First-in-human phase 2 trial with mite allergoids coupled to mannan in subcutaneous and sublingual immunotherapy.

BACKGROUND: Polymerized allergens conjugated to non-oxidized mannan (PM-allergoids) are novel vaccines targeting dendritic cells (DCs). Previous experimental data indicate that PM-allergoids are readily taken up by DCs and induce Treg cells. This first-in-human study was aimed to evaluate safety and...

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Detalles Bibliográficos
Autores: Nieto A, Mazón Á, Nieto M, Ibáñez E, Jang DT, Calaforra S, Alba P, Pérez-Francés C, Llusar R, Montoro J, Mateo A, Alamar R, El-Qutob D, Fernández J, Moral L, Toral T, Antón M, Andreu C, Ferrer Á, Flores IM, Cerdá N, Del Pozo S, Caballero R, Subiza JL, Casanovas M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p8943
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones8943
Access Level:acceso abierto
Palabra clave:Allergoid
Clinical trial
House dust mite
Immunotherapy
Mannan
Polymerized
Descripción
Sumario:BACKGROUND: Polymerized allergens conjugated to non-oxidized mannan (PM-allergoids) are novel vaccines targeting dendritic cells (DCs). Previous experimental data indicate that PM-allergoids are readily taken up by DCs and induce Treg cells. This first-in-human study was aimed to evaluate safety and to find the optimal dose of house dust mite PM-allergoid (PM-HDM) administered subcutaneously (SC) or sublingually (SL). METHODS: In a randomized, double-blind, double-dummy, placebo-controlled trial, 196 subjects received placebo or PM-HDM at 500, 1,000, 3,000 or 5,000 mannan-conjugated therapeutic units (mTU)/mL in 9-arm groups for 4 months. All subjects received 5 SC doses (0.5 mL each) every 30 days plus 0.2 mL SL daily. The primary efficacy outcome was the improvement of titrated nasal provocation tests (NPT) with D. pteronyssinus at baseline and at the end of the study. All adverse events and reactions were recorded and assessed. Secondary outcomes were the combination of symptom and medication scores (CSMS) and serological markers. RESULTS: No moderate or severe adverse reactions were reported. Subjects improving the NPT after treatment ranged from 45% to 62% in active SC, 44% to 61% in active SL and 16% in placebo groups. Statistical differences between placebo and active groups were all significant above 500 mTU, being the highest with 3,000 mTU SL (p=.004) and 5,000 mTU SC (p=.011). CSMS improvement over placebo reached 70% (p<.001) in active 3,000 mTU SC and 40% (p=0.015) in 5,000 mTU SL groups. CONCLUSIONS: PM-HDM immunotherapy was safe and successful in achieving primary and secondary clinical outcomes in SC and SL at either 3,000 or 5,000 mTU/mL.