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J Allergy Clin Immunol. 2017 Aug;140(2):486-496. doi: 10.1016/j.jaci.2016.11.043. Epub 2017 Feb 21.

Treatment with grass allergen peptides improves symptoms of grass pollen-induced allergic rhinoconjunctivitis.

Author information

1
Departments of Medicine and Biomedical & Molecular Science, Queen's University, Kingston, Ontario, Canada; Allergy Research Unit, Kingston General Hospital, Kingston, Ontario, Canada. Electronic address: ellisa@KGH.KARI.NET.
2
Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
3
Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Australia.
4
Adiga Life Sciences, Hamilton, Ontario, Canada.
5
Allergy Research Unit, Kingston General Hospital, Kingston, Ontario, Canada.
6
McMaster University/St. Joseph's Healthcare, Hamilton, Ontario, Canada.
7
Circassia Ltd, The Oxford Science Park, Oxford, United Kingdom.

Abstract

BACKGROUND:

Synthetic peptide immunoregulatory epitopes are a new class of immunotherapy to treat allergic rhinoconjunctivitis (ARC). Grass allergen peptides, comprising 7 synthetic T-cell epitopes derived from Cyn d 1, Lol p 5, Dac g 5, Hol l 5, and Phl p 5, is investigated for treatment of grass pollen-induced ARC.

OBJECTIVE:

We sought to evaluate the efficacy, safety, and tolerability of intradermally administered grass allergen peptides.

METHODS:

A multicenter, randomized, double-blind, placebo-controlled study evaluated 3 regimens of grass allergen peptides versus placebo in patients with grass pollen-induced allergy (18-65 years). After a 4-day baseline challenge to rye grass in the environmental exposure unit (EEU), subjects were randomized to receive grass allergen peptides at 6 nmol at 2-week intervals for a total of 8 doses (8x6Q2W), grass allergen peptides at 12 nmol at 4-week intervals for a total of 4 doses (4x12Q4W), or grass allergen peptides at 12 nmol at 2-week intervals for a total of 8 doses (8x12Q2W) or placebo and treated before the grass pollen season. The primary efficacy end point was change from baseline in total rhinoconjunctivitis symptom score across days 2 to 4 of a 4-day posttreatment challenge (PTC) in the EEU after the grass pollen season. Secondary efficacy end points and safety were also assessed.

RESULTS:

Two hundred eighty-two subjects were randomized. Significantly greater improvement (reduction of total rhinoconjunctivitis symptom score from baseline to PTC) occurred across days 2 to 4 with grass allergen peptide 8x6Q2W versus placebo (-5.4 vs -3.8, respectively; P = .0346). Greater improvement at PTC also occurred for grass allergen peptide 8x6Q2W versus placebo (P = .0403) in patients with more symptomatic ARC. No safety signals were detected.

CONCLUSION:

Grass allergen peptide 8x6Q2W significantly improved ARC symptoms after rye grass allergen challenge in an EEU with an acceptable safety profile.

KEYWORDS:

Allergen challenge; allergen peptides; allergic rhinitis; allergic rhinoconjunctivitis; allergy; environmental exposure unit; epitope; grass; immunotherapy; synthetic peptide immunoregulatory epitope

PMID:
28236469
DOI:
10.1016/j.jaci.2016.11.043
[Indexed for MEDLINE]

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