Vaccination

AIT is technically a form of vaccination, but there are some more advanced forms of vaccination that involve lab-generated molecules. These molecules were created to increase the safety and efficacy of treatments that induce tolerance to allergens.

Molecular Allergy Vaccines

© 2020 Tulaeva, Kratzer, Campana, Curin, van Hage, Karsonova, Riabova, Karaulov, Khaitov, Pickl and Valenta.¹¹

Molecular allergy vaccines take advantage of modified allergen proteins with varying degrees of allergenicity and immunogenicity. Allergenicity means how likely it is to cause an allergic reaction, and immunogenicity means how likely it is to provoke an immune response that induces tolerance.

Folded Wildtype-Like Recombinant Allergens

Wildtype-like molecules mimic all properties of naturally occurring allergens but are able to be manufactured. They are commonly used for allergy testing and AIT.

Hypoallergenic Recombinant Allergens

Hypoallergenic molecules are similar to wildtype-like allergens but have reduced IgE reactivity, decreasing the risk for allergic inflammation while maintaining similar immunogenicity.

Chemically modified aluminum-hydroxide adsorbed allergens (CMAHAAs) are one hypoallergenic recombinant allergen being studied and used in human trials.

Peptide Immunotherapy

Peptide immunotherapy involves the use of overlapping peptides which represent the entire sequence of an allergen. These peptides can be in different forms to induce tolerance to various immune cells. T cell epitope-containing peptides allow for T cell recognition of allergen peptides without the risk of IgE binding as the whole allergen is not used. Carrier-bound peptides of B cell epitopes are an improvement of hypoallergenic allergens as they reduce side effects from T cells and allergic inflammation while still inducing tolerance.

In summary, peptide immunotherapy modifies the underlying allergic disease by providing small doses of synthetic peptides derived from a specific allergen to induce tolerance without the risk of an allergic reaction.

Nanoparticle Immunotherapy (NPIT)⁹

Nanoparticle immunotherapy is a novel approach to AIT that uses nanoparticles containing encapsulated allergens, which enables safe intravenous delivery of allergens through injection. The goal of nanoparticle immunotherapy is to leverage intravenous biology to induce tolerance.

Typically, the risk of adverse events from injecting allergens intravenously is too great as it often results in anaphylaxis. However, by concealing the allergen in a biodegradable sheath, the immune system does not react and these particles are picked up by phagocytic cells; where the sheath is broken down and the allergen is presented to induce tolerance.

Due to the injection process and risks associated with administering NPIT, it cannot be self-administered and must be administered by a medical professional.

Currently, no NPIT treatments are FDA-approved as this form of AIT is still severely underdeveloped.

Plasmid DNA/mRNA Vaccines¹²

Plasmid DNA or mRNA allergy vaccines utilize the same technology as the Pfizer and Moderna COVID-19 vaccines; that is, within transfected cells, the encoded allergen proteins are created and presented to the immune system to induce tolerance.

This technology is still very new, so plasmid DNA or mRNA allergy vaccines are still in the development phase but are promising treatments for inducing tolerance to specific major allergens.