Explore the vast range of titles available.

Die Therapieallergene-Verordnung (TAV) hat zum Ziel, Allergen-Immuntherapie (AIT)-Produkte zur Therapie häufiger Allergien, die in Deutschland als Individualrezepturen vertrieben wurden, bei entsprechend nachgewiesener Qualität, Wirksamkeit und Sicherheit in geprüfte, zugelassene Produkte zu überführen. Die TAV gilt für alle Individualrezepturen, welche Wirkstoffe auf Basis folgender Allergenquellen enthalten: Hausstaubmilben, Bienengift, Wespengift, Pollen der Süßgräser (ohne Mais), Birke, Erle oder Hasel. Die letzten unter der TAV gewährten produktspezifischen Fristen zur Vorlage zulassungsrelevanter klinischer Daten enden im Verlauf des Jahres 2026. Die anschließende finale Bewertung der aktualisierten Zulassungsunterlagen erfolgt durch die zuständige Zulassungsbehörde, das Paul-Ehrlich-Institut. Während dieser Bearbeitungszeiten der Zulassungsbehörde bleiben die Produkte bis zur Entscheidung über den Zulassungsantrag verkehrsfähig. Aktuell (Stand 08.08.2025) sind unter den Übergangsvorschriften der TAV noch 40 AIT-Produkte verkehrsfähig (10 Präparate zur Behandlung von Allergien gegen Hausstaubmilben, 10 gegen Baumpollenallergien, 16 gegen Graspollenallergien und 4 Mischpräparate, die nicht-homologe Allergengruppen enthalten). Für 8 dieser Produkte wurde eine Rücknahme der Zulassungsanträge zum 01.10.2025 bzw. zum 31.01.2026 von Seiten der pharmazeutischen Unternehmen veranlasst. Vor der abschließenden Bewertung der aktualisierten Zulassungsdossiers ist es der Zulassungsbehörde nicht möglich, öffentliche Einschätzungen dazu abzugeben, ob für die verbliebenen 32 Produkte, deren Verfahren aktuell noch anhängig sind, die einzelnen Zulassungsanträge mit Erteilung der Zulassung oder mit einer Versagung derselben abgeschlossen werden. Mit der Bekanntgabe der Versagung einer Zulassung endet sofort die Verkehrsfähigkeit, das heißt es gibt keine zusätzliche Abverkaufsfrist für die betreffenden TAV-Produkte. Mit einer Zulassung wird die Verkehrsfähigkeit für das spezifische Produkt verstetigt.Erstpublikation in Allergologie select, mit freundlicher Genehmigung der AutorenPubMedCentralAllergologie selectZitierung:Mahler V, Hartenstein D, Lauer I, Vieths S, Ruoff C, Zimmer J, Kaul S. Therapy Allergen Ordinance (TAO): The final stretch. Allergol Select. 2025; 9: 93-99.DOI 10.5414/ALX02594E

Airway epithelial cells are the first line of defense against the constituents of the inhaled air, which include allergens, pathogens, pollutants, and toxic compounds. The epithelium not only prevents the penetration of these foreign substances into the interstitium, but also senses their presence and informs the organism's immune system of the impending assault. The epithelium accomplishes the latter through the release of inflammatory cytokines and chemokines that recruit and activate innate immune cells at the site of assault. These epithelial responses aim to eliminate the inhaled foreign substances and minimize their detrimental effects to the organism. Quite frequently, however, the innate immune responses of the epithelium to inhaled substances lead to chronic and high level release of pro-inflammatory mediators that may mediate the lung pathology seen in asthma. The interactions of airway epithelial cells with allergens will be discussed with particular focus on interactions-mediated epithelial release of cytokines and chemokines and their role in the immune response. As pollutants are other major constituents of inhaled air, we will also discuss how pollutants may alter the responses of airway epithelial cells to allergens.

Die Allergen-Immuntherapie (AIT) ist die einzige kausale Therapie für allergische Erkrankungen und daher besonders wichtig. Allergenpräparate sind seit 1989 als Arzneimittel eingestuft (Richtlinie 89/342/EWG) und wurden 2001 in die Richtlinie 2001/83/EG übernommen. Darüber hinaus trat 2008 die Therapieallergene-Verordnung (TAV) in Kraft, um die Ausnahmeregelung für patientenbezogene Produkte (NPP) strenger zu regeln, indem häufige Therapieallergene von der Ausnahme ausgeschlossen wurden, als NPP vermarktet werden zu dürfen. Die TAV regelt die Anforderungen an die Prüfung der Unbedenklichkeit und Wirksamkeit für diese häufigen Therapieallergene. Aufgrund der langen Übergangsbestimmungen enden die letzten Fristen zur Behebung klinischer Mängel im Jahr 2026. Der Vorteil dieser Regelung ist, dass der Markt für häufige Allergene von Produkten ohne Wirksamkeitsnachweis bereinigt wurde und neue Präparate mit einem optimalen Dosisbereich durch Dosisfindungsstudien entwickelt werden. Die Forderung nach pädiatrischen Langzeitstudien wurde durch das Standard-Pädiatrische Prüfkonzept (PIP) für Allergenprodukte des Pädiatrieausschusses der EMA (PDCO) umrissen. Dies ist besonders problematisch, da absehbar ist, dass die Rekrutierung von Patienten begrenzt sein wird und ethische Probleme durch die verlängerte Verwendung von Placebo entstehen. Außerdem werden viele neu zugelassene Präparate auf absehbare Zeit nicht in der Pädiatrie eingesetzt werden, da für diese Altersgruppe noch keine Zulassung erteilt wurde. Dies wird zu einer ernsthaften Versorgungslücke für Kinder führen.Erstpublikation in Allergologie select, mit freundlicher Genehmigung der AutorenAllergologie selectZitierung:Vogelberg C, Gerstlauer M. AIT in pediatric allergology: Opportunities and difficulties on the home stretch of the Therapy Allergen Ordinance. Allergol Select. 2023; 7: 236-241.DOI 10.5414/ALX02443E

Purpose of ReviewThe recent introduction of edible insects in Western countries has raised concerns about their safety in terms of allergenic reactions. The characterization of insect allergens, the sensitization and cross-reactivity mechanisms, and the effects of food processing represent crucial information for risk assessment.Recent FindingsAllergic reactions to different insects and cross-reactivity with crustacean and inhalant allergens have been described, with the identification of new IgE-binding proteins besides well-known pan-allergens. Depending on the route of sensitization, different potential allergens seem to be involved. Food processing may affect the solubility and the immunoreactivity of insect allergens, with results depending on species and type of proteins. Chemical/enzymatic hydrolysis, in some cases, abolishes immunoreactivity.SummaryMore studies based on subjects with a confirmed insect allergy are necessary to identify major and minor allergens and the role of the route of sensitization. The effects of processing need to be further investigated to assess the risk associated with the ingestion of insect-containing food products.

Due to the widespread use of shellfish ingredients in food products, accurate food labelling is urgently needed for consumers with shellfish allergies. Most crustacean allergen detection systems target the immunorecognition of the allergenic protein tropomyosin. However, this mode of detection may be affected by an origin-dependent protein composition. This study determined if the geographic location of capture, or aquaculture, influenced the allergenic protein profiles of Black Tiger Shrimp (Penaeus monodon), one of the most farmed and consumed shrimp species worldwide. Protein composition was analysed in shrimp from nine different locations in the Asia–Pacific by SDS-PAGE, immunoblotting, and mass spectrometry. Ten of the twelve known shrimp allergens were detected, but with considerable differences between locations. Sarcoplasmic calcium-binding protein, myosin light chain, and tropomyosin were the most abundant allergens in all locations. Hemocyanin-specific antibodies could identify up to six different isoforms, depending on the location of origin. Similarly, tropomyosin abundance varied by up to 13 times between locations. These findings suggest that allergen abundance may be related to shrimp origin and, thus, shrimp origin might directly impact the readout of commercial crustacean allergen detection kits, most of which target tropomyosin, and this should be considered in food safety assessments.

Key determinants for the development of an allergic response to an otherwise ‘harmless’ food protein involve different factors like the predisposition of the individual, the timing, the dose, the route of exposure, the intrinsic properties of the allergen, the food matrix (e.g. lipids) and the allergen modification by food processing. Various physicochemical parameters can have an impact on the allergenicity of animal proteins. Following our previous review on how physicochemical parameters shape plant protein allergenicity, the same analysis was proceeded here for animal allergens. We found that each parameter can have variable effects, ranging on an axis from allergenicity enhancement to resolution, depending on its nature and the allergen. While glycosylation and phosphorylation are common, both are not universal traits of animal allergens. High molecular structures can favour allergenicity, but structural loss and uncovering hidden epitopes can also have a similar impact. We discovered that there are important knowledge gaps in regard to physicochemical parameters shaping protein allergenicity both from animal and plant origin, mainly because the comparability of the data is poor. Future biomolecular studies of exhaustive, standardised design together with strong validation part in the clinical context, together with data integration model systems will be needed to unravel causal relationships between physicochemical properties and the basis of protein allergenicity.

Peanut seeds are currently widely used as source of human food ingredients in the United States of America and in European countries due to their high quality protein and oil content. This article describes the classification and molecular biology of peanut seed allergens with particular reference to their cross-reactivities. Currently, the IUIS allergen nomenclature subcommittee accepts 12 peanut allergens. Two allergens belong to the cupin and four to the prolamin superfamily, and six are distributed among profilins, Bet v 1-like proteins, oleosins, and defensins. Clinical observations frequently report an association of peanut allergy with allergies to legumes, tree nuts, seeds, fruits and pollen. Molecular cross-reactivity has been described between members of the Bet v 1-like proteins, the non-specific lipid transfer proteins, and the profilins. This review also addresses the less well-studied cross-reactivity between cupin and prolamin allergens of peanuts and of other plant food sources and the recently discovered cross-reactivity between peanut allergens of unrelated protein families.

Purpose of ReviewTo critically review the evidence in favor or against the use of house dust mite (HDM) allergen avoidance measures in patients with asthma.Recent FindingsSystematic reviews and meta-analyses suggested no positive effect of mite allergen avoidance strategies on asthma outcomes, resulting in a lack of consensus regarding the utility of these measures. However, such analyses have a number limitations and might not be the most adequate tool to evaluate current evidence and to derive clinical recommendations regarding mite allergen avoidance in asthmatic patients. We should not disproportionately rely on the results of meta-analyses and systematic reviews to inform clinical practice and asthma guidelines in this area. Recent high-quality evidence from randomized controlled trial in children confirmed that mite allergen–impermeable bed encasings reduce emergency hospital attendance with acute severe asthma exacerbations.SummaryUntil better evidence is available, we suggest that physicians should adopt a pragmatic approach to mite allergen avoidance and advise sensitized patients to implement a multifaceted set of measures to achieve as great a reduction in exposure as possible. Potential predictors of positive response (e.g., patient’s sensitization and exposure status) can pragmatically be evaluated using the size of skin test wheal or the titer of allergen-specific IgE. Finally, the intervention should be started as early as possible.

Purpose of Review This review addresses the most recent developments on cockroach allergen research in relation to allergic diseases, especially asthma. Recent Findings The number of allergens relevant to cockroach allergy has recently expanded considerably up to 12 groups. New X-ray crystal structures of allergens from groups 1, 2, and 5 revealed interesting features with implications for allergen standardization, sensitization, diagnosis, and therapy. Summary Cockroach allergy is strongly associated with asthma particularly among children and young adults living in inner-city environments, posing challenges for disease control. Environmental interventions targeted at reducing cockroach allergen exposure have provided conflicting results. Immunotherapy may be a way to modify the natural history of cockroach allergy and decrease symptoms and asthma severity among sensitized and exposed individuals. The new information on cockroach allergens is important for the assessment of allergen markers of exposure and disease, and for the design of immunotherapy trials.