Universität zu Köln

Moesges, R., Koch, A. F., Raskopf, E., Singh, J., Shah-Hosseini, K., Astvatsatourov, A., Hauswald, B., Yarin, Y., Corazza, F., Haazen, L., Pirotton, S., Allekotte, S., Zadoyan, G., Legon, T., Durham, S. R. and Shamji, M. H. (2018). Lolium perenne peptide immunotherapy is well tolerated and elicits a protective B-cell response in seasonal allergic rhinitis patients. Allergy, 73 (6). S. 1254 - 1263. HOBOKEN: WILEY. ISSN 1398-9995

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Abstract

BackgroundSystemic allergic reactions are a risk for allergen immunotherapy that utilizes intact allergen preparations. We evaluated the safety, efficacy and immune mechanisms of short-course treatment with adjuvant-free Lolium perenne peptides (LPP) following a 6-week dose-escalation protocol. MethodsIn a prospective, dose-escalation study, 61 grass pollen-allergic patients received 2 subcutaneous injections of LPP once weekly for 6weeks. Safety was assessed evaluating local reactions, systemic reactions and adverse events. The clinical effect of LPP was determined by reactivity to the conjunctival provocation test (CPT). Specific IgE, IgG(4) and blocking antibodies were measured at baseline (V1), during (V6) and after treatment (V8). ResultsNo fatality, serious adverse event or epinephrine use was reported. Mean wheal diameters after injections were <0.6cm and mean redness diameters <2.5cm, independent of dose. Transient and mostly mild adverse events were reported in 33 patients. Two patients experienced a grade I and 4 patients a grade II reaction (AWMF classification). At V8, 69.8% of patients became nonreactive to CPT. sIgG(4) levels were higher at V6 (8.1-fold, P<.001) and V8 (12.2-fold, P<.001) than at V1. The sIgE:sIgG(4) ratio decreased at V6 (-54.6%, P<.001) and V8 (-71.6%, P<.001) compared to V1. The absolute decrease in IgE-facilitated allergen binding was 18% (P<.001) at V6 and 25% (P<.001) at V8. ConclusionIncreasing doses of subcutaneous LPP appeared safe, substantially diminished reactivity to CPT and induced blocking antibodies as early as 4weeks after treatment initiation. The benefit/risk balance of LPP immunotherapy remains to be further evaluated in large studies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moesges, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, A. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Raskopf, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Singh, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah-Hosseini, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Astvatsatourov, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hauswald, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Yarin, Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Corazza, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haazen, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pirotton, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Allekotte, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zadoyan, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Legon, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Durham, S. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shamji, M. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-184663
DOI:	10.1111/all.13392
Journal or Publication Title:	Allergy
Volume:	73
Number:	6
Page Range:	S. 1254 - 1263
Date:	2018
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1398-9995
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PLACEBO-CONTROLLED TRIAL; GRASS-POLLEN ALLERGENS; SUBCUTANEOUS IMMUNOTHERAPY; DOUBLE-BLIND; SYSTEMIC REACTIONS; PROVOCATION TEST; EXTRACT; SAFETY; RHINOCONJUNCTIVITIS; CONJUNCTIVAL Multiple languages Allergy; Immunology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18466