title: [Specific immunotherapy : clinical experience with recombinant molecular major allergens and hypoallergenic variants].
abstract: Currently, preparations containing native allergens or allergoids are used predominantly in allergen-specific immunotherapy (SIT) of inhaled allergies. The safety and efficacy of these preparations has been demonstrated. However, their reproducible production and standardisation requires substantial effort. Besides this, improved efficacy is often associated with higher doses and an increase in adverse events. The production of recombinant allergens could make SIT preparations more precisely definable, purer, more reproducible, safer and more efficacious. Furthermore, a more specific and individually tailored therapy would be conceivable. These effects could be further amplified by modification to hypoallergenic variants and peptides, or by the addition of adjuvants. Results of clinical trials with recombinant grass, birch and ragweed pollen, as well as with cat hair allergens have already been published. Particularly broad clinical experience exists for recombinant birch and grass pollen preparations, and results are promising for commercial application. Taken as a whole, this new technology can both improve the therapy of allergic diseases and deepen the understanding of the molecular mechanisms of SIT.
authors.affiliation: HNO-Universitätsklinik Würzburg, Würzburg, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Schendzielorz
authors.forename: L
authors.initials: L
authors.lastname: Klimek
mesh_terms: D000485:Allergens / Q000235:genetics / Q000276:immunology / Q000627:therapeutic use*; D003888:Desensitization, Immunologic / Q000379:methods*; D019317:Evidence-Based Medicine; D014644:Genetic Variation / Q000235:genetics; D006801:Humans; D057285:Precision Medicine / Q000379:methods*; D011994:Recombinant Proteins / Q000276:immunology / Q000627:therapeutic use*; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000235:genetics / Q000276:immunology / Q000628:therapy*
chemical_list: D000485:Allergens; D011994:Recombinant Proteins
references.citation: Nat Rev Immunol. 2006 Oct;6(10):761-71
references.pmid: 16998509
references.citation: Allergy. 2011 Jun;66(6):775-83
references.pmid: 21352238
references.citation: J Allergy Clin Immunol. 2012 May;129(5):1290-6
references.pmid: 22464647
references.citation: Cochrane Database Syst Rev. 2007 Jan 24;(1):CD001936
references.pmid: 17253469
references.citation: N Engl J Med. 1999 Aug 12;341(7):468-75
references.pmid: 10441602
references.citation: Immunol Allergy Clin North Am. 2006 May;26(2):261-81, vii
references.pmid: 16701144
references.citation: Clin Exp Allergy. 2011 Sep;41(9):1305-12
references.pmid: 21672053
references.citation: Allergy. 2002 Apr;57(4):306-12
references.pmid: 11906360
references.citation: J Allergy Clin Immunol. 2005 Sep;116(3):608-13
references.pmid: 16159631
references.citation: Allergy. 2011 Jun;66(6):784-91
references.pmid: 21507007
references.citation: Allergy Asthma Proc. 2010 Sep-Oct;31(5):375-80
references.pmid: 20929603
references.citation: Clin Exp Allergy. 2000 Oct;30(10):1335-41
references.pmid: 10998006
references.citation: Clin Exp Allergy. 2008 Sep;38(9):1514-25
references.pmid: 18564326
references.citation: J Allergy Clin Immunol. 2007 Apr;119(4):906-9
references.pmid: 17418662
references.citation: J Allergy Clin Immunol. 2007 Apr;119(4):826-30
references.pmid: 17335886
references.citation: Allergy. 2008 Aug;63(8):990-6
references.pmid: 18691301
references.citation: Clin Exp Allergy. 2012 Jun;42(6):936-45
references.pmid: 22909165
references.citation: J Allergy Clin Immunol. 2008 Nov;122(5):951-60
references.pmid: 19000581
references.citation: N Engl J Med. 2006 Oct 5;355(14):1445-55
references.pmid: 17021320
references.citation: J Allergy Clin Immunol. 2011 Apr;127(4):865-72
references.pmid: 21377719
references.citation: J Allergy Clin Immunol. 1998 Oct;102(4 Pt 1):558-62
references.pmid: 9802362
references.citation: Proc Natl Acad Sci U S A. 2008 Nov 18;105(46):17908-12
references.pmid: 19001265
references.citation: Curr Opin Immunol. 2006 Dec;18(6):761-8
references.pmid: 17010585
references.citation: J Allergy Clin Immunol. 2007 Apr;119(4):1013-6
references.pmid: 17292956
references.citation: Int Arch Allergy Immunol. 2003 Feb;130(2):87-107
references.pmid: 12673063
references.citation: Int Arch Allergy Immunol. 2004 Aug;134(4):324-31
references.pmid: 15240999
references.citation: Clin Exp Allergy. 2001 Sep;31(9):1392-7
references.pmid: 11591189
references.citation: Int Arch Allergy Immunol. 2000 Mar;121(3):173-82
references.pmid: 10729775
references.citation: J Allergy Clin Immunol. 2002 Feb;109(2):251-6
references.pmid: 11842293
references.citation: Methods. 2004 Mar;32(3):300-12
references.pmid: 14962765
references.citation: Int Arch Allergy Immunol. 2002 Jul;128(3):171-8
references.pmid: 12119498
references.citation: J Allergy Clin Immunol. 2011 Jan;127(1):89-97, 97.e1-14
references.pmid: 21211644
references.citation: J Immunol. 2009 Aug 1;183(3):1821-7
references.pmid: 19592660