Impact Of Age And Region On Immune Responses To Allergy Immunotherapy

Allergy immunotherapy (AIT) can prevent allergic disease by modifying the adaptive immune system, similar to anti-pathogen vaccines, supporting the concept of AIT as an “allergy vaccination”. Some vaccines, e.g. influenza, pneumococcal pneumoniae, are administered globally with the same dose for all age groups. The aim of this study was to determine if sublingual immunotherapy (SLIT) across regions and age groups induce similar immunologic changes in IgE and IgG4 with the goal of using the same dose and formulation worldwide. Immunologic data from 12 completed multi-national pivotal trials of birch, timothy grass, ragweed, and house dust mite SLIT-tablet (N=5645) were analysed post-hoc by age and region. PubMed was searched for relevant human trials from 01/01/2000 to 04/01/2020 evaluating age and regional factors related to dosage and immunologic response to AIT or vaccine prevention of hepatitis A, influenza, and pneumococcal pneumoniae. The literature search did not reveal conclusive data supporting a universal AIT dosage. Published data indicated that age and other host factors can influence anti-pathogen vaccine immunogenicity. SLIT-tablets induced a significant immunologic response compared with placebo shortly after initiation. The pattern and magnitude of the response for both IgE and IgG4 were similar across species, regions, and age. The results support that the overall immunologic responses to SLIT-tablet are insensitive to region and age.