Allergy Research

Prof. Dr. med. Torsten Zuberbier et. al.

Trials in immunotherapy for Allergic Rhinitis

"How to design and evaluate randomized controlled trials in immunotherapy for allergic rhinitis: an ARIA-GA(2) LEN statement"

Allergy, 2011

Summary:
The above mentioned study helps fill the gaps in our knowledge concerning the evaluation of this respected form of therapy for sufferers of allergic rhinitis. The Allergen-Specific Immunotherapy along with the more traditional method of treatment (pharmacotherapy) is an important therapy method for allergic rhinitis. Both types of therapy are regularly tested by randomised controlled trials (RCT). The results of these RCTs should, according to this study, be viewed critically. The study points to unanswered questions concerning the design of such studies, that makes clear that Allergen-Specific Immunotherapy should be tested independently of pharmacotherapy. Particular attention is paid to sublingual immunotherapy. In this specific form of immunotherapy the desensitising of the body to the allergen takes place via the oral mucus membrane through the application of drops. The study also makes critical suggestions for an improved study design for RCTs.

Prof. Dr. med. Torsten Zuberbier et. al.

New therapeutic option for patients with Atopic Dermatitis with birch pollen extract 

"Subcutaneous immunotherapy with a depigmented polymerized birch pollen extract - a new therapeutic option for patients with atopic dermatitis."

Int Arch Allergy Immunol, 2011

Summary:
The study contributes to research concerning new therapy possibilities for patients with atopic dermatitis, especially with patients who are allergic to birch tree pollen. Allergen-Specific Immunotherapy (ASI) which is also known as hypo-sensitising, is simply the immune system „getting used to“ an allergen. Normally this type of therapy is used for allergies affecting the respiratory system but could also be used as a possible therapy for allergic skin diseases. Studies have already shown that ASI with house dust mites can be successfully used with AD-patients with a house dust mite allergy. Birch tree pollen is an important natural airborne allergen which can magnify the symptoms of atopic dermatitis (AD). This study evaluates for the first time the safety and effectiveness of ASI for birch tree pollen on patients with atopic dermatitis and birch tree pollen allergy. The results of the study showed a dramatic improvement in the symptoms shown by the patients.

Prof. Dr. med. Torsten Zuberbier et. al.

Treatment of Chronic Urticaria with secondgeneration antihistamines 

"Pharmacologic rationale for the treatment of chronic urticaria with secondgeneration nonsedating antihistamines at higher-than-standard doses."

JEADV, 2011

Summary:
The study examines the therapy of chronic urticaria with second generation non-sedating antihistamines paying particular attention to the conflict between dosage, effectiveness and quality of life. Some background information may be useful: non-sedating antihistamines (which means the patient does not suffer from fatigue), are the first choice today for the treatment of chronic urticaria, mainly because the treatment is tolerated well by patients. Some patients do not display a strong enough reaction at the normal dosage of one tablet a day as recommended in international guidelines. This study examines several possible solutions whilst focusing on the balance between effectiveness, safety and factors affecting quality of life. The authors recommend an increase in dosage in the majority of cases.

Prof. Dr. med. Torsten Zuberbier et. al.

Classifikation and Diagnostics of Urticaria

"Klassifikation und Diagnostik der Urtikaria: German language version of the international S3-guideline"

Allergo Journal, 2011

Summary:
Urticaria is a common illness. The lifetime prevalence of urticaria is almost 20%. Urticaria not only has a detrimental affect on the quality of life, but also reduces effectiveness at work and at school and is therefore categorised as a serious allergic illness. This guideline concerns the definition and classification of Urticaria making reference to the considerable advancement in the research into the causes, triggering factors and pathogenic mechanisms of this illness. In addition it examines the evidence-based strategies for economic diagnostics of the different sub-forms of Urticaria. For the first time the Grading-of-Recommendations-Assessment-Development-and-Evaluation(GRADE) method has been applied as far as possible, with minor modifications, and supporting evidence has been provided. The grading is applied not only to the effectiveness of the treatment but also the quality of treatment from the point of view of the patient.

Prof. Dr. med. Torsten Zuberbier et. al.

Therapy of Urticaria

"Therapie der Urtikaria: German language version of the international S3-guideline"

Allergo Journal, 2011

Summary:
A long term urticaria has a considerable detrimental effect on the quality of life of the patient. Since the causal factors cannot be eliminated the only option is to treat the symptoms. The recommended therapy of choice is treatment with the latest generation of non-sedating H1-antihistamines. If the standard dosage is not effective enough, the dosage should be quadrupled. For patients that do not react to such a therapy a second choice of therapy together with antihistamines is recommended. The risk-benefit profile as well as the costs should be considered. Corticosteroids cannot be considered for long-term treatment due to the unavoidable and serious side-effects. This guideline, together with other guidelines for classification and diagnosis of the Urticaria was the result of a consensus reached at a podium discussion at the 3rd International Urticaria consensus meeting, „Urticaria 2008“.

Dr. med. Martin Metz et. al.

Anaphylactic Reaction

"Evidence that the endothelin A receptor can enhance IgE-dependent anaphylaxis in mice"

Journal of Allergy and Clinical Immunology, 2011

Summary:
In this study on the topic of allergic reactions, the medicinal blockage of Endothelin A receptors (ETA) was shown in mice to lead to the reduced activation of mast cells and therefore a less severe allergic inflammatory reaction. This suggests that the increased production of Endothelin-1, which often occurs in connection with bacterial infections and which causes the activation of mast cells through ETA, can cause a more severe allergic reaction. 

Dr. med. Martin Metz et. al.

Allergic reaction without evidence of an allergy

"Evidence for Non-Allergic Mast Cell Activation in Pollen-Associated Inflammation"

Journal of Investigative Dermatology, 2011

Summary:
Patients who show no sensitisation with respect to an allergen may still report seasonal allergic symptoms. In this study, certain substances, for example birch pollen, were shown in mice to trigger a direct mast cell activation independent of IgE (without the involvement of antibodies as in an allergic reaction), resulting in a “non-allergic allergy”. In periods with a high pollen count, symptoms such as itchy eyes and runny nose can occur without the presence of a diagnosable allergy.

Prof. Dr. med. Marcus Maurer and Dr. med. Markus Magerl

Risks involved in prophylaxis with androgen derivates in patients with HAE (hereditary angioedema, a rare hereditary disease)

"Long-term prophylaxis of hereditary angioedema with androgen derivates: a critical appraisal and potential alternatives."

Journal  der Deutschen Dermatologischen Gesellschaft, 2011

Summary:
Hereditary angioedema is a rare hereditary disease in which spontaneous swelling occurs, often painful and in some even life-threatening. Male hormones have been used a preventative treatment for more than 50 years. The treatment is adequately effective in most cases, but instances of swelling cannot be completely eliminated. When used over the long term, the treatment can have problematic side effects involving several organ systems. Alternative treatment methods have been available for some time, and the treatment of hereditary angioedema with male hormones should be considered carefully.

Prof. Dr. med. Marcus Maurer et. al.

Study to test the effectiveness of the medicine Omalizumab in urticaria patients

"Efficacy and safety of omalizumab in patients with chronic urticaria who exhibit IgE against thyroperoxidase"

Journal of Allergy and Clinical Immunology, 2011

Summary:
In this study it was found that the medicine Omalizumab, which is already used effectively in the treatment of asthma, led to the elimination of symptoms in 70% of patients with chronic spontaneous urticaria.
ECARF press release

Prof. Dr. med. Marcus Maurer et. al.

Frequency of psychiatric or psychosomatic illness in patients with chronic spontaneous urticaria

"High Prevalence of Mental Disorders and Emotional Distress in Patients with Chronic Spontaneous Urticaria"

Acta Derm Venereol, 2011

Summary:
This publication examines how often patients with chronic spontaneous urticaria suffer from psychiatric or psychosomatic illness and what effects these secondary illnesses have on the patient. Half of all patients with chronic spontaneous urticaria showed a psychosomatic or psychiatric illness, in particular one involving anxiety, such as phobias, depression, or somatic disturbance. Patients with such secondary illnesses show a higher level of emotional distress.

Prof. Dr. med. Marcus Maurer et. al.

Body’s innate method of eliminating allergies

"T cell killing by tolerogenic dendritic cells protects from allergy in mice"

Journal of Clinical Investigation, 2011

Summary:
This study examines the body’s innate mechanism for preventing the emergence of allergies. It was demonstrated that certain cells of the immune system, known as killer dendritic cells, are able to shut down allergy cells. The results of the study open new perspectives in the development of anti-allergy strategies.
Charité press release

Prof. Dr. med. Marcus Maurer et. al.

Urticaria

“Evaluating the Minimally Important Difference of the Urticaria Activity Score (UAS) and other measures of disease activity in patients with Chronic Idiopathic Urticaria”

„Annals of Allergy, Asthma & Immunology“, 2011

Summary:
This study makes a closer examination of the urticaria activity score (the “gold standard” in compiling infection activity in patients with chronic spontaneous urticaria). Through a complex statistical process, the “Minimal Important Difference” (MID) could be determined. The MID is the minimum amount of improvement that must occur in patients being monitored using the urticaria activity score in order for the improvement to be considered clinically significant. This number allows for the first time a clear fixation of the level of improvement in the urticaria activity score necessary for a treatment procedure to be considered useful for the patient. The study implies that any future treatment procedures will only be approved if they demonstrate an improvement in urticaria activity level in the amount of the MID or higher. 

Prof. Dr. med. Marcus Maurer et. al.

Medication for the treatment of hereditary angioedema 

"Inflammatory skin responses induced by icatibant injection are mast cell mediated and attenuated by H1-antihistamines"

Experimental Dermatology, 2011

Summary:
Research has now addressed the question of why the subcutaneous application of new medicines for the treatment of hereditary angioedema leads to infection. These skin reactions are caused by the activation of mast cells. This new information, collected by researchers at the Allergie-Centrum-Charité, makes possible the preventative use of antihistamines and an improved approach to these skin reactions.

Prof. Dr. med. Margitta Worm et.al.

"Provoking allergens and treatment of anaphylaxis in children and adolescents – data from the anaphylaxis registry of German-speaking countries"

Pediatr Allergy Immunol. 2011

Summary:
In this study, statistics on children and young people taken from the anaphylaxis registry are analysed with respect to food allergies. The analysis shows that peanuts and hazelnuts are the most common triggers of severe allergic reactions in childhood and that certain co-factors such as physical exertion can also play a role.

Prof. Dr. med. Margitta Worm et.al.

"Development and preliminary clinical evaluation of a peptide immunotherapy vaccine for cat allergy"

Journal of Allergy and Clinical Immunology, 2011

Summary:
In this placebo-controlled study, peptides (proteins) were examined with regard to tolerance and clinical effectiveness in a dose-response relationship for the first time. The results show that peptide-specific immunotherapy is well tolerated, and the first statistics on effectiveness and tolerance suggest promising results for tolerance induction. This suggests that peptide-based immunotherapy presents a promising new approach for the treatment of allergic illnesses.

Prof. Dr. med. Margitta Worm et.al.

"Targeting the vitamin D receptor inhibits the B cell-dependent allergic immune response"

Allergy 2011 

Summary:
A change in immune system response is the basis of an allergic reaction. The goal of our research work is to correct the changed immune response through unspecific substances that have a positive effect on the immune system (immunomodulators). Vitamin D was already identified several years ago as a molecule that inhibits allergic immune response. In this study, we were able to expand our invitro data and demonstrate for the first time that other molecules similar in structure to Vitamin D can also be used effectively in restricting allergic immune responses without causing side effects specific to Vitamin D such as hyperkalaemia (potassium surplus).

Prof. Dr. med. Margitta Worm et.al.

"Sustained 3-year efficacy of pre- and coseasonal 5-grass-pollen sublingual immunotherapy tablets in patients with grass pollen-induced rhinoconjunctivitis"

Journal of Allergy and Clinical Immunology 2011

Summary:
Specific immunotherapy is the only cause-oriented therapy for IgE-related illnesses (IgE = the antibody immunoglobulin E). While subcutaneous immunotherapy has been in use for several decades, sublingual treatment with pills has only recently been established as an option on the basis of evidence from recent studies. Here, it is particularly important that the clinical effects remain in place after the immunotherapy has ended, demonstrating a so-called “disease modifying effect”. In this study, it was demonstrated for the first time that with the use of pre-seasonal and co-seasonal 5-grass-pollen sublingual immunotherapy pills, an extended effect can be seen even after treatment has been completed. 

Prof. Dr. med. Karl Christian Bergmann et. al.

Skin tests for diagnostics of allergic immediate-type reactions

"Skin tests for diagnostics of allergic immediate-type reactions. Guideline of the German Society for Allergology and Clinical Immunology"

Pneumologie, 2011

Prof. Dr. med. Karl Christian Bergmann et. al.

Trials for allergic rhinitis

"How to design and evaluate randomized controlled trials in immunotherapy for allergic rhinitis: an ARIA-GA(2) LEN statement."

Allergy, 2011

Prof. Dr. med. Karl Christian Bergmann

Pneumology

"Pneumologie"

DGP-Newsletter (Deutsche Gesellschaft für Pneumologie), March 2011

Prof. Dr. med. Karl Christian Bergmann et. al.

Allergies against cattle

"Testing for cattle allergy: modified diagnostic cutoff levels improve sensitivity in symptomatic claw trimmers."

Int Arch Occup Environ Health, 2011 

Dr. med. Christina Elisabeth Zielinski et.al. 

Human immunological memory against pathogens

"Dissecting the human immunological memory against pathogens"

Immunological Reviews, March 2011

Summary:
In this overview, studies from the laboratory at the Allergie-Centrum-Charité are collected that demonstrate how results from ground level research on immunological memory can lead to the development of new vaccination strategies. In particular, innovative experimental approaches are presented in which human immune cells are analysed in a “high throughput” process in order to collect important information for the development of new vaccines.

Dr. med. Christina Elisabeth Zielinski et.al. 

"Pathogen-induced human TH17 cells produce IFN-γ or IL-10 and are regulated by IL-1βW"

Nature, April 2012