Bhalla Prem L, Singh Mohan B
Plant Molecular Biology and Biotechnology Laboratory, Australian Research Council Centre of Excellence for Integrative Legume Research, Institute of Land and Food Resources, The University of Melbourne, Parkville, Victoria, Australia.
Curr Opin Allergy Clin Immunol. 2004 Dec;4(6):569-73. doi: 10.1097/00130832-200412000-00016.
Specific immunotherapy is a clinically effective causative treatment for allergic conditions. However, the reagents used for immunotherapy are crude extracts prepared from natural sources with potential life-threatening anaphylactic side effects. Molecular cloning of allergens has made it feasible to design novel therapeutic approaches for improved and safer forms of allergen-specific immunotherapy. The purpose of this review is to examine recent advances made in the last 2 years in genetic engineering of allergens for specific immunotherapy.
Genetic engineering of allergen with nil or low IgE reactivity but retained T-cell reactivity offers a novel therapeutic approach to improving safety and efficacy of allergen-specific immunotherapy. Hypoallergenic forms of major allergens have been produced, with reduced IgE epitopes while preserving other characteristics of the molecule to induce a protective response.
Hypoallergenic forms of major allergens are potential candidates for allergen-specific immunotherapy in the future. These genetically engineered hypoallergens now need to be tested in clinical trials before being widely used. Safer and more efficacious vaccines would increase patient compliance leading to extensive use of immunotherapy.
特异性免疫疗法是治疗过敏性疾病的一种临床有效病因疗法。然而，用于免疫疗法的试剂是从天然来源制备的粗提取物，具有潜在的危及生命的过敏副作用。过敏原的分子克隆使得设计新型治疗方法以改进和更安全地进行过敏原特异性免疫疗法成为可能。本综述的目的是探讨过去两年在用于特异性免疫疗法的过敏原基因工程方面取得的最新进展。
对IgE反应性为零或低但保留T细胞反应性的过敏原进行基因工程改造，为提高过敏原特异性免疫疗法的安全性和有效性提供了一种新的治疗方法。已经产生了主要过敏原的低变应原形式，其IgE表位减少，同时保留了分子的其他特性以诱导保护性反应。
主要过敏原的低变应原形式是未来过敏原特异性免疫疗法的潜在候选物。这些基因工程改造的低变应原现在需要在临床试验中进行测试，然后才能广泛使用。更安全、更有效的疫苗将提高患者的依从性，从而导致免疫疗法的广泛应用。
