Mechanisms of allergen-specific immunotherapy and novel ways for vaccine development

M Jutel, W Van de Veen, I Agache, KA Azkur… - Allergology …, 2013 - Elsevier
Allergology International, 2013Elsevier
Allergen-specific immunotherapy (SIT) is the only available curative treatment of allergic
diseases. Recent evidence provided a plausible explanation to its multiple mechanisms
inducing both rapid desensitization and long-term allergen-specific immune tolerance, and
suppression of allergic inflammation in the affected tissues. During SIT, peripheral tolerance
is induced by the generation of allergen-specific regulatory T cells, which suppress
proliferative and cytokine responses against the allergen of interest. Regulatory T cells are …
Abstract
Allergen-specific immunotherapy (SIT) is the only available curative treatment of allergic diseases. Recent evidence provided a plausible explanation to its multiple mechanisms inducing both rapid desensitization and long-term allergen-specific immune tolerance, and suppression of allergic inflammation in the affected tissues. During SIT, peripheral tolerance is induced by the generation of allergen-specific regulatory T cells, which suppress proliferative and cytokine responses against the allergen of interest. Regulatory T cells are characterized by IL-10 and TGF-beta secretion and expression of important cell surface suppressive molecules such as cytotoxic T lymphocyte antigen-4 and programmed death-1 that directly or indirectly influence effector cells of allergic inflammation, such as mast cells, basophils and eosinophils. Regulatory T cells and particularly IL-10 also have an influence on B cells, suppressing IgE production and inducing the production of blocking type IgG4 antibodies. In addition, development of allergen-specific B regulatory cells that produce IL-10 and develop into IgG4 producing plasma cells represent essential players in peripheral tolerance. These findings together with the new biotechnological approaches create a platform for development of the advanced vaccines. Moreover, reliable biomarkers could be selected and validated with the intention to select the patients who will benefit most from this immune-modifying treatment. Thus, allergen-SIT could provide a complete cure for a larger number of allergic patients and novel preventive approaches need to be elaborated.
Elsevier