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Medical professionals: New preparations based on antibodies against allergies


Experts see a wide range of possible uses for antibodies
The treatment of allergies is still difficult today and mostly focuses on alleviating the symptoms. But "Antibody preparations that have been introduced as biologicals in recent years to treat asthma and skin diseases could make life easier for people who suffer from severe allergies," reports the German Society for Ear, Nose and Throat - Medical science, head and neck surgery (DGHNO KHC).

At the 88th Annual General Meeting of the DGHNO KHC in Erfurt, the expert Professor Ludger Klimek from the Allergy Center Wiesbaden informed about the possibilities of allergy treatment with antibodies. Almost every third German suffers from allergies, the majority of them from hay fever. The consequences of allergic rhinitis include chronically blocked sinuses and nasal polyps. DGHNO KHC reports that the symptoms are often dealt with by nasal sprays from the pharmacy, which act as antihistamines to block the action of the messenger histamine in the mucous membrane. In the future, drugs based on special antibodies could offer an alternative.

Previous treatment options for allergies are inadequate
Nasal sprays with antihistamines, cortisone-containing nasal sprays or eye drops and a so-called specific immunotherapy (previously known as hyposensitization) are the treatment approaches available to date for allergies. "But not all patients achieve a satisfactory result with the current therapies," emphasizes Professor Klimek. And in particular, patients with very strong allergies (allergic shock) or reactions to many different allergy-causing substances have so far been insufficiently cared for.

New group of drugs based on antibodies
According to the expert, a further group of medications could be available for the patients mentioned in the next few years, which has already proven itself in other inflammatory diseases. These are antibodies that specifically intervene in the inflammatory processes that cause swelling of the mucous membrane in the nose, sinuses and conjunctiva of the eye. "Allergic inflammation is a combination of different cells that communicate with each other via messenger substances," explains Professor Klimek.

Several active ingredients have already been approved for the treatment of asthma
According to Professor Klimek, the crucial messenger substances in allergies can be trapped with the help of antibodies. For example, three antibodies that are injected under the skin several weeks apart have already been introduced in Germany in recent years to treat severe asthma. The first was omalizumab (early 2005). This "antibody binds the allergic IgE antibodies, which has saved many asthma patients from emergency admissions to a clinic," reports Prof. Klimek. In addition, asthma patients have been treated with mepolizumab, which binds the messenger interleukin 5, since last year. Furthermore, reslizumab has been on the market as another interleukin-5 antibody since the beginning of the year.

Antibodies can also be used against eczema and hay fever?
In addition to the three active substances that are already available, according to the expert, a fourth antibody (dupilumab) is already pending approval, which neutralizes interleukins 4 and 13. This had achieved good results in children with neurodermatitis. In view of the fact that the immunological mechanisms for different allergies are comparable, Prof. Klimek assumes that the antibodies "sooner or later" will also be used for other allergies. The specialist is convinced that in addition to the prevention of allergic shock reactions (anaphylaxis), food allergies, insect venom allergies and neurodermatitis, severe courses of allergic rhinitis, chronic sinusitis and nasal polyps will also be used.

According to Professor Klimek, the IgE antagonist omalizumab has already proven itself in some studies in patients with chronic sinusitis, but also in patients with hay fever. According to the expert, the mode of action of antibodies is comparable to that of natural biology, which is why they are also called biopharmaceuticals or biologics. (fp)

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Video: Types of immune responses: Innate and adaptive, humoral vs. cell-mediated. NCLEX-RN. Khan Academy (October 2020).