Current pharmacological therapies for allergic diseases can improve clinical symptoms but cannot change their long-term clinical course. There is an unmet need for a curative treatment for allergic diseases. Allergen immunotherapy (AIT) is the practice of administering increasing doses of clinically relevant allergens to an allergic subject to reduce the clinical symptoms associated with subsequent exposure to the allergen. AIT is clinically effective for allergic asthma, allergic rhinitis, venom-induced anaphylaxis, and atopic dermatitis. AIT can change the natural course of allergic diseases and induce allergen-specific immune tolerance. In current clinical practice, AIT is delivered either subcutaneously or sublingually. Both subcutaneous and sublingual AIT have long-term therapeutic efficacy after of 3-5 years of treatment. The development of safer and more effective AIT strategies is needed. Conclusion: AIT is a disease-modifying therapy for allergic diseases. Future development of AIT should be directed toward achieving long-term clinical remission in patients with allergic diseases by the safe and effective induction of immune tolerance.
Allergens ; Anaphylaxis ; Asthma ; Dermatitis, Atopic ; Desensitization, Immunologic* ; Humans ; Hypersensitivity ; Immune Tolerance ; Immunomodulation ; Immunotherapy ; Rhinitis

PURPOSE: Allergen immunotherapy (AIT) induces immunological tolerance, and there is increasing evidence of the clinical efficacy of AIT in the treatment of allergic asthma. However, the optimal parameters for asthma control in clinical trials are still unclear. We investigated the efficacy of AIT with respect to changes in the inhaled corticosteroid (ICS) dose in patients with allergic asthma. METHODS: A total of 117 adults with allergic asthma who had used ICS for more than 1 year in a single tertiary hospital in Korea were included in this retrospective study. We compared the clinical parameters and outcomes between the AIT group (ICS with AIT, n = 48) and the non-AIT group (ICS without AIT, n = 69) by applying an inverse probability of treatment weighting method. The patients in the AIT group had received subcutaneous AIT monthly as a maintenance treatment for more than 1 year. The changes in the ICS dose from baseline were evaluated in the 2 groups for 3 years. RESULTS: The proportion of responders who discontinued or decreased in the ICS dose with achieving control status of asthma was significantly higher in the AIT group than in the non-AIT group throughout the study period (at 6 months, 52.1% vs. 24.6%; at 1 year, 70.8% vs. 34.7%; at 2 years, 89.5% vs. 35.6%; at 3 years, 96.3% vs. 51.2%). Treatment responses did not differ significantly by type of allergen (single- or multi-allergens or 3 different products) used throughout the study period. CONCLUSIONS: Irrespective of the type of allergen, long-term maintenance AIT helps to spare ICS dose and achieve better control in patients with allergic asthma in real-world clinical practice.
Adult ; Asthma ; Desensitization, Immunologic ; Humans ; Immunomodulation ; Korea ; Methods ; Retrospective Studies ; Tertiary Care Centers ; Treatment Outcome

This report evaluated long-term changes in clinical severity and laboratory parameters in 3 adult patients with severe recalcitrant atopic dermatitis (AD) who were treated with intramuscular injections of 50 mg of autologous immunoglobulin G (IgG) twice a week for 4 weeks (autologous immunoglobulin therapy, AIGT) and followed up for more than 2 years after the treatment. We observed the following 4 major findings in these 3 patients during the long-term follow-up after AIGT. (1) Two of the 3 patients showed a long-term clinical improvement for more than 36 weeks after AIGT with a maximum decrease in clinical severity score greater than 80% from baseline. (2) These 2 patients also showed long-term decreases in serum total IgE concentrations and peripheral blood eosinophil count for more than 36 weeks after AIGT with a maximum decrease in the two laboratory parameters of allergic inflammatory greater than 70% from baseline. (3) No significant side effect was observed during the 2 years of follow-up period after the AIGT in all 3 patients. (4) Serum levels of IgG anti-idiotype antibodies to the F(ab')2 fragment of autologous IgG administered for the treatment were not significantly changed after AIGT in all 3 patients. These findings suggest that AIGT has long-term favorable effects on both clinical severity and laboratory parameters in selected patients with severe recalcitrant AD. Further studies are required to evaluate the clinical usefulness and therapeutic mechanism of AIGT for AD.
Adult ; Antibodies ; Antibodies, Anti-Idiotypic ; Dermatitis, Atopic* ; Eosinophils ; Follow-Up Studies ; Humans ; Immunization, Passive* ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins* ; Immunomodulation ; Injections, Intramuscular

Booster immunization is the following vaccination after a period of vaccine primary immunization schedule in order to maintain immunity against a certain pathogen. In this article, the immunological mechanism of booster immunization is elaborated, and the effectiveness and public health value of booster immunization for common vaccines is discussed. Subsequently, three hot issues of general concern in booster immunization are addressed, and the public health viewpoint that "Primary immunization of vaccines is fundamental, and booster immunization is the guarantee" is emphasized, so as to raise awareness of the importance and necessity of booster immunization as well as to provide scientific evidences for vaccine immunization practice.
Humans ; Immunization, Secondary ; Public Health ; Immunization Schedule ; Vaccination ; Viral Vaccines

Adjuvants can be defined as pharmacological and immunological components that are able to modify and/or enhance antigen-specific immune responses. Based on the interdisciplinary research between immunology and material science/engineering, various vaccine adjuvant materials have been developed. By rational design and engineering of antigen or adjuvant materials, immune-modulatory vaccine systems generated to activate immune system. Here, we review the current progress of bioengineered prophylactic and/or therapeutic vaccine adjuvant for cancer and/or infectious disease, and discuss the prospect of future vaccine adjuvant materials.
Adjuvants, Immunologic ; Allergy and Immunology ; Communicable Diseases* ; Immune System ; Immunomodulation ; Immunotherapy*

This article attempts to review the current understanding of non-surgical management of fungal rhinosinusitis. Fungal rhinosinusitis can be divided into an invasive or non-invasive form based on the clinical, radiologic, and histologic manifestations. For the proper management of acute fulminant invasive fungal sinusitis, antifungal medications, complete surgical debridement, and reversal of the underlying state of immune dysfunction are necessary. Antifungal medication and complete extirpation of the disease are required in the treatment of chronic invasive fungal sinusitis or granulomatous fungal sinusitis. Sinus fungal ball can be adequately treated through a complete surgical removal of the fungal ball and irrigation of the involved sinus. Post-operative antifungal therapy is rarely necessary unless the patient suffers from a compromised immune function. Treatment of an allergic fungal rhinosinusitis is marked by a high rate of recidivism. Earlier 'radical' surgery has currently been replaced with a combination of conservative surgery and medical therapy, including immunomodulation with corticosteroids or immunotherapy.
Adrenal Cortex Hormones ; Debridement ; Humans ; Immunomodulation ; Immunotherapy ; Sinusitis*

The current standard medical therapy for atopic dermatitis (AD) mainly focuses on symptomatic relief by controlling skin inflammation with topical corticosteroids and/or topical calcineurin inhibitors. However, the clinical efficacy of pharmacological therapy is often disappointing to both patients and physicians. The terminology of AD contains a historical meaning of eczematous dermatitis caused by hypersensitivity reaction to environmental inhalant or food allergen. Complex interrelationships among genetic abnormalities, environmental triggers, skin barrier defects, and immune dysfunction resulting in a vicious domino-circle seem to be involved in the development and maintenance of AD. In the viewpoint of AD as an allergic disease, complete avoidance of clinically relevant allergen or induction of specific immune tolerance through administrations of allergen (allergen immunotherapy) can provide clinical remission by breaking the vicious domino-circle maintaining a chronic disease state. In recent clinical studies, monoclonal antibodies including the anti-interleukin-4 receptor antibody and anti-B cell antibody induced significant clinical improvements in patients with AD. The detailed characteristics of immune dysfunction are heterogeneous among patients with AD. Therefore, a personalized combination of immunomodulatory therapies to reduce hypersensitivity (allergen immunotherapy) and correct immune dysfunction (monoclonal antibody therapy) could be a reasonable therapeutic approach for patients with AD. Future immunomodulatory therapies for AD should be developed to achieve long-term treatment-free clinical remission by induction of immune tolerance.
Adrenal Cortex Hormones ; Allergens ; Antibodies, Monoclonal ; Calcineurin ; Chronic Disease ; Dermatitis, Atopic* ; Eczema ; Humans ; Hypersensitivity ; Immune Tolerance ; Immunomodulation* ; Inflammation ; Skin

As allogeneic blood transfusion plays a role in clinical treatment effects, it also produces a number of immune-related side effects, such as the increased rate of postoperative infection, the rising relapse rate of malignant resection and so on. All those factors, such as CD200 surface molecule of allogeneic mononuclear cells, interleukin, sHLA and sFasL which are detached from the leukocyte surface during the period of storage, and serum bioactive molecules related to a certain degree with the occurrence of transfusion-related immunomodulation (TRIM). The clinical controlled trials, laboratory researches and animal models demonstrated that cloning deletion, induction of anergy and immune suppression are the three major mechanisms of TRIM. In this article, the research advances on mechanism of TRIM and the mediators inducing TRIM are reviewed.
Animals ; Humans ; Immunomodulation ; Immunosuppression ; Platelet Transfusion ; adverse effects ; Transfusion Reaction

With rising prevalence of food allergy (FA), allergen-specific immunotherapy (AIT) for FA has become an active area of research in recent years. In AIT, incrementally increasing doses of inciting allergen are given with the goal to increase tolerance, initially through desensitization, which relies on regular exposure to allergen. With prolonged therapy in some subjects, AIT may induce sustained unresponsiveness, in which tolerance is retained after a period of allergen avoidance. Methods of AIT currently under study in humans include oral, sublingual, epicutaneous, and subcutaneous delivery of modified allergenic protein, as well as via DNA-based vaccines encoding allergen with lysosomal-associated membrane protein I. The balance of safety and efficacy varies by type of AIT, as well as by targeted allergen. Age, degree of sensitization, and other comorbidities may affect this balance within an individual patient. More recently, AIT with modified proteins or combined with immunomodulatory therapies has shown promise in making AIT safer and/or more effective. Though methods of AIT are neither currently advised by experts (oral immunotherapy [OIT]) nor widely available, AIT is likely to become a part of recommended management of FA in the coming years. Here, we review and compare methods of AIT currently under study in humans to prepare the practitioner for an exciting new phase in the care of food allergic patients in which improved tolerance to inciting foods will be a real possibility.
Comorbidity ; Food Hypersensitivity* ; Humans ; Immunomodulation ; Immunotherapy* ; Membrane Proteins ; Prevalence ; Sublingual Immunotherapy ; Vaccines

Immunotherapy was long considered as an attractive modality in the treatment of lung cancer. However, clinical successes were hampered by the inability to achieve potent activation of the antitumor immune system and effectively overcome the immune suppressive environment associated with lung cancer. Recent advances in cancer immunotherapy demonstrate that these limitations can be surmounted. In this review, we discuss the recent advances in immunotherapy of lung cancer and their potential implication for management of this disease.
Immune System ; Immunomodulation ; Immunotherapy ; Lung ; Lung Neoplasms ; Translational Medical Research ; Vaccines