Immunotherapy with Bet v 1-derived contiguous overlapping peptides leads to long term immunoregulatory responses (107.14)

Abstract Allergen specific immunotherapy with whole pollen extract may induce anaphylaxis, is poorly standardized and of long duration. We thus designed a randomized, placebo-controlled phase I/II trial in volunteers with birch pollen allergic rhinitis and asthma to evaluate the safety and immunogenicity of a novel immunotherapy based on contiguous overlapping peptides (COPs) derived from Bet v 1, the major birch pollen allergen. A mixture of three COPs (AllerT™, Anergis SA, Switzerland) spanning the whole Bet v 1 molecule was selected for its inability to bind IgE. Prior to the pollen season, AllerT (in Alum) was injected subcutaneously to 15 adult volunteers at D0 (57 μg), D7, D14, D21 and D51 (95 μg each). Control volunteers (n=5) received only adjuvant. Overall AllerT was safe. No serious adverse events and no immediate allergic reactions were reported. AllerT induced a vigorous early Bet v 1 specific immune response marked by vaccine associated INFγ and IL-10 secretion. This contributed to a strong anti-Bet v 1-specific IgG4 enhancement. Moreover, two months after the second season post treatment (July 2010), serum Bet v 1 specific IgG4 response was still markedly increased as compared to pre-treatment values and to placebo whereas post seasonal Bet v 1 specific IgE titers were similar to baseline values. Taken together this indicates that immunotherapy with a mixture of three COPs derived from Bet v 1 (AllerT) was safe and immunogenic, and led to long term immunological memory.