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What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
What 2012 immunotherapy
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What 2012 immunotherapy

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  • 1. WHAT YOU SHOULD HAVE READ BUT….2012  immunotherapyAttilio BonerUniversity ofVerona, Italy
  • 2. sottocutanea
  • 3. SottocutaneaEffetti collaterali
  • 4. Systemic reactions associated with subcutaneous allergen immunotherapy: timing and risk assessment DaVeiga Ann Allergy Asthma Immunol 2011;106:533 Rate of systemic reaction from subcutaneous allergen immunotherapy 0.5 – A retrospective review from January 2001 0.4 – to December 2007. 0.3 – Systemic reaction from 0.28% 0.2 – immunotherapy. 0.1 – 1.0
  • 5. Systemic reactions associated with subcutaneous allergen immunotherapy: timing and risk assessment DaVeiga Ann Allergy Asthma Immunol 2011;106:533 1) All severe reactions occurred within 30 minutes. 2) The estimated odds of systemic A retrospective review reaction were almost 6 times from January 2001 higher for patients with more to December 2007. than 33% 3 to 4+ positive skin tests (OR = 5.83). Systemic reaction from 3) For each additional 4+ skin immunotherapy. test, the estimated odds for systemic reaction increased by 17% (P = 0.020).
  • 6. sublingual
  • 7. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care De Bot, Pediatr Allergy Immunol 2012;23:150 Mean nose symptom score 251 children (6–18 yrs) after 2 years of treatment with house dust mite– 03 – induced allergic rhinitis 02 – 2.26 ns SLIT with Oralgen 2.02 House Dust Mite (Oralgen Mijten, Artu 01 – Biologicals, Lelystad, T he Netherlands) or placebo 0 SLIT PLACEBO for 2 years
  • 8. Sublingual immunotherapy not effective in house dust mite-allergic children in primary care De Bot, Pediatr Allergy Immunol 2012;23:150 Mean nose symptom score 251 children (6–18 yrs) after 2 years of treatment with house dust mite– 03 – inducedSublingual allergic rhinitis immunotherapy with house dust mite 02 – 2.26 ns SLIT with Oralgen allergen was 2.02 House Dust Mite (Oralgen better Artu not Mijten, than 01 – placebo Biologicals, Lelystad, T he Netherlands) or placebo 0 SLIT PLACEBO for 2 years
  • 9. Epicutaneous allergen administration: is this the future of allergen-specific immunotherapy? Senti, Allergy 2011;66:798 Allergen-specific immunotherapy (SIT) either subcutaneously or via the sublingual route is effective, but only few patients (<5%) choose immunotherapy, as treatment takes several years and because allergen administrations are associated with local and, in some cases, even systemic allergic side-effects.
  • 10. Epicutaneous allergen administration: is this the future of allergen-specific immunotherapy? Senti, Allergy 2011;66:798  In order to resolve these two major drawbacks, the ideal application site of SIT should have two characteristics. - 1st it should contain a high number of potent antigen- presenting cells to enhance efficacy and shorten treatment duration; - 2nd it should be nonvascularized in order to minimize inadvertent systemic distribution of the allergen;  The epidermis, a nonvascularized multilayer epithelium, that contains high numbers of potent antigen- presenting Langerhans cells (LC) could therefore be an interesting administration route.
  • 11. Epicutaneous allergen administration: is this the future of allergen-specific immunotherapy? Senti, Allergy 2011;66:798Timeline for the developments in allergen-specific immunotherapyOn the top: Development of currently approved forms of allergen-specific immunotherapy.On the bottom: Development of epicutaneous allergen-specific immunotherapy.
  • 12. Recombinant DNA immunotherapy ameliorate established airway allergy in a IL-10 dependent pathway. Fonseca, Clin Exp Allergy 2012;42:131 Background Previous studies have established that mycobacterial infections (M. vaccae) ameliorate allergic inflammation. However, a non-infectious approach that controls allergic responses might represent a safer and more promising strategy. The 60–65 kDa heat shock protein (Hsp) family is endowed with anti-inflammatory properties, but it is still unclear whether and how single mycobacterial Hsp control allergic disorders. Objective Therefore, in this study we determined whether the administration of Mycobacterial leprae Hsp65 expressed by recombinant a DNA plasmid could attenuate a previously established allergic response.
  • 13. Recombinant DNA immunotherapy ameliorate established airway allergy in a IL-10 dependent pathway. Fonseca, Clin Exp Allergy 2012;42:131 Sensitized and challenged with ovalbumin Administration of Mycobacterial leprae Hsp65 expressed by recombinant a DNA plasmid.Allergic mice (-) Eosinophilia, pulmonary inflammation, Th2 cytokine and mucus production
  • 14. Recombinant DNA immunotherapy ameliorate established airway allergy in a IL-10 dependent pathway. Fonseca, Clin Exp Allergy 2012;42:131 Sensitized and challenged with ovalbumin Administration of Mycobacterial leprae Hsp65 Inhibition expressed by recombinant a DNA plasmid.of allergic response is dependentAllergic IL-10 on mice production. (-) Eosinophilia, pulmonary inflammation, Th2 cytokine and mucus production

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