Re-Print: New Perspectives in Immunotherapy: The importance of Dendritic Cells in Allergen-Specific Immunotherapy

Abstract

Allergen-specific immunotherapy is the only treatment capable of altering the natural course of the allergic disease. Clinical trials show that immunotherapy is safe and effective for many patients. However, it still faces problems related to efficacy, safety, long treatment duration and low patient adherence. Contrary to what was imagined, the shift in immunity from Th2 to Th1 is not the key to successful treatment. Recent advances in the knowledge of Treg and Breg cells and tolerance mechanisms have been essential to explain the immunological changes resulting from immunotherapy. In this context, there has been intense research into the development of adjuvants with the aim of increasing safety, optimizing treatment regimens and improving patient adherence. Allergens were modified (glycoconjugates) with carbohydrates derived from Saccharomyces Cerevisae to increase their uptake and presentation through carbohydrate receptors present in Dendritic Cells, benefiting from the ability to act in inducing tolerance to initiate immune responses. Dendritic cells are the most professional antigen presenters of the APC system. They represent the bridge between innate and adaptive immunity and are capable of initiating and maintaining immune responses. In light of new evidence, they constitute a key therapeutic target to obtain an adequate response to allergen-specific immunotherapy with the potential to contribute to innovation in the field of immunotherapy.