Synthetic and Genetically Engineered Allergen Derivatives for Specific Immunotherapy of Type I Allergy

Abstract

This chapter reports recent advances in the development of synthetic and genetically engineered allergen derivatives and compares the strategies with modifications applied to increase the safety of allergen extracts for immunotherapy. It summarize experiences gained from clinical studies performed with synthetic and genetically modified allergen-derivatives in humans. The chapter discusses perspectives on how the use of genetically engineered or synthetic hypoallergenic allergen derivatives may improve specific immunotherapy. Based on epitope and structural analyses of biologically active recombinant allergen molecules, synthetic and genetically engineered hypoallergenic versions thereof are currently being developed for safe and component-resolved immunotherapy. The authors suggest continuing to improve injection immunotherapy with adjuvant-bound allergen extracts by utilizing recombinant and synthetic hypoallergenic allergen derivatives instead of natural extracts. Owing to their greatly reduced allergenic activity, it will be possible to inject much higher doses of the synthetic or genetically engineered allergens with reduced risk of anaphylactic side effects.