Molecular mechanisms involved in the mode of action of allergoid-mannan conjugates and anti-IgE treatments in human dendritic cells

Allergy is defined as the unexpected abnormal or exaggerated reaction to an exogenous stimulus (allergen) involving the immune system. Allergic diseases represent a major health problem of increasing prevalence with high socio-economic burden, decreasing the quality of life of many patients. Nowadays, allergen-specific immunotherapy (AIT) is the only treatment with potential long-lasting disease-modifying effects for allergic diseases, and together with biologicals such as monoclonal antibodies (mAbs), represent the most effective therapies for allergic patients when conventional medication is not enough to control the symptoms. However, they still have drawbacks in terms of efficacy, security, long duration or high cost. Therefore, there is an urgent need to develop more effective and safer treatments. Allergoid-mannan conjugates represent next-generation vaccines for AIT targeting dendritic cells (DCs) able to promote the generation of functional regulatory T (Treg) cells. On the other hand, omalizumab, an anti-IgE biological, is approved for the treatment of severe allergic asthma, for chronic spontaneous urticaria (CSU) and for chronic rhinosinusitis with nasal polyps (CRSwNP). Recently, a next-generation anti-IgE mAb (ligelizumab) with significant higher affinity for IgE than omalizumab, has been developed and it is being currently assayed in phase III random clinical trials for CSU..