Hacking the immune system could cure pollen and house dust mite allergies

More than 150 million Europeans suffer from allergies and this number is on the rise due to triggers such as growing pollution. By 2025, an estimated half of the EU’s population could be affected by allergies, according to the European Academy of Allergy and Clinical Immunology.

Allergies are most commonly treated by taking lifelong medication, such as antihistamines, that relieve symptoms like red eyes and a runny nose. However, about five to 10% of sufferers use another type of treatment called immunotherapy, where the immune system is desensitised to specific allergens, which can eventually cure allergies.

The process can be quite cumbersome though. Although drops or tablets can sometimes be administered under the tongue, frequent visits to the doctor for shots are more typical. Patients start with a low dose of the allergen which is gradually increased over several years. ‘It requires quite a lot from that patient so that’s probably one of the reasons that it isn’t the most popular treatment,’ said Dr Ronald van Ree from Amsterdam University Medical Center in the Netherlands. ‘If you do injection immunotherapy you have to do it for at least three years.’

Furthermore, some patients can have side effects such as skin reactions or may not choose the treatment because of cost since it isn’t covered by public healthcare in all countries. 

Dr van Ree and his colleagues aim to improve immunotherapy as part of the BM4SIT project by focussing on birch pollen allergy, in which a specific pollen protein is the allergen.

One of their goals is to reduce secondary effects that can occur during treatment, something they’ve achieved in lab experiments and animal tests. ‘We have modified this molecule slightly in such a way that it doesn't give the side effects anymore as easily as the original molecule,’ said Dr van Ree.

The team is now testing the tweaked allergen in patients in Denmark.

Faster

Making immunotherapy more effective and faster is another project aim. Dr van Ree and his colleagues are looking at adding vitamin D3 to the treatment, which has been shown to have a protective effect against allergies.

‘We hope that the addition of vitamin D3 will change the speed by which the effect is reached so that it will be reached quicker and that we will need less injections,’ he said.

They are currently conducting a study with patients in Amsterdam to compare the effect of an existing birch pollen treatment when administered alone and when vitamin D3 is injected alongside it. If the trials are successful, they’d like to bring together the vitamin and altered birch pollen molecule to test their combined effect.

The addition of vitamin D3 could also help alleviate the symptoms of inflammatory diseases such as rheumatoid arthritis, diabetes and multiple sclerosis.

‘They could all benefit from this type of adjuvant which sort of dampens inflammation,’ said Dr van Ree.

The innovations should be applicable to a wide range of allergies as well. In terms of modifying the allergen, the team began with birch pollen since a single protein is involved. Cat allergies also involve one molecule. But for grass pollen and house dust mite allergies, for example, several molecules are responsible for the allergy so each one would have to be redesigned.

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‘Immunotherapy is almost never effective for asthmatic symptoms.’

If the study goes well, Dr van Ree plans to next focus on treating house dust mite allergy – the most common allergy globally. This allergy can trigger allergic asthma and is more severe than other forms since it affects the lungs, rather than the eyes, nose or skin. Allergic asthma is also harder to treat.

‘Immunotherapy is almost never effective for asthmatic symptoms,’ said Henk Viëtor, the CEO of DC4U Technologies in Amsterdam. 

Asthma

Viëtor and his team have developed a technique that could make immunotherapy more effective for asthma. ‘That's something completely new to the table,’ said Viëtor.

The innovation should improve immunotherapy for a wide range of allergies as well, and dramatically decrease the duration of the treatment from about three to five years to three to five months, according to Viëtor and his colleagues. ‘We think that with only two or three shots, just like vaccines for infectious diseases, we can really shorten the experience and make it very effective,’ said Viëtor.

Existing immunotherapy uses the raw extract of an allergen dissolved in liquid which is then injected into a patient. But Viëtor and his team have been experimenting in the lab by adding sugars to specific parts of allergens used in the treatment which bind to receptors on immune system cells.

The allergen-sugar combination reeducates the immune system so that an allergen no longer induces an allergic reaction. ‘We think our technology can really provide a cure for patients with allergies,’ Viëtor said.

The team looked at how to bring their innovation to market as part of the GAIT project.

They are now investigating potential collaborations, where new projects could focus on treating house dust mite and peanut allergies. ‘We're in the negotiation phase at this stage and we are already trying to get more evidence that our technology works,’ said Viëtor.

He and his colleagues are currently following up with lab experiments on cells and in animals to develop a proof of concept. If they are successful, they will continue with clinical trials.

‘The incidence of allergies is rapidly increasing so I think that innovation in this field is urgently needed to prevent an epidemic in allergies and asthma,’ said Viëtor.

The research in this article was funded by the EU. If you liked this article, please consider sharing it on social media.