The Present and Future of Allergen Immunotherapy in Personalized Medicine

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (15 June 2023) | Viewed by 10012

Special Issue Editor


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Guest Editor
1. Personalized Medicine, Asthma and Allergy-IRCCS Humanitas Research Hospital-Via Alessandro Manzoni, 56, 20089 Rozzano, Italy
2. Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy
Interests: allergen immunotherapy; allergy; asthma; allergic rhinitis; immunotherapy; personalized medicine; precision medicine; disease-modifying treatment

Special Issue Information

Dear Colleagues,

Allergen immunotherapy is a medical treatment for allergies. It is a disease-modifying therapy, indicated for the treatment of allergic rhinitis, allergic conjunctivitis, allergic asthma, and Hymenoptera hypersensitivity. Allergen immunotherapy can be administered either subcutaneously in a physician’s office or sublingually by a patient at home. Oral immunotherapy is used in food allergies. In addition, several biologics that control specific responsible molecules and directly suppress allergic reactions have recently become available. Even in the current era, the significance of allergen immunotherapy, which modifies the natural history of allergic diseases, seems to be prominent.

This Special Issue aims to highlight the role of personalized medicine in clinical practice, providing a complete overview of allergen immunotherapy and highlighting the critical issues in its management. We welcome the submission of original papers and reviews regarding allergen immunotherapy for allergic diseases.

Prof. Dr. Giorgio Walter Canonica
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • allergen immunotherapy
  • allergy
  • asthma
  • allergic rhinitis
  • immunotherapy
  • personalized medicine

Published Papers (4 papers)

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Review

15 pages, 1020 KiB  
Review
Mechanisms of Allergen Immunotherapy and Potential Biomarkers for Clinical Evaluation
by Umit M. Sahiner, Mattia Giovannini, Maria M. Escribese, Giovanni Paoletti, Enrico Heffler, Montserrat Alvaro Lozano, Domingo Barber, Giorgio Walter Canonica and Oliver Pfaar
J. Pers. Med. 2023, 13(5), 845; https://doi.org/10.3390/jpm13050845 - 17 May 2023
Cited by 12 | Viewed by 3330
Abstract
Allergen-immunotherapy (AIT) is an efficacious and disease-modifying treatment option for IgE-mediated diseases. Among these allergic rhinitis, insect venom allergy, food allergy, and allergic asthma are the most common candidates for AIT. AIT gives rise to clinical immunotolerance which may last for years after [...] Read more.
Allergen-immunotherapy (AIT) is an efficacious and disease-modifying treatment option for IgE-mediated diseases. Among these allergic rhinitis, insect venom allergy, food allergy, and allergic asthma are the most common candidates for AIT. AIT gives rise to clinical immunotolerance which may last for years after the treatment cessation. Mechanisms of AIT include suppression of allergic inflammation in target tissues and stimulation of the production of blocking antibodies, especially IgG4 and IgA. These mechanisms are followed by a reduction of underlying allergen-specific Th2 cell-driven responses to the allergens. Tolerance induction takes place through the desensitization of effector cells and stimulation of regulatory T cells that show their effects by mechanisms involving cell-cell cross-talk, but also other mechanisms, e.g., by the production of immunomodulatory cytokines such as, e.g., IL-10 and TGF-beta. From a personalized medical perspective, there is a need for clinical biomarkers of value in selecting responders and optimizing patient care during AIT. Also, a deeper understanding of underlying mechanistic processes will improve AIT’s future outcomes. In this paper, the current knowledge of mechanisms in AIT is reviewed with a special focus on biomarkers of this therapy. Full article
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16 pages, 774 KiB  
Review
Deciphering Differential Behavior of Immune Responses as the Foundation for Precision Dosing in Allergen Immunotherapy
by Antoine Magnan, Jean-François Nicolas, Davide Caimmi, Marc Vocanson, Thierry Haddad, Luc Colas, Silvia Scurati, Laurent Mascarell and Mohamed H. Shamji
J. Pers. Med. 2023, 13(2), 324; https://doi.org/10.3390/jpm13020324 - 13 Feb 2023
Cited by 2 | Viewed by 1427
Abstract
Like in many fields of medicine, the concept of precision dosing has re-emerged in routine practice in allergology. Only one retrospective study on French physicians’ practice has addressed this topic so far and generated preliminary data supporting dose adaptation, mainly based on experience, [...] Read more.
Like in many fields of medicine, the concept of precision dosing has re-emerged in routine practice in allergology. Only one retrospective study on French physicians’ practice has addressed this topic so far and generated preliminary data supporting dose adaptation, mainly based on experience, patient profile understanding and response to treatment. Both intrinsic and extrinsic factors shape the individual immune system response to allergen immunotherapy (AIT). Herein, we focus on key immune cells (i.e., dendritic cells, innate lymphoid cells, B and T cells, basophils and mast cells) involved in allergic disease and its resolution to further understand the effect of AIT on the phenotype, frequency or polarization of these cells. We strive to discriminate differences in immune responses between responders and non-responders to AIT, and discuss the eligibility of a non/low-responder subset for dose adaptation. A differential behavior in immune cells is clearly observed in responders, highlighting the importance of conducting clinical trials with large cohorts of well-characterized subjects to decipher the immune mechanism of AIT. We conclude that there is a need for designing new clinical and mechanistic studies to support the scientific rationale of dose adaptation in the interest of patients who do not properly respond to AIT. Full article
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13 pages, 510 KiB  
Review
Intradermal Allergen Immunotherapy for Allergic Rhinitis: Current Evidence
by Kawita Atipas, Dichapong Kanjanawasee and Pongsakorn Tantilipikorn
J. Pers. Med. 2022, 12(8), 1341; https://doi.org/10.3390/jpm12081341 - 21 Aug 2022
Cited by 2 | Viewed by 2210
Abstract
Allergic rhinitis (AR) is an immunoglobulin E (IgE)-mediated inflammatory disease that is induced by allergen introduction to the nasal mucosa, which triggers an inflammatory response. The current treatments for AR include allergen avoidance and pharmacotherapy; however, allergen-specific immunotherapy (AIT) is the only treatment [...] Read more.
Allergic rhinitis (AR) is an immunoglobulin E (IgE)-mediated inflammatory disease that is induced by allergen introduction to the nasal mucosa, which triggers an inflammatory response. The current treatments for AR include allergen avoidance and pharmacotherapy; however, allergen-specific immunotherapy (AIT) is the only treatment that can be employed to modify immunologic responses and to achieve a cure for allergic diseases. The current standard routes of AIT administration are the subcutaneous and sublingual routes. Alternatively, the dermis contains a high density of dermal dendritic cells that act as antigen-presenting cells, so intradermal administration may confer added advantages and increase the efficacy of AIT. Moreover, intradermal immunotherapy (IDIT) may facilitate a reduction in the allergen dosage and a shortening of the treatment duration. The aim of this review was to search and evaluate the current evidence specific to IDIT, including its modified formulations, such as allergoids and peptides. The results of this review reveal conflicting evidence that suggests that the overall benefit of IDIT remains unclear. As such, further clinical trials are needed to establish the clinical utility of IDIT, and to determine the optimal treatment-related protocols. Full article
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9 pages, 613 KiB  
Review
The Present and Future of Allergen Immunotherapy in Personalized Medicine
by Erminia Ridolo, Cristoforo Incorvaia, Enrico Heffler, Carlo Cavaliere, Giovanni Paoletti and Giorgio Walter Canonica
J. Pers. Med. 2022, 12(5), 774; https://doi.org/10.3390/jpm12050774 - 10 May 2022
Cited by 9 | Viewed by 2236
Abstract
Allergic diseases are particularly suitable for personalized medicine, because they meet the needs for therapeutic success, which include a known molecular mechanism of the disease, a diagnostic tool for that disease and a treatment that blocks this mechanism. A range of tools is [...] Read more.
Allergic diseases are particularly suitable for personalized medicine, because they meet the needs for therapeutic success, which include a known molecular mechanism of the disease, a diagnostic tool for that disease and a treatment that blocks this mechanism. A range of tools is available for personalized allergy diagnosis, including molecular diagnostics, treatable traits and omics (i.e., proteomics, epigenomics, metabolomics, transcriptomics and breathomics), to predict patient response to therapies, detect biomarkers and mediators and assess disease control status. Such tools enhance allergen immunotherapy. Higher diagnostic accuracy results in a significant increase (based on a greater performance achieved with personalized treatment) in efficacy, further increasing the known and unique characteristics of a treatment designed to work on allergy causes. Full article
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