title: T Cell Epitope Peptide Therapy for Allergic Diseases.
abstract: Careful selection of dominant T cell epitope peptides of major allergens that display degeneracy for binding to a wide array of MHC class II molecules allows induction of clinical and immunological tolerance to allergen in a refined treatment strategy. From the original concept of peptide-induced T cell anergy arising from in vitro studies, proof-of-concept murine models and flourishing human trials followed. Current randomized, double-blind, placebo-controlled clinical trials of mixtures of T cell-reactive short allergen peptides or long contiguous overlapping peptides are encouraging with intradermal administration into non-inflamed skin a preferred delivery. Definitive immunological mechanisms are yet to be resolved but specific anergy, Th2 cell deletion, immune deviation, and Treg induction seem implicated. Significant efficacy, particularly with short treatment courses, in a range of aeroallergen therapies (cat, house dust mite, grass pollen) with inconsequential non-systemic adverse events likely heralds a new class of therapeutic for allergy, Synthetic Peptide Immuno-Regulatory Epitopes (SPIRE).
authors.affiliation: Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Commercial Road, Melbourne, Victoria, 3004, Australia. r.ohehir@alfred.org.au.|Department of Immunology, Monash University, Melbourne, Victoria, Australia. r.ohehir@alfred.org.au.
authors.forename: Robyn E
authors.initials: RE
authors.lastname: O'Hehir
authors.affiliation: Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Commercial Road, Melbourne, Victoria, 3004, Australia. sara.prickett@monash.edu.
authors.forename: Sara R
authors.initials: SR
authors.lastname: Prickett
authors.affiliation: Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Commercial Road, Melbourne, Victoria, 3004, Australia. jennifer.rolland@monash.edu.|Department of Immunology, Monash University, Melbourne, Victoria, Australia. jennifer.rolland@monash.edu.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Rolland
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D002986:Clinical Trials as Topic; D018984:Epitopes, T-Lymphocyte; D000949:Histocompatibility Antigens Class II / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000188:drug therapy* / Q000276:immunology; D010455:Peptides / Q000627:therapeutic use*
chemical_list: D000485:Allergens; D018984:Epitopes, T-Lymphocyte; D000949:Histocompatibility Antigens Class II; D010455:Peptides
keywords: Allergy; Immunotherapy; Peptide; SPIRE; Synthetic peptide immuno-regulatory epitopes; T cell epitope