Intralymphatic Immunotherapy: Update and Unmet Needs

Gabriela Senti¹, Andreas U Freiburghaus², Désirée Larenas-Linnemann³, Hans Jürgen Hoffmann^{4

5}, Amber M Patterson⁶, Ludger Klimek⁷, Danilo Di Bona⁸, Oliver Pfaar^{7

9}, Lars Ahlbeck¹⁰, Mübeccel Akdis¹¹, Dan Weinfeld¹², Francisco A Contreras-Verduzco¹³, Alvaro Pedroza-Melendez¹³, Søren H Skaarup¹⁴, Sang Min Lee¹⁵, Lars-Olaf Cardell¹⁶, Johannes M Schmid⁵, Ulla Westin^{17

18}, Ralph Dollner¹⁹, Thomas M Kündig²⁰

Affiliations

¹ Clinical Trials Center, University Hospital Zurich, Zurich, Switzerland, gabriela.senti@usz.ch.
² Clinical Trials Center, University Hospital Zurich, Zurich, Switzerland.
³ Hospital Médica Sur, Mexico City, Mexico.
⁴ Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
⁵ Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.
⁶ ENT & Allergy Specialists of Northwest Ohio, Findlay, Ohio, USA.
⁷ Center for Rhinology and Allergology, Wiesbaden, Germany.
⁸ Department of Emergency and Organ Transplantation, Chair and School of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy.
⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
¹⁰ Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Sciences, Linköping University, Linköping, Sweden.
¹¹ Swiss Institute of Allergy and Asthma Research SIAF, Davos Platz, Switzerland.
¹² Asthma and Allergy Clinic (Adults), Department of Internal Medicine, South Alvsborgs (Central) Hospital, Boras, Sweden.
¹³ Allergy Department, National Institute of Pediatrics, Mexico City, Mexico.
¹⁴ Department of Clinical Medicine - Department of Respiratory Diseases and Allergy, Aarhus University, Aarhus, Denmark.
¹⁵ Division of Allergy and Pulmonology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
¹⁶ Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
¹⁷ Division of Ear, Nose and Throat Diseases, Head and Neck Surgery, Department of Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden.
¹⁸ Region Skane, Skane University Hospital, Malmö, Sweden.
¹⁹ Department Otorhinolaryngology - Head and Neck Surgery, Clinic for Head-Neck and Reconstructive Surgery, Oslo University Hospital (OUS) HF - Rikshospitalet, Oslo, Norway.
²⁰ Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

PMID: 30391954
DOI: 10.1159/000493647

Free article

Review

Intralymphatic Immunotherapy: Update and Unmet Needs

Gabriela Senti et al. Int Arch Allergy Immunol. 2019.

Free article

. 2019;178(2):141-149.

doi: 10.1159/000493647. Epub 2018 Nov 2.

Authors

Affiliations

¹ Clinical Trials Center, University Hospital Zurich, Zurich, Switzerland, gabriela.senti@usz.ch.
² Clinical Trials Center, University Hospital Zurich, Zurich, Switzerland.
³ Hospital Médica Sur, Mexico City, Mexico.
⁴ Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
⁵ Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.
⁶ ENT & Allergy Specialists of Northwest Ohio, Findlay, Ohio, USA.
⁷ Center for Rhinology and Allergology, Wiesbaden, Germany.
⁸ Department of Emergency and Organ Transplantation, Chair and School of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy.
⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
¹⁰ Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Sciences, Linköping University, Linköping, Sweden.
¹¹ Swiss Institute of Allergy and Asthma Research SIAF, Davos Platz, Switzerland.
¹² Asthma and Allergy Clinic (Adults), Department of Internal Medicine, South Alvsborgs (Central) Hospital, Boras, Sweden.
¹³ Allergy Department, National Institute of Pediatrics, Mexico City, Mexico.
¹⁴ Department of Clinical Medicine - Department of Respiratory Diseases and Allergy, Aarhus University, Aarhus, Denmark.
¹⁵ Division of Allergy and Pulmonology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
¹⁶ Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
¹⁷ Division of Ear, Nose and Throat Diseases, Head and Neck Surgery, Department of Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden.
¹⁸ Region Skane, Skane University Hospital, Malmö, Sweden.
¹⁹ Department Otorhinolaryngology - Head and Neck Surgery, Clinic for Head-Neck and Reconstructive Surgery, Oslo University Hospital (OUS) HF - Rikshospitalet, Oslo, Norway.
²⁰ Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.

PMID: 30391954
DOI: 10.1159/000493647

Abstract

Allergen-specific immunotherapy (AIT) is the only allergy treatment that confers long-term symptom amelioration for patients suffering from allergy. The most frequently used allergen application route is subcutaneous injection (SCIT), commonly taken as the gold standard, followed by sublingual (SLIT) or oral (OIT) application of allergen preparations. This is an up-to-date review of the clinical evidence for a novel route of allergen application, i.e., directly into lymph nodes - intralymphatic immunotherapy (ILIT). The major advantages of ILIT over the current AIT approaches are its short duration and the low allergen doses administered. The whole treatment consists of merely 3 ultrasound-guided injections into inguinal lymph nodes 1 month apart. While the number of patients included in randomised controlled trials is still limited, the clinical results for ILIT are encouraging, but more clinical trials are needed, as well as more preclinical work for optimising formulations.

Keywords: Allergen-specific immunotherapy; Allergy; Clinical trials; Intralymphatic immunotherapy.

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Intralymphatic Immunotherapy: Update and Unmet Needs

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Intralymphatic Immunotherapy: Update and Unmet Needs

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