Epicutaneous allergen administration as a novel method of allergen-specific immunotherapy
Open accessAbstract
Background Subcutaneous allergen-specific immunotherapy is an effective treatment of IgE-mediated allergies, but it requires repeated allergen injections with a risk of systemic allergic reactions. Transcutaneous immunotherapy may improve patient compliance and safety.Objective To assess the safety and efficacy of epicutaneous allergen immunotherapy.Methods This monocentric, placebo-controlled, double-blind trial was conducted from March 2006 to December 2007 at the University Hospital Zurich. Thirty-seven adult patients with positive skin prick and nasal provocation tests to grass pollen were randomized to receive patches containing either allergen (n = 21) or placebo (n = 16). Treatment took place before and during the pollen season 2006, and follow-up visits took place before (n = 26) and after the pollen season 2007 (n = 30). The primary outcome measures were nasal provocation tests.Results Allergen-treated patients showed significantly decreased scores in nasal provocation tests in the first (P < .001) and second year (P = .003) after treatment. In contrast, placebo-treated patients had decreased scores in the first treatment year, 2006 (P = .03), but the effect diminished in the second year (P = .53). Although improvement of nasal provocation test scores was not significantly better in the verum versus placebo group, the overall treatment success was rated significantly higher by the allergen-treated group than by the placebo group (2006, P = .02; 2007, P = .005). No severe adverse events were observed. Occurrence of eczema after allergen patch applications proved stimulation of specific T-cell responses, but was noted as an adverse effect of the treatment.Conclusion Epicutaneous allergen immunotherapy is a promising strategy to treat allergies and merits further investigation.
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In that trial, placebo-treated patients' nasal challenge scores decreased after year 1 (p = 0.03) but the effect diminished in year 2 (p = 0.53).
“In placebo-treated patients, scores decreased after year 1 (p = 0.03), but the effect diminished in year 2 (p = 0.53).”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1712]
In a single-center, placebo-controlled, double-blind trial of 37 adults with positive SPT and nasal challenge to grass pollen, nasal challenge test scores significantly decreased in grass immunotherapy-treated patients in the first year (p < 0.001) and second year (p = 0.003).
“In grass immunotherapy-treated patients, nasal challenge test scores significantly decreased in the first (p < 0.001) and second year (p = 0.003).”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1712]
In that trial, improvement of nasal provocation test scores was not significantly better in treatment vs placebo groups.
“However, the improvement of nasal provocation test scores was not significantly better in the treatment vs placebo groups.”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1712]
In that trial, eczema at the application site was significantly higher in the treatment arm, and there were no serious adverse events.
“Eczema at the application site was significantly higher in the treatment arm, and there were no serious adverse events.”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1712]
In that trial, patients in the treatment arm had improvement in subjective symptom scores after the 2006 (p = 0.02) and 2007 (p = 0.005) pollen seasons.
“Patients in the treatment arm had improvement in subjective symptom scores, both after the pollen seasons of 2006 (p = 0.02) and 2007 (p = 0.005).”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1712]
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- Authors
- Senti, G., Graf, N., Haug, S., Rüedi, N., von Moos, S., Sonderegger, T., Johansen, P., & Kündig, T. M.
- Affiliations
- University Hospital Zurich (CH)
- Corresponding author
- Kündig, Thomas M.
- Venue
- Journal of Allergy and Clinical Immunology
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 124
- Issue
- 5
- Pages
- 997-1002
- ISSN
- 0091-6749 (ISSN-L)
- OpenAlex
- W2050387062
- Cited by
- 203
- References
- 34
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 6 · 2023: 9 · 2022: 12 · 2021: 7 · 2020: 9 · 2019: 7 · 2018: 10 · 2017: 13 · 2016: 17 · 2015: 18 · 2014: 16 · 2013: 20 · 2012: 21
- FWCI
- 13.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Allergy and Clinical Immunology (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Universität Zürich
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- allergen immunotherapy, grass pollen allergy, allergic rhinitis, nasal provocation test, IgE-mediated allergy, treatment safety, T cell response
- MeSH terms
- Administration, Cutaneous, Adolescent, Adult, Aged, Allergens, Desensitization, Immunologic, Double-Blind Method, Eczema, Female, Humans, Hypersensitivity, Male, Middle Aged, Nasal Provocation Tests, Placebos, Pollen, Skin Tests, Phleum, Young Adult
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