“Work is underway on new recombinant vaccines”: MD on methods for treating allergies

- Olga Guryevna,

- To begin with, completely different mechanisms can be responsible for the occurrence of food allergies - both immunological reactions and disorders of the intestinal microbiome.

This study focuses on just such cases.

In general, a lot has been said about butyrate in the scientific community in recent years, not only in relation to food allergies, but also in connection with various diseases of the gastrointestinal tract.

Butyrate is a derivative of butyric acid, its salt.

Butyric acid and butyrate in the human body are synthesized by certain anaerobic bacteria - clostridia, eubacteria and others.

Butyrate plays a very important role for the body: for example, it is a source of energy for the epithelial cells of the large intestine.

As for the American study, the scientists in this case managed to get very good results in experiments on mouse models of peanut allergy.

It is still difficult to say how applicable they will be to a person, although the work is interesting and promising.

• Gettyimages.ru

• © D-Keine

— The prevalence of allergies among the population has been growing over the past decades.

By the early 2000s, from 20 to 40% of the world's inhabitants suffered from allergies.

There was even a forecast that this figure would soon reach 50%.

Is the prevalence of allergies still on the rise?

If yes, how is this explained?

Allergy is sometimes called the “plague of the 21st century” for a reason.

On average, today in industrialized countries, one in four people suffer from allergies - this is about 25% of the population.

If we talk, for example, about allergic rhinitis, then in some regions up to 40-50% of the population suffers from it.

In general, there is an upward trend in the prevalence of allergic diseases.

The main hypothesis that explains this phenomenon was proposed in the 1980s by the British epidemiologist David Strachan.

He suggested that when people live in an environment poor in natural antigens (bacteria, parasites, etc.), their immune system does not receive a pronounced stimulation.

And since the immune system is programmed to respond to some kind of irritant in any case, in their absence it begins to react to substances that do not pose a danger to the body - plant pollen, house dust, food proteins, etc.

This theory has received statistical confirmation: indeed, people in cities are more likely to suffer from allergies than in rural areas.

However, these are only epidemiological studies that show a correlation between phenomena, but do not prove the existence of a causal relationship.

There are other hypotheses as well.

For example, there is a theory that links allergies to the already mentioned disruption of the microbiome.

In addition, in modern conditions, people are constantly faced with new chemical agents for our immune system: synthesized molecules, drugs, etc. Chemical products can affect the development of the nervous and endocrine systems.

Thus, the frequency of allergic reactions may also increase.

But by and large, science does not yet know why some people develop a certain type of allergy, while others do not.

• Gettyimages.ru

• © Thanasis Zovoilis

To what extent is the development of allergies genetically predetermined?

And if so, approximately what percentage of the population are carriers of such genes?

- This is also a very difficult question.

So far, it is only clear that genetic factors play a role in the development of allergies, but more detailed conclusions are difficult to draw.

For example, data vary for different diseases.

So, it is believed that the risk of a person developing atopic dermatitis is 80% if both his parents suffered from this disease.

If only one parent was ill, then the risk for children is 40-50%.

At the same time, it is impossible to identify a specific gene for atopic dermatitis, since this predisposition can be determined by different genes that are located on different chromosomes and can be associated with several functions at once.

By "turning off" any one gene, we can turn off a number of some useful mechanisms.

In addition, much depends on environmental factors that can contribute to the activation of these genes.

- If one of the causes of allergies is microbiome disturbances, are there ways to influence the microflora?

- Unfortunately, it is very difficult to change the microflora.

Now in the scientific community there is a lot of talk about fecal transplantation, this is a promising direction, but not yet widely used.

It is believed that the microbiome is formed in the first days of a newborn's life, it is then that a set of microorganisms is formed with which a person will have to live in the future.

For example, studies have shown that if the upper respiratory tract of an infant is colonized with microflora from a mother suffering from bronchial asthma, the child also increases the risk of developing this disease.

-

Allergies often affect almost every aspect of a patient's life.

Allergy symptoms, for example, can affect the mental state of a person, his social activity.

However, there is still no exact data on whether allergies affect the incidence of other infectious diseases.

There is a very important point to be made.

Even 10-20 years ago, it was believed that allergic children could not be vaccinated, all such children had medical exemptions.

This view has now been refuted.

On the contrary, allergy sufferers should be vaccinated first, because if such a child becomes ill during a seasonal allergy, the disease will be more severe for him.

At the same time, the risk of allergic reactions to the vaccine in such children is no higher than in the general population.

This also applies to vaccination against coronavirus infection.

In addition to some individual reactions and the state of severe exacerbation of allergies, allergy sufferers have no contraindications to such vaccinations.

• RIA News

• © Maxim Bogodvid

-

— There is such a hypothesis.

Previously, large epidemiological studies have been carried out, which have provided quite encouraging data.

For example, participants who suffered from asthma and allergic rhinitis were found to be less likely to develop certain types of cancer.

However, the mechanisms that would explain such a correlation have not yet been discovered.

For example, it is believed that the type of immune response that develops in patients with allergies contributes to a more active recognition and destruction of tumor cells.

On the other hand, there is also a theory according to which allergies, on the contrary, can lead to pro-oncogenic tissue mutations if the immune system is constantly stimulated by allergens.

Based on my experience, I cannot say that allergy sufferers have any protection against cancer.

But, unfortunately, they can also develop cancer.

-

- ASIT allows you to influence the immune mechanisms responsible for the formation of allergies and completely cure this disease.

The essence of the method is as follows: in gradually increasing doses, the allergen is introduced to the patient, as a result of which the sensitivity to the antigen disappears.

The method is really effective, this is shown by many studies.

But such therapy implies that the patient must take the allergen orally, sublingually or by injection for about several months every day.

Not all people are ready to pay so much attention to their health.

In addition, such therapy is difficult to prescribe if a causally significant allergen is not isolated for the patient, and different substances cause the reaction.

You have to alternate, select drugs, monitor the dynamics - not all patients are ready for this.

In addition, there are allergens against which vaccines have not yet been created - these are, for example, mold fungi.

Therefore, unfortunately, many patients prefer to go the easy way: fight allergy symptoms with antihistamines.

-

- This is also a good way to treat allergies, but it has its own indications.

So far, preparations based on monoclonal antibodies have been developed and registered for the treatment of certain allergic diseases: bronchial asthma, chronic urticaria, atopic dermatitis, polypous rhinosinusitis.

Moreover, these drugs are used for severe or moderate allergic diseases.

With mild symptoms, doctors do not prescribe such complex drugs.

• Gettyimages.ru

• © Westend61

This therapy works as follows: monoclonal antibodies are able to bind immunoglobulin E (IgE) in the human body, which is the main "culprit" of allergies and provokes a whole cascade of inflammatory reactions, including the release of histamine into the blood.

Combinations of modern methods of treatment are also possible, for example, monoclonal antibody therapy can be performed, and then allergen-specific immunotherapy, which was previously inaccessible to the patient due to the risk of adverse reactions.

In addition, monoclonal antibodies to certain interleukins are now being used - these are cytokines (active proteins of the immune system.

), which also cause inflammation in bronchial asthma and atopic dermatitis.

But this is a long-term therapy, in some cases it can be prescribed for life.

Not to mention the fact that this is quite an expensive treatment.

The attending physician determines the specific tactics for each patient.

—

- If we talk about the already mentioned allergen-specific immune therapy, then such vaccines have drawbacks: they are currently produced from an extract of plant pollen, such as birch, while the preparations may contain a large number of impurities.

This can cause the development of adverse reactions, lead to insufficient effectiveness of therapy ... However, now work is underway on new recombinant allergy vaccines, which will contain only those protein components that cause an allergic reaction.

• Gettyimages.ru

• © Svetlana Evseeva / EyeEm

I can proudly say that such work is being carried out at the Institute of Immunology of the FMBA of Russia.

Together with the University of Vienna, we are developing a vaccine based on recombinant peptides for the treatment of birch pollen allergy and associated food allergy to apples.

If clinical studies show efficacy and safety - and we hope so - then three injections of the drug given before the birch flowering season will be enough to treat allergies.

In addition, there are technologies based on the mechanism of RNA interference (suppression of gene expression.

).

Such a drug was created at the Institute of Immunology of the Federal Medical and Biological Agency of Russia for the treatment of COVID-19, it is called MIR-19.

The application of this technique is also possible in other diseases, this is also a very promising area of ​​scientific work.