Mechanisms of asthma and allergic inflammation
Recombinant allergens for immunotherapy

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Recombinant allergens can be produced as defined molecules in consistent quality and unlimited amounts according to the corresponding DNA template. Furthermore, they can be modified to reduce their allergenic activity and to foster certain advantageous immunologic properties. Recombinant allergens equaling the natural allergens are available for diagnostic and therapeutic purposes, and modified versions have been developed with the aim to to reduce IgE-mediated side effects during immunotherapy. First injection immunotherapy trials conducted with recombinant vaccines for birch pollen and grass pollen allergy show that recombinant allergen–based immunotherapy has vaccination characteristics and is clinically effective. The obtained results hold promise that recombinant allergen–based immunotherapy will improve current immunotherapy practice and may open possibilities for new treatment strategies and possibly even for prophylactic vaccination.

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Critical steps in the development of recombinant allergen–based vaccines

Important questions that need to be addressed for the rational design of recombinant allergen–based vaccines are displayed in Fig 1. These issues are exemplified for 2 allergen sources, birch pollen and grass pollen, for which recombinant allergen–based vaccines have been developed and have entered clinical trials. The first important step is the selection of the predominant allergen sources. Selection criteria may include the frequency of sensitization, the clinical relevance, the magnitude of

Current status of recombinant allergen–based immunotherapy

The selection of the relevant recombinant allergen molecules is the prerequisite for rationale vaccine development. Two types of recombinant allergen–based vaccines have been developed and tested in clinical trials. The first type is based on the use of recombinant allergens that equal the natural allergens (ie, recombinant wild-type–based vaccines), and the second type is based on genetically engineered/modified recombinant allergens that exhibit reduced allergenic activity (Table II).

In fact,

Future perspectives

Encouraging results have been obtained with recombinant allergen–based vaccines in the first proof of principle studies conducted for birch and grass pollen allergy. It is therefore likely that recombinant allergen–based therapeutic vaccines can be developed according to the same principles—that is, use of recombinant wild-type allergens and hypoallergenic derivatives for the most common allergen sources. Future work will have to focus on the identification of the relevant allergens in these

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    Supported by grants F1815, F1818 and L214-B13 from the Austrian Science Fund and by the Christian Doppler Research Association, Austria.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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