Major Allergen Content in Allergen Immunotherapy Products: The Limited Value of Numbers

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • S. Becker - , University of Tübingen (Author)
  • F. Fassio - , Centro Studi Allergie ETS (Author)
  • R. Muñoz-Cano - , University of Barcelona (Author)
  • L. Klimek - , Center for Rhinology and Allergy (Author)
  • C. Vidal - , University of Santiago de Compostela (Author)
  • M. D. Heath - , Allergy Therapeutics (UK) Ltd (Author)
  • T. M. Kündig - , University of Zurich (Author)
  • C. Vogelberg - , Department of Paediatrics, TUD Dresden University of Technology (Author)
  • C. Toran - , Allergy Therapeutics Ibérica (Author)
  • E. Jensen-Jarolim - , Medical University of Vienna, University of Veterinary Medicine Vienna (Author)
  • E. Heffler - , IRCCS Istituto Clinico Humanitas - Rozzano (Milano), Humanitas University (Author)
  • P. V. Tomazic - , Medical University of Graz (Author)
  • M. Feindor - , Allergy Therapeutics (UK) Ltd, Bencard Allergie GmbH (Author)
  • S. Hewings - , Allergy Therapeutics (UK) Ltd (Author)
  • T. Carreno - , Allergy Therapeutics (UK) Ltd (Author)
  • M. Morales - , Allergy Therapeutics Ibérica (Author)
  • R. Mösges - , University of Cologne (Author)
  • M. A. Skinner - , Allergy Therapeutics (UK) Ltd (Author)
  • A. Graessel - , Allergy Therapeutics (UK) Ltd, Bencard Allergie GmbH (Author)
  • D. Hernandez - , Allergy Therapeutics Ibérica (Author)
  • M. F. Kramer - , Allergy Therapeutics (UK) Ltd, Bencard Allergie GmbH (Author)

Abstract

The prevalence of allergic disorders has increased drastically over the last 50 years to the extent that they can be considered epidemic. At present, allergen-specific immunotherapy (AIT) is the only therapy that targets the underlying cause of allergic disorders, and evidence of its superiority is based on data accumulated from clinical trials and observational studies demonstrating efficacy and safety. However, several aspects remain unresolved, such as harmonization and standardization of manufacturing and quantification procedures across manufacturers, homogeneous reporting of strength, and the establishment of international reference standards for many allergens. This article discusses issues related to the measurement of major allergen content in AIT extracts, raising the question of whether comparison of products from different manufacturers is an appropriate basis for selecting a specific AIT product. Allergen standardization in immunotherapy products is critical for ensuring quality and, thereby, safety and efficacy. However, lack of harmonization in manufacturing processes, allergen quantification (methodologies and references), national regulatory differences, clinical practice, and labeling shows that the comparison of AIT products based solely on major allergen amounts is not rational and, in fact, impossible. Moreover, when rating the information given for a specific product, it is necessary to take into account further inherent characteristics of products and their application in clinical practice, such as the state of extract modification, addition of adjuvant or adjuvant system, route of administration (sublingual/ subcutaneous), and cumulative dose as per posology (including the volume per administration). Finally, only convincing clinical data can serve as the basis for product-specific evaluation and cross-product comparability of individual products.

Details

Original languageEnglish
Pages (from-to)345-356
Number of pages12
JournalJournal of Investigational Allergology and Clinical Immunology
Volume32
Issue number5
Publication statusPublished - 2022
Peer-reviewedYes

External IDs

PubMed 35522054

Keywords

ASJC Scopus subject areas

Keywords

  • Adjuvants, AIT, Immunotherapy, Major allergen content, Product comparability, Quality, Standardization methods