Peptide immunotherapy for allergic disease.
The only disease-modifying treatment available for IgE-mediated disease is specific immunotherapy, but the retention of B cell epitopes in whole allergen preparations confers a risk of IgE-mediated systemic reactions to their administration. Compelling evidence for the central role of T cells in allergic disease suggests that IgE-binding epitopes could be removed from such therapy, improving safety without affecting efficacy. Short, allergen-derived peptides lack the conformational determinants required for IgE crosslinking and are, therefore, an attractive therapeutic possibility. However, human leukocyte antigen (HLA) polymorphism means that T cell peptide epitopes present a huge diversity, which makes the design of peptide-based vaccines problematic. Over the past 10 years, advances in our understanding of epitope selection and major histocompatibility complex (MHC)-peptide-T cell receptor interactions have taken this therapy forward to early clinical trials with human volunteers.
Tarzi
Michael
M
Allergy and Clinical Immunology, Faculty of Medicine, Imperial College London, National Heart and Lung Institute, Dovehouse Street, London, SW3 6LY, UK. m.tarzi@ic.ac.uk
Larché
Mark
M
D000818:Animals; D002986:Clinical Trials as Topic; D006801:Humans; D006967:Hypersensitivity / Q000473:pathology / Q000628:therapy*; D007167:Immunotherapy; D010455:Peptides / Q000627:therapeutic use*
D010455:Peptides