Interest Groups

IG - Allergen Immunotherapy

  • Resources

    immunotherapyThis section contains References to the literature and links to meetings of Immunotherapy Interest. Something completely new is presenting interviews; Key Opinion Leaders are interviewed, about Immunotherapy and... not only.
    Last updated: 18 January 2017
  • Pascal Demoly's Interview

    We are happy to present an interview of Pascal Demoly; Professor at the Montpellier University (France) and EAACI’s Vice-President for Education & Specialty. Apart from a very long list of studies and papers, he is a tutor, always available. Our IG’s board has always felt him near, since Immunotherapy is (apparently) his favorite field of Allergology. He is currently contacting Clinical trials on new Immunotherapy products and is conducting a French survey on how do French allergists deal with their tree-pollen allergic patients.

    -Dear Pascal, do you think that performing allergen Immunotherapy is challenging?
    No it is not. Indications are clear, good products for the most common allergies exist and they are safe.

    -Looking back to the early years you started performing AIT do you have the feeling that lots have changed?
    It’s amazing, indeed. In France, we used to use mixtures of SCIT products and as a resident I never understood how prescriptions were set. To me there was no rationality behind it, not one prescription resembled another although some patients looked the same to me.

    -Do you prefer SCIT or SLIT?
    I was educated mostly to use SLIT, so I use SLIT for respiratory allergic patients. However, I use SCIT for venom allergic patients

    -Do you use pretreatment before an AIT visit?                                                      
    I am using pharmacotherapy before starting on AIT, so as to control the disease. I do not premedicate with H1 antihistamines, with the exception of large local reactions during venom SCIT.

    -Which are your "key words" to convince a patient to start a 3-years-long treatment?
    I insist on some words indeed when I define both the disease and AIT talking to the patient.  Respiratory allergy is a chronic disease with consequences at work/school. It is a progressive disease that gradually worsens over time, with an increased risk of polysensitization and asthma in rhinitic patients.  AIT is the only allergy treatment with a long-lasting effect on all symptoms. It induces tolerance to allergens by rebalancing the immune system. It is a targeted/tailored solution.   

    -Finally, as a very active member of EAACI, which are your favorite memories?
    Sharing different views with people of different backgrounds, different cultures and most importantly adapting and changing my views at their contact.

    Last updated: 18 January 2017
  • Useful documents for those interested in immunotherapy

    Just in case you were  unable to visit the Immunotherapy Booth at the Clinical Village in Barcelona here we want to share with you some useful documents. The Spansih society (SEAIC) is very concern about immunotherapy and is happy to share with us some of the work and experience that its immunotherapy interest group has gathered.

    Here you can find some of the documents showed at the Clinical Village, that can be very useful:


    What Spanish allergists think about the AIT Regulatory Procedure. These are the results of a suvey undertaken by 56 AIT Spanish experts about the AIT regulatory procedure.


    Approach and management of the polysensitised patient. Here we attach the Spanish consensus on diagnosis and allergen immunotherapy treatment of polysensitsed patients with respiratory allergy in Spain.


    Immunotherapy booklet. This is the booklet used for a proper follow up and control of the immunotherapy patient. It is the way to avoid mistakes and to verify the adherence to the treatment.


    Optimizing immunotherapy in pollinosis. Tips and trouble in order to prescribe an appropriate immunotherapy.


    Immunotherapy products guide. This tool made by the Spanish society (SEAIC) is meant to gather the information of the different immunotherapy products available with a proper scientific background. This will help the allergist make the decission on which product has to be prescribed in the different patients.


    Clinical settings for administering AIT. We present the results of a survey on how and where immunotherapy is administered in Spain.


    CLINICAL VILLAGE AIT MEMBERS




    Last updated: 16 November 2015
  • IT IG References

    OUTSTANDING INTEREST PAPERS

    Pfaar O, Demoly P, Gerth van Wijk R, Bonini S, Bousquet J, Canonica GW, Durham S, Jacobsen L, Malling HJ, Moesges R, Papadopoulos NG, Rak S, Rodriguez del Rio P, Valovirta E, Wahn U, Calderon MA. Allergy.
    Recommendations for the Standardisation of Clinical Outcomes used in Allergen Immunotherapy (AIT) Trials for Allergic Rhinoconjunctivitis: an EAACI Position Paper.

    Allergy, 2014 Jul;69(7):854-67.

    Calderon MA, Larenas D, Kleine-Tebbe J, Jacobsen L, Passalacqua G, Eng PA, Varga EM, Valovirta E, Moreno C, Malling HJ, Alvarez-Cuesta E, Durham S, Demoly P.
    European Academy of Allergy and Clinical Immunology task force report on 'dose-response relationship in allergen-specific immunotherapy'.
    Allergy, 2011 Oct;66(10):1345-59


    General aspects of Allergen-Specific Immunotherapy

    Subcutaneous Immunotherapy:

    Cox L, Calderón M, Pfaar O.
    Subcutaneous allergen immunotherapy for allergic disease: examining efficacy, safety and cost effectiveness of current and novel formulations.
    Immunotherapy. 2012 Jun; 4(6): 601-16.

    Pfaar O, Urry Z, Robinson DS, Sager A, Richards D, Hawrylowicz CM, Bräutigam M, Klimek L.
    A randomized placebo-controlled trial of rush preseasonal depigmented polymerized grass pollen immunotherapy.
    Allergy. 2012 Feb;67(2):272-9.

    Cox L, Larenas-Linnemann D, Lockey RF, Passalacqua G.
    Speaking the same language: The World Allergy Organization Subcutaneous Immunotherapy Systemic Reaction Grading System.
    J Allergy Clin Immunol. 2010 Mar;125(3):569-74.

    Soyer OU, Akdis M, Akdis CA.
    Mechanisms of subcutaneous allergen immunotherapy.
    Immunol Allergy Clin North Am. 2011 May;31(2):175-90, vii-vii.

    Cox L, Nelson H, Lockey R et al.
    Allergen immunotherapy: a practice parameter third update.
    J Allergy Clin Immunol. 2011 Jan;127(1 Suppl):S1-55.

    Sublingual Immunotherapy:

    Canonica GW, Bousquet J, Casale T, et al. Sub-lingual immunotherapy: World Allergy Organization Position Paper 2009. Allergy. 2009 Dec;64 Suppl 91:1-59

    http://www.ncbi.nlm.nih.gov/pubmed/20041860

    Scadding G, Durham SR. Mechanisms of sublingual immunotherapy. Immunol Allergy Clin North Am. 2011 May;31(2):191-209, viii.

    http://www.ncbi.nlm.nih.gov/pubmed/21530814

    Durham SR, Emminger W, Kapp A, et al. Long-term clinical efficacy in grass pollen-induced rhinoconjunctivitis after treatment with SQ-standardized grass allergy immunotherapy tablet. J Allergy Clin Immunol. 2010 Jan;125(1):131-8.e1-7.

    http://www.ncbi.nlm.nih.gov/pubmed/20109743

    Horak F, Zieglmayer P, Zieglmayer R, et al. Early onset of action of a 5-grass-pollen 300-IR sublingual immunotherapy tablet evaluated in an allergen challenge chamber. J Allergy Clin Immunol. 2009 Sep;124(3):471-7.

    http://www.ncbi.nlm.nih.gov/pubmed?term=19647862

    Radulovic S, Calderon MA, Wilson D, Durham S. Sublingual immunotherapy for allergic rhinitis. Cochrane Database Syst Rev. 2010 Dec 8;(12).

    http://www.ncbi.nlm.nih.gov/pubmed/21154351

    Future approaches:

    Casale TB, Stokes JR. Future forms of immunotherapy. J Allergy Clin Immunol. 2011 Jan;127(1):8-15;

    http://www.ncbi.nlm.nih.gov/pubmed?term=21094518

    Valenta R, Linhart B, Swoboda I, Niederberger V.Recombinant allergens for allergen-specific immunotherapy: 10 years anniversary of immunotherapy with recombinant allergens. Allergy. 2011 Jun;66(6):775-83.

    http://www.ncbi.nlm.nih.gov/pubmed?term=21352238

    Moldaver D, Larche M. Immunotherapy with peptides. Allergy. 2011 Jun;66(6):784-91
    http://www.ncbi.nlm.nih.gov/pubmed?term=21507007

    Senti G, von Moos S, Kundig TM. Epicutaneous allergen administration: is this the future of allergen-specific immunotherapy? Allergy. 2011 Jun;66(6):798-809

    http://www.ncbi.nlm.nih.gov/pubmed?term=21518374

    Martinez-Gomez JM, Johansen P, Erdmann I, Senti G, Crameri R, Kundig TM. Intralymphatic injections as a new administration route for allergen-specific immunotherapy. Int Arch Allergy Immunol. 2009;150(1):59-65.

    http://www.ncbi.nlm.nih.gov/pubmed/19339803

    Suzuki K, Kaminuma O, Yang L, et al Development of transgenic rice expressing mite antigen for a new concept of immunotherapy. Int Arch Allergy Immunol. 2009;149 Suppl 1:21-4

    http://www.ncbi.nlm.nih.gov/pubmed/19494500

    Non respiratory allergens

    Bilo BM, Bonifazi F. Hymenoptera venom immunotherapy. Immunotherapy. 2011 Feb;3(2):229-46.

    http://www.ncbi.nlm.nih.gov/pubmed/21322761

    Niedoszytko M, de Monchy J, van Doormaal JJ, Jassem E, Oude Elberink JN. Mastocytosis and insect venom allergy: diagnosis, safety and efficacy of venom immunotherapy. Allergy. 2009 Sep;64(9):1237-45.

    http://www.ncbi.nlm.nih.gov/pubmed/19627278

    Nowak-Wegrzyn A, Sampson HA. Future therapies for food allergies. J Allergy Clin Immunol. 2011 Mar;127(3):558-73.

    http://www.ncbi.nlm.nih.gov/pubmed/21277625

    Fernandez-Rivas M, Garrido Fernandez S, Nadal JA et al. Randomized double-blind, placebo-controlled trial of sublingual immunotherapy with a Pru p 3 quantified peach extract. Allergy. 2009 Jun;64(6):876-83.

    http://www.ncbi.nlm.nih.gov/pubmed/19183164

    Other:

    Bousquet J, Schunemann HJ, Bousquet PJ et al. How to design and evaluate randomized controlled trials in immunotherapy for allergic rhinitis: an ARIA-GA(2) LEN statement. Allergy. 2011 Jun;66(6):765-74.

    http://www.ncbi.nlm.nih.gov/pubmed?term=21496059

    Ring J, Gutermuth J.100 years of hyposensitization: history of allergen-specific immunotherapy (ASIT). Allergy. 2011 Jun;66(6):713-24

    http://www.ncbi.nlm.nih.gov/pubmed?term=21320133

    Bousquet PJ, Calderon MA, Demoly P, et al. The Consolidated Standards of Reporting Trials (CONSORT) Statement applied to allergen-specific immunotherapy with inhalant allergens: a Global Allergy and Asthma European Network (GA(2)LEN) article. J Allergy Clin Immunol. 2011 Jan;127(1):49-56.

    http://www.ncbi.nlm.nih.gov/pubmed/21112079mmm
    Last updated: 18 January 2017
  • Erkka Valovirta's interview

    We are happy and honored to present an interview of Professior Erkka Valovirta. He has been Chairman of our IG and a great tutor for many of us. He works in the Allergy Clinic of Terveystalo Turku, in the University of Turku, Finland and is currently traveling allover Finland for the Finnish Allergy Programme, run by the Finnish lung Health Association. The program started on 2008 and aims to reduce burden of allergies. Until now he has had 236 educational meetings all over the country to all levels of the Health Care.



     

    Why did Immunotherapy attract you?

    As a young resident in the Department of Pediatrics at Turku University, I was very much interested in intensive care, cardiology and neonatology. This was just after I finnished medical school in 1980, so I went directly to the Dept. of Pediatrics. However, the Allergy Group in the Dept of Pediatrics was very active in scientific research; they just asked me if  would be interested to start an Allergen Specific ImmunoTherapy (ASIT) study in asthmatic chlidren with dog allergy. And, I did! At that time I had no idea about ASIT or in general about allergic diseases. But, very soon I knew that ASIT was going to be my topic. This happened already in 1982, so just 2 yrs after I had started in pediatrics. And, then I started the scientific work ; the name of my doctoral thesis was Allergen Specific Immunotherapy in Dog Allergic Asthmatic Children in 1987. So, I think more or less my immunotherapeutist career started by accident. Good so! I am very happy!

    Do you feel that "things" are changing in AIT?


    Yes, I really belive so. In Finnish Allergy Program we have started to educate more and more primary care nurses and doctors about the possibilities of ASIT, especially SLIT. In EFA, European umbrella organization of allergy and asthma patient association, we have Allergy Awareness Project, and the target groups are political decision makers and authorities, so that they understand better the  burden of allergic diseases. Especially now during EU elections we work very much with the MEPs and candidates. We also have a joint task force with ARIA, EAACI, UEMS in order to harmonize allergy education in nursing and medical schools; one part in basic education is ASIT also. And, scientific studies about inguinal and epidermal ASITA are interesting, in Finland we have a study going on with adjuvants and there is also a group studying possibilities about allergy vaccination. Somehow I feel that even if there is so much high quality scientific data about ASIT, many patients do not get this treatment, this is at least the situation in Scandinavian countries.

    Do you prefer SCIT or SLIT to treat your patients?

    In Finland we only have grass tablet, and we only have allergen extracts from one company. In general I prefer SLIT!

    Do you remember any interesting story of an AIT-treated patient?

    My youngest ASIT patient was a boy named Santeri, we started ASIT to him with birch injections at the age 3½! And, it was just a success story; he was very brave! The subcutaneous space in his upper arm was very, very little and we had to - during the maintenance phase - give to each upper arm 0.5ml of volume, because 1ml was much too much! This happened in 1985, he is still my patient, but now more with his two own allergic children, 4 and 6 yrs of age, and both are on grass-SLIT.

    Finally, as a member and an ex-Chairman of our IG, which are your favorite memories?

    When I started as the Secretary, Emilio Alvarez Cuesta was the Chairman at that time, we were only some 10-15 in IT IG. We were all good friends, like a family. During my time as the Chairman IG started to grow, but still we were like a family. And, today IT IG is the biggest IG in EAACÌ, and still we are all good friends, we are a family which is to me very important. I love you all!
    Last updated: 18 January 2017
  • Meetings of Immunotherapy Interest

    Our Annual Business meeting will take place on June 7th, during the 2015 EAACI Congress at Barcelona
    Last updated: 18 January 2017