Sublingual Immunotherapy of Birch Pollen Associated Apple Allergy

Summary

More than 70% of birch pollen allergic patients suffer from allergic reactions to certain foods, e.g. stone fruits, hazelnut and some vegetables. However, specific immunotherapy (SIT) with birch pollen extract is not effective for the treatment of associated food allergy in a substantial number of patients. Based on our previous clinical and immunological investigations of birch pollen related food allergy (BPRFA) the investigators hypothesize that for effective SIT of this abundant food allergy the disease-eliciting food allergens should be employed. To prove this concept, the investigators aim to sublingually administer the major apple allergen, Mal d 1, to birch pollen-allergic patients with concomitant apple allergy and evaluate clinical and immunological effects of this treatment. The investigators choose Mal d 1 as model food allergen because (i) its cross-reactivity with Bet v 1 has been well characterized,(ii) apple is the most frequent trigger for BPRFA and (iii) recombinant(r)Mal d 1 was well tolerated after sublingual administration to 20 birch pollen-allergic patients in a previous study. Sublingual administration of a defined concentration of GMP-rMal d 1 will be compared with equal doses of GMP-rBet v 1 as a positive control and placebo-treatment. Clinical parameters will include skin prick tests (SPT) and objective and subjective assessment of apple and birch pollen-induced allergic symptoms. Immunological parameters will comprise the analysis of antibody and T cell responses to Mal d 1 and Bet v 1 as well as the evaluation of basophil activation.

The proposed pilot study will be a first investigation of the concept to specifically treat BPRFA with the involved food allergens and thus, represents an important step in the development of an efficient and safe therapy in the future.

Conditions

• Birch Pollen Related Apple Allergy
• Birch Pollen Allergy

Interventions

DRUG

rMal d 1

25 µg daily as sublingually administered drops, 16 weeks

DRUG

rBet v 1

25 µg daily administered sublingually as drops over 16 weeks

OTHER

placebo drops

25 µg of placebo Drops daily administered sublingually over 16 weeks

Sponsors & Collaborators

• Austrian Science Fund (FWF)

  collaborator OTHER

• Medical University of Vienna

  lead OTHER

Principal Investigators

• Barbara Bohle, PhD, Prof. · Medical University of Vienna

• Tamar Kinaciyan, MD · Medical University of Vienna

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2012-03-14

Primary Completion

2014-02-28

Completion

2016-12-20

Countries

• Austria

Study Locations