Which allergen extract for grass pollen immunotherapy? An in vitro study

Area of Science:

• Allergy and Immunology
• Immunotherapy Research
• Pollen Allergenicity

Background:

• Grass pollen allergy is a widespread global health concern.
• Specific immunotherapy (IT) is the only causal treatment for allergies.
• The optimal grass extract composition for IT remains undetermined.

Purpose of the Study:

• To investigate the IgE-binding patterns of different grass pollen extracts.
• To compare a 5-grass pollen extract with a single grass (Phleum pratense) extract.
• To evaluate optimal grass extract selection for specific immunotherapy in grass pollen-allergic patients.

Main Methods:

• Study involved IT-naïve patients with grass pollen-induced allergic rhinitis/asthma in central Italy.
• RAST-inhibition technique was employed for IgE-binding analysis.
• A 5-grass extract (Dactylis glomerata, Poa pratensis, Lolium perenne, Antoxanthum odoratum, Phleum pratense) was compared to Phleum pratense extract.

Main Results:

• The 5-grass extract exhibited significantly higher IgE-binding to Antoxanthum odoratum and Poa pratensis compared to Phleum pratense extract.
• Both extracts showed similar binding affinity for Phleum pratense.
• Similar binding was observed for the non-Pooideae grass, Cynodon dactylon, across both extract types.

Conclusions:

• A mixed-grass pollen extract appears to be the preferred option for specific immunotherapy.
• This approach is recommended for grass pollen-allergic individuals in the Mediterranean area.
• The findings support the use of multi-grass extracts for broader allergen coverage in IT.