Skip to main content
Erschienen in: Die Dermatologie 9/2021

17.08.2021 | Allergologie in der HNO-Heilkunde | Leitthema

Welche Rolle spielt die Allergenimmuntherapie bei Immunglobulin-E-vermittelter Nahrungsmittelallergie?

verfasst von: Prof. Dr. med. Regina Treudler, Jan-Christoph Simon

Erschienen in: Die Dermatologie | Ausgabe 9/2021

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Therapie der Nahrungsmittelallergie (NMA) besteht bisher in einer Allergenkarenz und dem Einsatz von Notfallmedikamenten. Die Möglichkeit einer allergenspezifischen Immuntherapie (AIT) auf unterschiedlichen Applikationswegen findet in den letzten Jahren zunehmend Beachtung. Bei der primären NMA wird vorrangig die orale AIT eingesetzt. Während dieses bisher nur in Studien möglich war, existiert seit Kurzem für die Erdnussallergie auch ein kommerziell erhältliches Extrakt in Europa. Bei der sekundären NMA kommen sublinguale und subkutane AIT v. a. mit den kreuzreagierenden Pollenallergenen zum Einsatz. Eine Zulassung für diese Indikation existiert nicht, sodass eine AIT nur bei gleichzeitig bestehender Atemwegssymptomatik erfolgen sollte.
Literatur
1.
Zurück zum Zitat Andorf S, Purington N, Block WM et al (2018) Anti-IgE treatment with oral immunotherapy in multifood allergic participants: a double-blind, randomised, controlled trial. Lancet Gastroenterol Hepatol 3(2):85–94PubMedCrossRef Andorf S, Purington N, Block WM et al (2018) Anti-IgE treatment with oral immunotherapy in multifood allergic participants: a double-blind, randomised, controlled trial. Lancet Gastroenterol Hepatol 3(2):85–94PubMedCrossRef
2.
Zurück zum Zitat Asero R (2004) Effects of birch pollen SIT on apple allergy: a matter of dosage? Allergy 59(12):1269–1271PubMedCrossRef Asero R (2004) Effects of birch pollen SIT on apple allergy: a matter of dosage? Allergy 59(12):1269–1271PubMedCrossRef
4.
Zurück zum Zitat Beyer S, Franke A, Simon JC et al (2016) Measurement of health-related quality of life in adult patients with birch pollen-associated food allergy. J Dtsch Dermatol Ges 14(4):397–404PubMed Beyer S, Franke A, Simon JC et al (2016) Measurement of health-related quality of life in adult patients with birch pollen-associated food allergy. J Dtsch Dermatol Ges 14(4):397–404PubMed
5.
Zurück zum Zitat Bird JA, Spergel JM, Jones SM et al (2018) Efficacy and safety of AR101 in oral immunotherapy for peanut allergy: results of ARC001, a randomized, double-blind, placebo-controlled phase 2 clinical trial. J Allergy Clin Immunol Pract 6(2):476–485.e3PubMedCrossRef Bird JA, Spergel JM, Jones SM et al (2018) Efficacy and safety of AR101 in oral immunotherapy for peanut allergy: results of ARC001, a randomized, double-blind, placebo-controlled phase 2 clinical trial. J Allergy Clin Immunol Pract 6(2):476–485.e3PubMedCrossRef
6.
Zurück zum Zitat Blumchen K, Trendelenburg V, Ahrens F et al (2019) Efficacy, safety, and quality of life in a multicenter, randomized, placebo-controlled trial of low-dose peanut oral immunotherapy in children with peanut allergy. J Allergy Clin Immunol Pract 7(2):479–491.e10PubMedCrossRef Blumchen K, Trendelenburg V, Ahrens F et al (2019) Efficacy, safety, and quality of life in a multicenter, randomized, placebo-controlled trial of low-dose peanut oral immunotherapy in children with peanut allergy. J Allergy Clin Immunol Pract 7(2):479–491.e10PubMedCrossRef
7.
Zurück zum Zitat Bolhaar STHP, Tiemessen MM, Zuidmeer L et al (2004) Efficacy of birch-pollen immunotherapy on cross-reactive food allergy confirmed by skin tests and double-blind food challenges. Clin Exp Allergy 34(5):761–769PubMedCrossRef Bolhaar STHP, Tiemessen MM, Zuidmeer L et al (2004) Efficacy of birch-pollen immunotherapy on cross-reactive food allergy confirmed by skin tests and double-blind food challenges. Clin Exp Allergy 34(5):761–769PubMedCrossRef
8.
Zurück zum Zitat Brar KK, Lanser BJ, Schneider A et al (2020) Biologics for the treatment of food allergies. Immunol Allergy Clin North Am 40(4):575–591PubMedCrossRef Brar KK, Lanser BJ, Schneider A et al (2020) Biologics for the treatment of food allergies. Immunol Allergy Clin North Am 40(4):575–591PubMedCrossRef
9.
Zurück zum Zitat Bucher X, Pichler WJ, Dahinden CA et al (2004) Effect of tree pollen specific, subcutaneous immunotherapy on the oral allergy syndrome to apple and hazelnut. Allergy 59(12):1272–1276PubMedCrossRef Bucher X, Pichler WJ, Dahinden CA et al (2004) Effect of tree pollen specific, subcutaneous immunotherapy on the oral allergy syndrome to apple and hazelnut. Allergy 59(12):1272–1276PubMedCrossRef
10.
Zurück zum Zitat Burney PGJ, Potts J, Kummeling I et al (2014) The prevalence and distribution of food sensitization in European adults. Allergy 69(3):365–371PubMedCrossRef Burney PGJ, Potts J, Kummeling I et al (2014) The prevalence and distribution of food sensitization in European adults. Allergy 69(3):365–371PubMedCrossRef
11.
Zurück zum Zitat Dispenza MC, Bochner BS, MacGlashan DW (2020) Targeting the FcεRI pathway as a potential strategy to prevent food-induced anaphylaxis. Front Immunol 11:614402PubMedPubMedCentralCrossRef Dispenza MC, Bochner BS, MacGlashan DW (2020) Targeting the FcεRI pathway as a potential strategy to prevent food-induced anaphylaxis. Front Immunol 11:614402PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Dorofeeva Y, Shilovskiy I, Tulaeva I et al (2021) Past, present, and future of allergen immunotherapy vaccines. Allergy 76(1):131–149PubMedCrossRef Dorofeeva Y, Shilovskiy I, Tulaeva I et al (2021) Past, present, and future of allergen immunotherapy vaccines. Allergy 76(1):131–149PubMedCrossRef
13.
Zurück zum Zitat Fleischer DM, Spergel JM, Kim EH et al (2020) Evaluation of daily patch application duration for epicutaneous immunotherapy for peanut allergy. Allergy Asthma Proc 41(4):278–284PubMedCrossRef Fleischer DM, Spergel JM, Kim EH et al (2020) Evaluation of daily patch application duration for epicutaneous immunotherapy for peanut allergy. Allergy Asthma Proc 41(4):278–284PubMedCrossRef
14.
Zurück zum Zitat Geroldinger-Simic M, Kinaciyan T, Nagl B et al (2013) Oral exposure to Mal d 1 affects the immune response in patients with birch pollen allergy. J Allergy Clin Immunol 131(1):94–102PubMedCrossRef Geroldinger-Simic M, Kinaciyan T, Nagl B et al (2013) Oral exposure to Mal d 1 affects the immune response in patients with birch pollen allergy. J Allergy Clin Immunol 131(1):94–102PubMedCrossRef
15.
Zurück zum Zitat Hansen KS, Khinchi MS, Skov PS et al (2004) Food allergy to apple and specific immunotherapy with birch pollen. Mol Nutr Food Res 48(6):441–448PubMedCrossRef Hansen KS, Khinchi MS, Skov PS et al (2004) Food allergy to apple and specific immunotherapy with birch pollen. Mol Nutr Food Res 48(6):441–448PubMedCrossRef
16.
Zurück zum Zitat Hofer H, Asam C, Hauser M et al (2017) Tackling Bet v 1 and associated food allergies with a single hybrid protein. J Allergy Clin Immunol 140(2):525–533.e10PubMedCrossRef Hofer H, Asam C, Hauser M et al (2017) Tackling Bet v 1 and associated food allergies with a single hybrid protein. J Allergy Clin Immunol 140(2):525–533.e10PubMedCrossRef
17.
Zurück zum Zitat Kinaciyan T, Jahn-Schmid B, Radakovics A et al (2007) Successful sublingual immunotherapy with birch pollen has limited effects on concomitant food allergy to apple and the immune response to the Bet v 1 homolog Mal d 1. J Allergy Clin Immunol 119(4):937–943PubMedCrossRef Kinaciyan T, Jahn-Schmid B, Radakovics A et al (2007) Successful sublingual immunotherapy with birch pollen has limited effects on concomitant food allergy to apple and the immune response to the Bet v 1 homolog Mal d 1. J Allergy Clin Immunol 119(4):937–943PubMedCrossRef
18.
Zurück zum Zitat Kinaciyan T, Nagl B, Faustmann S et al (2018) Efficacy and safety of 4 months of sublingual immunotherapy with recombinant Mal d 1 and Bet v 1 in patients with birch pollen-related apple allergy. J Allergy Clin Immunol 141(3):1002–1008PubMedCrossRef Kinaciyan T, Nagl B, Faustmann S et al (2018) Efficacy and safety of 4 months of sublingual immunotherapy with recombinant Mal d 1 and Bet v 1 in patients with birch pollen-related apple allergy. J Allergy Clin Immunol 141(3):1002–1008PubMedCrossRef
19.
Zurück zum Zitat Klimek L, Pfaar O, Worm M (2016) New opportunities for allergen immunotherapy using synthetic peptide immuno-regulatory epitopes (SPIREs). Expert Rev Clin Immunol 12(10):1123–1135PubMedCrossRef Klimek L, Pfaar O, Worm M (2016) New opportunities for allergen immunotherapy using synthetic peptide immuno-regulatory epitopes (SPIREs). Expert Rev Clin Immunol 12(10):1123–1135PubMedCrossRef
20.
Zurück zum Zitat Kopac P, Rudin M, Gentinetta T et al (2012) Continuous apple consumption induces oral tolerance in birch-pollen-associated apple allergy. Allergy 67(2):280–285PubMedCrossRef Kopac P, Rudin M, Gentinetta T et al (2012) Continuous apple consumption induces oral tolerance in birch-pollen-associated apple allergy. Allergy 67(2):280–285PubMedCrossRef
21.
Zurück zum Zitat Langlois A, Lavergne M‑H, Leroux H et al (2020) Protocol for a double-blind, randomized controlled trial on the dose-related efficacy of omalizumab in multi-food oral immunotherapy. Allergy Asthma Clin Immunol 16(1):1–16 Langlois A, Lavergne M‑H, Leroux H et al (2020) Protocol for a double-blind, randomized controlled trial on the dose-related efficacy of omalizumab in multi-food oral immunotherapy. Allergy Asthma Clin Immunol 16(1):1–16
22.
Zurück zum Zitat Long A, Borro M, Sampath V et al (2020) New developments in non-allergen-specific therapy for the treatment of food allergy. Curr Allergy Asthma Rep 20(1):3PubMedCrossRef Long A, Borro M, Sampath V et al (2020) New developments in non-allergen-specific therapy for the treatment of food allergy. Curr Allergy Asthma Rep 20(1):3PubMedCrossRef
23.
Zurück zum Zitat Lozano-Ojalvo D, Martínez-Blanco M, Pérez-Rodríguez L et al (2019) Oral immunotherapy with egg peptides induces innate and adaptive tolerogenic responses. Mol Nutr Food Res 63(17):e1900144PubMedCrossRef Lozano-Ojalvo D, Martínez-Blanco M, Pérez-Rodríguez L et al (2019) Oral immunotherapy with egg peptides induces innate and adaptive tolerogenic responses. Mol Nutr Food Res 63(17):e1900144PubMedCrossRef
24.
Zurück zum Zitat Lyons SA, Clausen M, Knulst AC et al (2020) Prevalence of food sensitization and food allergy in children across Europe. J Allergy Clin Immunol Pract 8(8):2736–2746.e9PubMedCrossRef Lyons SA, Clausen M, Knulst AC et al (2020) Prevalence of food sensitization and food allergy in children across Europe. J Allergy Clin Immunol Pract 8(8):2736–2746.e9PubMedCrossRef
26.
Zurück zum Zitat Mauro M, Russello M, Incorvaia C et al (2011) Birch-apple syndrome treated with birch pollen immunotherapy. Int Arch Allergy Immunol 156(4):416–422PubMedCrossRef Mauro M, Russello M, Incorvaia C et al (2011) Birch-apple syndrome treated with birch pollen immunotherapy. Int Arch Allergy Immunol 156(4):416–422PubMedCrossRef
27.
Zurück zum Zitat Mondoulet L, Dioszeghy V, Thébault C et al (2015) Epicutaneous immunotherapy for food allergy as a novel pathway for oral tolerance induction. Immunotherapy 7(12):1293–1305PubMedCrossRef Mondoulet L, Dioszeghy V, Thébault C et al (2015) Epicutaneous immunotherapy for food allergy as a novel pathway for oral tolerance induction. Immunotherapy 7(12):1293–1305PubMedCrossRef
28.
Zurück zum Zitat Nowak-Wegrzyn A, Sato S, Fiocchi A et al (2019) Oral and sublingual immunotherapy for food allergy. Curr Opin Allergy Clin Immunol 19(6):606–613PubMedCrossRef Nowak-Wegrzyn A, Sato S, Fiocchi A et al (2019) Oral and sublingual immunotherapy for food allergy. Curr Opin Allergy Clin Immunol 19(6):606–613PubMedCrossRef
29.
Zurück zum Zitat Nucera E, Ricci AG, Rizzi A et al (2018) Specific oral immunotherapy in food allergic patients: transient or persistent tolerance? Postepy Dermatol Alergol 35(4):392–396PubMedPubMedCentralCrossRef Nucera E, Ricci AG, Rizzi A et al (2018) Specific oral immunotherapy in food allergic patients: transient or persistent tolerance? Postepy Dermatol Alergol 35(4):392–396PubMedPubMedCentralCrossRef
30.
Zurück zum Zitat O’B Hourihane J, Beyer K, Abbas A et al (2020) Efficacy and safety of oral immunotherapy with AR101 in European children with a peanut allergy (ARTEMIS): a multicentre, double-blind, randomised, placebo-controlled phase 3 trial. Lancet Child Adolesc Health 4(10):728–739PubMedCrossRef O’B Hourihane J, Beyer K, Abbas A et al (2020) Efficacy and safety of oral immunotherapy with AR101 in European children with a peanut allergy (ARTEMIS): a multicentre, double-blind, randomised, placebo-controlled phase 3 trial. Lancet Child Adolesc Health 4(10):728–739PubMedCrossRef
31.
Zurück zum Zitat Ogura K, Yanagida N, Sato S et al (2020) Evaluation of oral immunotherapy efficacy and safety by maintenance dose dependency: a multicenter randomized study. World Allergy Organ J 13(10):100463PubMedPubMedCentralCrossRef Ogura K, Yanagida N, Sato S et al (2020) Evaluation of oral immunotherapy efficacy and safety by maintenance dose dependency: a multicenter randomized study. World Allergy Organ J 13(10):100463PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Oppenheimer JJ, Nelson HS, Bock SA, Christensen F, Leung DY (1992) Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol 90:256–262PubMedCrossRef Oppenheimer JJ, Nelson HS, Bock SA, Christensen F, Leung DY (1992) Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol 90:256–262PubMedCrossRef
33.
Zurück zum Zitat Pajno GB, Fernandez-Rivas M, Arasi S et al (2018) EAACI guidelines on allergen immunotherapy: IgE-mediated food allergy. Allergy 73(4):799–815PubMedCrossRef Pajno GB, Fernandez-Rivas M, Arasi S et al (2018) EAACI guidelines on allergen immunotherapy: IgE-mediated food allergy. Allergy 73(4):799–815PubMedCrossRef
35.
Zurück zum Zitat Pfaar O (2014) Leitlinie zur (allergen-)spezifischen Immuntherapie bei IgE-vermittelten allergischen Erkrankungen. Allergo J 23(8):28–67CrossRef Pfaar O (2014) Leitlinie zur (allergen-)spezifischen Immuntherapie bei IgE-vermittelten allergischen Erkrankungen. Allergo J 23(8):28–67CrossRef
37.
Zurück zum Zitat Romantsik O, Tosca MA, Zappettini S et al (2018) Oral and sublingual immunotherapy for egg allergy. Cochrane Database Syst Rev 4:CD10638PubMed Romantsik O, Tosca MA, Zappettini S et al (2018) Oral and sublingual immunotherapy for egg allergy. Cochrane Database Syst Rev 4:CD10638PubMed
38.
Zurück zum Zitat Sagara N, Fujita S, Suzuki R et al (2021) Successful sublingual immunotherapy for severe egg allergy in children: a case report. Allergy Asthma Clin Immunol 17(1):2PubMedPubMedCentralCrossRef Sagara N, Fujita S, Suzuki R et al (2021) Successful sublingual immunotherapy for severe egg allergy in children: a case report. Allergy Asthma Clin Immunol 17(1):2PubMedPubMedCentralCrossRef
39.
Zurück zum Zitat Sampson HA, Shreffler WG, Yang WH et al (2017) Effect of varying doses of epicutaneous immunotherapy vs placebo on reaction to peanut protein exposure among patients with peanut sensitivity: a randomized clinical trial. JAMA 318(18):1798–1809PubMedPubMedCentralCrossRef Sampson HA, Shreffler WG, Yang WH et al (2017) Effect of varying doses of epicutaneous immunotherapy vs placebo on reaction to peanut protein exposure among patients with peanut sensitivity: a randomized clinical trial. JAMA 318(18):1798–1809PubMedPubMedCentralCrossRef
40.
Zurück zum Zitat Subbarayal B, Schiller D, Möbs C et al (2013) Kinetics, cross-reactivity, and specificity of Bet v 1‑specific IgG4 antibodies induced by immunotherapy with birch pollen. Allergy 68(11):1377–1386PubMedCrossRef Subbarayal B, Schiller D, Möbs C et al (2013) Kinetics, cross-reactivity, and specificity of Bet v 1‑specific IgG4 antibodies induced by immunotherapy with birch pollen. Allergy 68(11):1377–1386PubMedCrossRef
41.
Zurück zum Zitat Till SJ, Stage BS, Skypala I et al (2020) Potential treatment effect of the SQ tree SLIT-tablet on pollen food syndrome caused by apple. Allergy 75(8):2059–2061PubMedCrossRef Till SJ, Stage BS, Skypala I et al (2020) Potential treatment effect of the SQ tree SLIT-tablet on pollen food syndrome caused by apple. Allergy 75(8):2059–2061PubMedCrossRef
42.
Zurück zum Zitat Treudler R, Franke A, Schmiedeknecht A et al (2016) Standardization of double blind placebo controlled food challenge with soy within a multicentre trial. Clin Transl Allergy 6:39PubMedPubMedCentralCrossRef Treudler R, Franke A, Schmiedeknecht A et al (2016) Standardization of double blind placebo controlled food challenge with soy within a multicentre trial. Clin Transl Allergy 6:39PubMedPubMedCentralCrossRef
43.
Zurück zum Zitat Treudler R, Franke A, Schmiedeknecht A et al (2017) BASALIT trial: double-blind placebo-controlled allergen immunotherapy with rBet v 1‑FV in birch-related soya allergy. Allergy 72(8):1243–1253PubMedCrossRef Treudler R, Franke A, Schmiedeknecht A et al (2017) BASALIT trial: double-blind placebo-controlled allergen immunotherapy with rBet v 1‑FV in birch-related soya allergy. Allergy 72(8):1243–1253PubMedCrossRef
45.
Zurück zum Zitat Treudler R, Klimek L (2019) Allergenspezifische Immuntherapie bei oralem Allergiesyndrom: Gibt es Evidenz für die Effektivität? Allergo J 28(2):28–36CrossRef Treudler R, Klimek L (2019) Allergenspezifische Immuntherapie bei oralem Allergiesyndrom: Gibt es Evidenz für die Effektivität? Allergo J 28(2):28–36CrossRef
46.
Zurück zum Zitat Treudler R, Simon J‑C (2012) Schwere Sojaallergie im Erwachsenenalter. Hilft eine spezifische Immuntherapie? Hautarzt 63(4):307–312 (Severe soy allergy in adults. Is there a role for specific immunotherapy?)PubMedCrossRef Treudler R, Simon J‑C (2012) Schwere Sojaallergie im Erwachsenenalter. Hilft eine spezifische Immuntherapie? Hautarzt 63(4):307–312 (Severe soy allergy in adults. Is there a role for specific immunotherapy?)PubMedCrossRef
48.
Zurück zum Zitat van Hoffen E, Peeters KABM, van Neerven RJJ et al (2011) Effect of birch pollen-specific immunotherapy on birch pollen-related hazelnut allergy. J Allergy Clin Immunol 127(1):100–101.e3PubMedCrossRef van Hoffen E, Peeters KABM, van Neerven RJJ et al (2011) Effect of birch pollen-specific immunotherapy on birch pollen-related hazelnut allergy. J Allergy Clin Immunol 127(1):100–101.e3PubMedCrossRef
49.
Zurück zum Zitat Vickery BP, Vereda A, Casale TB et al (2018) AR101 oral immunotherapy for peanut allergy. N Engl J Med 379(21):1991–2001PubMedCrossRef Vickery BP, Vereda A, Casale TB et al (2018) AR101 oral immunotherapy for peanut allergy. N Engl J Med 379(21):1991–2001PubMedCrossRef
50.
Zurück zum Zitat Worm M, Reese I, Ballmer-Weber B et al (2015) Leitlinie zum Management IgE-vermittelter Nahrungsmittelallergien. Allergo J 24(7):38–77CrossRef Worm M, Reese I, Ballmer-Weber B et al (2015) Leitlinie zum Management IgE-vermittelter Nahrungsmittelallergien. Allergo J 24(7):38–77CrossRef
51.
Zurück zum Zitat Zuidmeer-Jongejan L, Fernandez-Rivas M, Poulsen LK et al (2012) FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies. Clin Transl Allergy 2(1):1–9CrossRef Zuidmeer-Jongejan L, Fernandez-Rivas M, Poulsen LK et al (2012) FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies. Clin Transl Allergy 2(1):1–9CrossRef
Metadaten
Titel
Welche Rolle spielt die Allergenimmuntherapie bei Immunglobulin-E-vermittelter Nahrungsmittelallergie?
verfasst von
Prof. Dr. med. Regina Treudler
Jan-Christoph Simon
Publikationsdatum
17.08.2021
Verlag
Springer Medizin
Erschienen in
Die Dermatologie / Ausgabe 9/2021
Print ISSN: 2731-7005
Elektronische ISSN: 2731-7013
DOI
https://doi.org/10.1007/s00105-021-04882-6

Weitere Artikel der Ausgabe 9/2021

Die Dermatologie 9/2021 Zur Ausgabe

Einführung zum Thema

Allergen-Immuntherapie

Leitlinien kompakt für die Dermatologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Dermatologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.