Mechanisms of allergen immunotherapy supporting its disease-modifying effect.

Roxana Silvia Bumbacea, Rama Boustani, Carmen Panaitescu, Laura Haidar, Maria-Roxana Buzan, Dragos Bumbacea, Alexandru Laculiceanu, Catalina Cojanu, Daniela Spanu, Ioana Agache

Immunotherapy 2022 Jun

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Allergen immunotherapy (AIT) is considered the only disease-modifying treatment available at present for allergic disorders. Its main benefits include improvement of symptoms, decreased need for pharmacotherapy, prevention of new sensitizations and sustained effect after AIT completion. The key pillars of AIT-induced tolerance include a shift from Th2 to Th1 response, an increase of regulatory T and B cells, pro-inflammatory effector cell downregulation and IgE suppression, in addition to IgG4, IgA and IgD induction. AIT may also induce trained immunity, characterized by a durable decrease in group 2 of innate lymphoid cells (ILCs) and increased ILC1 and ILC3s. Understanding the immune mechanisms of AIT is essential for validating biomarkers for the prediction of AIT response and for achieving AIT success.

Citation

Roxana Silvia Bumbacea, Rama Boustani, Carmen Panaitescu, Laura Haidar, Maria-Roxana Buzan, Dragos Bumbacea, Alexandru Laculiceanu, Catalina Cojanu, Daniela Spanu, Ioana Agache. Mechanisms of allergen immunotherapy supporting its disease-modifying effect. Immunotherapy. 2022 Jun;14(8):627-638