2013年9月28日星期六

New treatments for cat / dog / pet allergy, vaccinations and novel medicines - examples what the future may hold

The pet-allergy dilemma is discussed in the Swedish newspaper http://www.expressen.se


http://www.expressen.se/nyheter/dilemmat/1.2324347/dilemmat-del-4-kattallergi


I am sure many Will there be any new treatments coming for reducing the burden of allergy and allergic symptoms in the future? The answer to that question is surely yes, but the weakness is that it is difficult and expensive to register new medicines, and “market reality” influence decisions within the pharmaceutical industry. Fortunately, allergic rhinitis (Hay Fever) and asthma are usually efficiently treated with inhaled and nasal medicines, such as glucocorticoids. For allergic rhinitis, the nasal glucocorticoids  are complemented with antihistamines (allergy tablets). Most patients with only allergic rhinitis are efficiently treated with these medications, but a very large proportion of patients is uncontrolled despite using combinations of the different medications currently available. I really hope that the industry invests in finding new and even more effective medications that may even be disease modifying (making severe disease milder, or maybe even curing milder disease). BUT, it will probably take at least five years before any new revolutionary medication becomes available.


A vast series of new medications are being tested for the treatment of allergic disease, and have been reported over the last few years. Here are a few “random” examples.


New types of vaccines are being tested airway allergy, including cat allergy. http://bit.ly/ie4KMl Basically, these vaccines contain cat allergen, but only the part of the allergen that will help in the vaccination process without causing side-effects.


Influencing the balance of the immune system by activating systems that otherwise defend us against pathogens such as viruses, is another way to prevent progression of allergic disease: http://bit.ly/h4G5tp . This has been tested in experimental animal models, and have resulted in a long-term attenuation of signs of allergic airway disease.


Allergic symptoms such as sneezing, itchy eyes and blocked nose are caused by the release of histamine and other chemicals that irritates the mucosa and activates the immune system. New drugs that have the capacity to totally block such immediate reactions have been tested and. These molecules have been shown to reduce symptoms induced by exposure to pollen http://bit.ly/eoarGT, and could also possibly block reactions in different allergic diseases, as they effectively block also other histamine releasing cells in the blood http://bit.ly/h2Ptoe.


In other words, science is moving forward rapidly, and hopefully the future will provide us with better medications against many allergic diseases including allergic rhinitis, asthma, food allergy and skin allergies.


FROM A PREVIOUS BLOG, about anti-IgE for treating cat-allergy, very expensive but efficient:


Investigators in the US and Canada are reporting on a study where they have exposed individuals with a history of cat-induced asthma to the allergen in a controlled room environment.


http://bit.ly/e5zH2i


Then they have allocated the patients treatments with either placebo or Omalizumab (anti-IgE, market name Xolair), which reduces the binding of IgE to mast cells. A good protective effect could be observed with the anti-IgE therapy, reducing the drop in lung function with close to 50%. Symptoms from the eyes and nose were also overall reduced with the anti-IgE therapy, which reduction in number of sneezes recorded. In a clinical setting, anti-IgE can really reduce allergic symptoms, and it is a pity that it is such a very expensive therapy, varying from USD7000-USD40000 / year (http://www.aafp.org/afp/2005/0115/p341.html). Even though the therapy is effective, it is certainly very difficult to prove cost-effectiveness unless the treated patient has severe allergic asthma with repeated exacerbations.


Blocking IgE can also be used to protect patients against side effects during allergen immunotherapy (allergen vaccination: http://bit.ly/htKUF0). With such approaches, it is possible that immunotherapy could be further enhanced, and could allow more severely allergic individuals to be treated with such approaches. It is also likely that the very allergic individuals would tolerate higher doses of immunotherapy, with possibly greater efficacy. This aspect is further discussed here http://bit.ly/gjWmQ9 .


Omalizumab is a monoclonal antibody, and is obviously expensive to produce, and has been expensive to develop as a therapy. However, if it became less costly, a vast population of allergic individuals would be likely to benefit with this treatment.


http://www.expressen.se/nyheter/dilemmat/1.2322905/dilemmat-del-3-kattallergi



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