit A, Niederberger V, Kronqvist M, et al. Clinical effects of immunotherapy with genetically modified recombinant birch pollen Bet v 1 derivatives. Clin Exp Allergy. 2008;38(9):1514–1525.
   PubMed Web of Science ®Google Scholar
• Larché M. Peptide and Recombinant Immunotherapy. Immunol Allergy Clinics North America. 2011;31(2):377–389.
   PubMed Web of Science ®Google Scholar
• Spertini F, Perrin Y, Audran R, et al. Safety and immunogenicity of immunotherapy with Bet v 1–derived contiguous overlapping peptides. J Allergy Clin Immunol. 2014;134(1):239–240.
   PubMed Web of Science ®Google Scholar
• Breitwieser A, Egelseer EM, Moll D, et al. A recombinant bacterial cell surface (S-layer)-major birch pollen allergen-fusion protein (rSbsC/Bet v1) maintains the ability to self-assemble into regularly structured monomolecular lattices and the functionality of the allergen. Prot Engineer. 2002;15(3):243–249.
   PubMedGoogle Scholar
• Linhart B, Hartl A, Jahn-Schmid B, et al. A hybrid molecule resembling the epitope spectrum of grass pollen for allergy vaccination. J Allergy Clin Immunol. 2005;115(5):1010–1016.
   PubMed Web of Science ®Google Scholar
• Kussebi F, Karamloo F, Rhyner C, et al. A major allergen gene-fusion protein for potential usage in allergen-specific immunotherapy. J Allergy Clin Immunol. 2005;115(2):323–329.
   PubMed Web of Science ®Google Scholar
• Zhu D, Kepley CL, Zhang K, et al. A chimeric human-cat fusion protein blocks cat-induced allergy. Nature Med. 2005;11(4):446–449.
   PubMed Web of Science ®Google Scholar
• Bonura A, Corinti S, Artale A, et al. A hybrid expressing genetically engineered major allergens of the Parietaria pollen as a tool for specific allergy vaccination. Int Arch Allergy Immunol. 2007;142(4):274–284.
   PubMed Web of Science ®Google Scholar
• Gonzalez-Rioja R, Ibarrola I, Arilla MC, et al. Genetically engineered hybrid proteins from Parietaria judaica pollen for allergen-specific immunotherapy. J Allergy Clin Immunol. 2007;120(3):602–609.
   PubMed Web of Science ®Google Scholar
• Wild C, Wallner M, Hufnagl K, et al. A recombinant allergen chimer as novel mucosal vaccine candidate for prevention of multi-sensitivities. Allergy. 2007;62(1):33–41.
   PubMed Web of Science ®Google Scholar
• Crameri R, Fluckiger S, Daigle I, et al. Design, engineering and in vitro evaluation of MHC class-II targeting allergy vaccines. Allergy. 2007;62(2):197–206.
   PubMed Web of Science ®Google Scholar
• Edlmayr J, Niespodziana K, Linhart B, et al. A combination vaccine for allergy and rhinovirus infections based on rhinovirus-derived surface protein VP1 and a nonallergenic peptide of the major timothy grass pollen allergen Phl p 1. J Immunol. 2009;182(10):6298–6306.
   PubMed Web of Science ®Google Scholar
• Asturias JA, Ibarrola I, Arilla MC, et al. Engineering of major house dust mite allergens Der p 1 and Der p 2 for allergen-specific immunotherapy. Clin Exp Allergy. 2009;39(7):1088–1098.
   PubMed Web of Science ®Google Scholar
• Bussieres L, Bordas-Le Floch V, Bulder I, et al. Recombinant fusion proteins assembling Der p 1 and Der p 2 allergens from Dermatophagoides pteronyssinus. Int Arch Allergy Immunol. 2010;153(2):141–151.
   PubMed Web of Science ®Google Scholar
• Focke-Tejkl M, Weber M, Niespodziana K, et al. Development and characterization of a recombinant, hypoallergenic, peptide-based vaccine for grass pollen allergy. J Allergy Clin Immunol. 2015;135(5):1207-1207 e1201-1211.
   PubMed Web of Science ®Google Scholar
• Fujimura T, Fujinami K, Ishikawa R, et al. Recombinant Fusion Allergens, Cry j 1 and Cry j 2 from Japanese Cedar Pollen, Conjugated with Polyethylene Glycol Potentiate the Attenuation of Cry j 1-Specific IgE Production in Cry j 1-Sensitized Mice and Japanese Cedar Pollen Allergen-Sensitized Monkeys. Int Arch Allergy Immunol. 2015;168(1):32–43.
   PubMed Web of Science ®Google Scholar
• Bousquet J, Lockey R, Malling HJ. Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper. J Allergy Clin Immunol. 1998;102(4 Pt 1):558–562.
   PubMed Web of Science ®Google Scholar