One of the really exciting things about being involved in allergy at the moment is the enormous range of different approaches different research groups are taking to try to find a solution to the risk of severe reactions that people with allergies face on a daily basis.
Currently, the state of the art is tolerance induction using approaches such as oral immunotherapy with exciting emerging approaches such as Sublingual and Epicutaneous Immunotherapy on the immediate horizon. An entirely different approach has been to look at the immune system pathways involved in causing allergic reactions.
Patients who suffer from allergy have produced an antibody called Immunoglobulin E that recognises the allergen and causes a reaction to happen. By interfering with this pathway, there’s an opportunity to stop reactions from happening.
This is the approach taken by the recently licensed biologics, such as omalizumab, which is being used widely in the US and is also available, albeit unlicensed, in the UK.
This anti-IgE antibody essentially sticks to IgE molecules in the bloodstream, taking them out of the active part of the immune system and consequently dramatically reducing the likelihood of allergic reactions happening.
In a landmark study published a couple of years ago in the US, it was shown that patients who were on omalizumab were often able to tolerate large amounts of the foods that they’re allergic to without any problem whatsoever. However, Omalizumab doesn’t work for everybody, with up to 15% of people not responding and still being just as sensitive. Alongside this, Omalizumab is expensive and requires regular injections, and as soon as the medication is stopped, the patient is just as allergic as they were before they started.
This exciting study just published reveals another approach here. Instead of simply injecting a patient with anti-IgE antibodies, instead they’ve taken the approach of creating a vaccine that will lead to the body’s immune system producing its own anti-IgE molecule. This is fraught with some very significant challenges because if the antibody that’s produced also binds to IgE antibodies that are already stuck to immune system cells, then it can actually trigger a reaction. However, it seems that this new approach has bypassed this by using very sophisticated methodology to identify exactly which part of the IgE molecule to stick to.
I would very much stress that this is extremely early days and that this is a study in humanised mice and not in actual patients. But I really liked the fact that it illustrated an entirely new approach to potentially preventing severe reactions happening.
And I’ll be following this research carefully and will try my best to keep you updated. Follow my account on Instagram ‘DrAdamFox’ where I post updates on the topic of children’s allergies.
