Having attended a lecture about the potential benefits of peptide therapy for controlling aberrant immune responses, I was interested to hear about how a radical therapy for curbing allergies could be employed in this treatment. The lecture focused upon peptide immunotherapy as a treatment for curing autoimmunity (i.e. the host immune system attacking itself), this works by providing the individuals immune system with a piece of protein targeted by the response which switches off the destructive process. This mechanism of ignoring self is known broadly as tolerance, in healthy individuals the process of tolerance is successful and occurs around birth, whereas in individuals with autoimmunity 'something' goes wrong.
People with an autoimmune disease targeting a self protein - like insulin in type 1 diabetes, which results in destruction of beta-cells - have immune cells which have escaped tolerance, recognising self as foreign and destroying the protein producing cell. The idea of peptide immunotherapy is to provide the targeted self-protein in a context which induces tolerance within the immune system. This method of treatment has been shown to be very effective in mouse models of autoimmune diseases, but has unfortunately shown little effect in clinical trials (however there haven't been that many).
The main problem with peptide immunotherapy is that the tolerising effect on the immune system is fleeting, lasting only until the treatment has finished before the autoimmune response recurs. So, to make this therapy a viable option it may have to be given continually to patients, and as this entails several visits over several months it could mean the hassle (for some people) outweighs the benefits, especially for those who can control their disease (e.g. insulin injections for controlling type 1 diabetes).
An alternative might be to implement some strategies used in the therapy for treating severe allergies, for example in those who enter anaphylactic shock after being stung by a bee, or who have incredibly acute hayfever, or nut allergies etc... This treatment has the rather cool name of 'ULTRA RUSH', and the rationale for the treatment is provided by bee keepers. Bee keeper undergo a massive number of stings at the beginning of a season, and this provides a large dose of bee venom which has the effect of 'tolerising' their response to the venom. By the end of the season the keepers don't notice stings. However, come the next season the first sting hurts like hell again and causes a swelling as the immune system requires constant exposure to the venom/allergen. The high dose exposure to allergens in bee keeping has been mimicked in the clinic using ultra rush for treating severe allergies.
Ultra rush therapy involves the administration of several doses of the allergen protein, given in increasing concentrations over 1 hour. In patients with severe reactions to allergens this kind of treatment can obviously be incredibly dangerous, and is therefore performed in an intensive care unit (ICU). When this kind of treatment would be given I'm not sure, maybe if a treasure trove was guarded by bees? Or maybe if you are allergic to bee stings but have an unbridled desire to win a beard of bees competition...The potential benefits however mean that if successful the patient is tolerised, and non-responsive to the allergen. If this kind of treatment were used in the treatment of autoimmunity, which doesn't have an associated hypersensitive response it could be a viable option for therapy. Also of benefit is the constant presence of the self-protein in individuals with autoimmunity, meaning that the constant exposure to the tolerising protein in question would mean the treatment could be life-long. However the major risk of this treatment would be exacerbation of the autoimmune response.
As the number of peptide immunotherapy trials increase, because manipulation of the immune system for controlling responses has potentially a much greater benefit than blanketed suppression, this route of peptide administration may be a viable, yet controversial strategy. We will see whether anyone is bold enough to approach this option...
 |
| Chinese bee beard competitor |
The main problem with peptide immunotherapy is that the tolerising effect on the immune system is fleeting, lasting only until the treatment has finished before the autoimmune response recurs. So, to make this therapy a viable option it may have to be given continually to patients, and as this entails several visits over several months it could mean the hassle (for some people) outweighs the benefits, especially for those who can control their disease (e.g. insulin injections for controlling type 1 diabetes).
An alternative might be to implement some strategies used in the therapy for treating severe allergies, for example in those who enter anaphylactic shock after being stung by a bee, or who have incredibly acute hayfever, or nut allergies etc... This treatment has the rather cool name of 'ULTRA RUSH', and the rationale for the treatment is provided by bee keepers. Bee keeper undergo a massive number of stings at the beginning of a season, and this provides a large dose of bee venom which has the effect of 'tolerising' their response to the venom. By the end of the season the keepers don't notice stings. However, come the next season the first sting hurts like hell again and causes a swelling as the immune system requires constant exposure to the venom/allergen. The high dose exposure to allergens in bee keeping has been mimicked in the clinic using ultra rush for treating severe allergies.
Ultra rush therapy involves the administration of several doses of the allergen protein, given in increasing concentrations over 1 hour. In patients with severe reactions to allergens this kind of treatment can obviously be incredibly dangerous, and is therefore performed in an intensive care unit (ICU). When this kind of treatment would be given I'm not sure, maybe if a treasure trove was guarded by bees? Or maybe if you are allergic to bee stings but have an unbridled desire to win a beard of bees competition...The potential benefits however mean that if successful the patient is tolerised, and non-responsive to the allergen. If this kind of treatment were used in the treatment of autoimmunity, which doesn't have an associated hypersensitive response it could be a viable option for therapy. Also of benefit is the constant presence of the self-protein in individuals with autoimmunity, meaning that the constant exposure to the tolerising protein in question would mean the treatment could be life-long. However the major risk of this treatment would be exacerbation of the autoimmune response.
As the number of peptide immunotherapy trials increase, because manipulation of the immune system for controlling responses has potentially a much greater benefit than blanketed suppression, this route of peptide administration may be a viable, yet controversial strategy. We will see whether anyone is bold enough to approach this option...
Comments
Post a Comment