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HYPOSENSITIZATION: PIONEERING WORK FOR ALLERGY PATIENTS

Allergies are troublesome illnesses of the immune system. EMD’s subsidiary, Allergopharma specializes in combating them. Their latest, innovative therapy is called hyposensitization.

THE IDEAL ENVIRONMENT FOR DUST MITES SHOULD BE STUFFY.

It should also be damp, warm, dark and dusty — most of all, dusty. However, the millions of dust mites being bred by scientist Frans Kniest in the basement rooms of Allergopharma in Reinbek, Germany, are not treated to any of these conditions. Kniest does not offer them a single ancient sofa or aging mattress; instead, he raises these tiny arachnids in numerous pocket-sized terrariums the size of smartphones in a lab illuminated by neon light. The inhabitants of the terrariums cannot be seen by the naked eye. Only under a microscope does their teeming social life become visible. 

Kniest’s mite breeding is not an eccentric hobby; it is the foundation of a struggle against one of the most aggravating allergies the human body can develop: dust mite allergy, which lasts all year round and bothers the patient around the clock. The human immune system reacts to allergens in the dust mite’s body and its excrement. Allergopharma collects exactly these substances and purifies them in order to be able to effectively combat this allergy later on.    

Pioneering work for allergy patients

Allergopharma in Reinbek, Germany is doing pioneering work for allergy patients.

Allergies are often played down

Allergopharma, which became a wholly owned subsidiary of Merck KGaA, Darmstadt, Germany in early 2013, specializes in diagnostics and treatments for numerous allergic diseases. The human body is inventive when it comes to developing allergies — for example, to birch pollen, grasses, cat hair, hamster hair, mildews or dust mites. According to Susanne Thum-Oltmer, Head of the Medical Science department at Allergopharma, the most sensible and effective way to live with an allergy is to teach one’s body to simply stop reacting to the allergen.

Specific immunotherapy is the research area at Allergopharma. Hyposensitization, which is also known as desensitization, aims to make the allergic patient’s immune system tolerant to the allergen that has previously led to sniffles, swollen eyes, skin rashes or even worse symptoms. "In 40 percent of the cases, it is worse than just a runny nose. Few people realize how quickly hay fever can turn into asthma," Thum-Oltmer explains. "The sooner one begins therapy, the better are the chances of a cure."

Hyposensitization stops allergies

However, she adds, many patients do not go to a doctor who can help them until many years after the allergy has begun. "Allergies are often played down. People use only nose spray and antihistamines on their own for years, and that does not help them very much," she says. As a rule, an allergy is diagnosed and a therapy is begun only six to eight years after the symptoms have started. However, in most cases several allergens have to be combated by then. 

Patients seldom continue having only a single allergy; in most cases, they are sensitized to additional allergies in following years. "This process, in which the allergy spreads through the immune system, can be stopped through hyposensitization," Thum-Oltmer says. "In the case of a single allergy, the chances of success are greater than 90 percent; in the case of multiple allergies, they are between 70 and 80 percent."

For hyposensitization treatment, allergen extracts are produced from various raw materials that are purchased from a certified raw materials specialist and carefully selected. The product spectrum of Allergopharma consists of a multitude of allergen preparations. Most of the raw materials are available in very good quality and adequate amounts, but obtaining the necessary amounts of dust mites used to be a problem. 

"At the end of the 1990s we finally arrived at the pragmatic idea of simply creating the best conditions for our research and production for ourselves," explains dust mite expert Frans Kniest.

The sooner one begins therapy, the better are the chances of a cure.

susanne thum-oltmer

Head of the Medical Science department

Allergopharma

In its basement in Reinbek, Germany, Allergopharma experts are raising dust mites to develop an innovative allergy therapy. In its basement in Reinbek, Germany, Allergopharma experts are raising dust mites to develop an innovative allergy therapy.

In its basement in Reinbek, Germany, Allergopharma experts are raising dust mites to develop an innovative allergy therapy.

A leading company for hyposensitization

Innovative solutions like this one have made Allergopharma a world-eading research-based pharmaceutical company in the field of specific immunotherapy. The research department, which employs 80 scientists, is continually working to develop new preparations, called allergoids. These hypoallergenic preparations are created via chemical processes. The higher the concentration of allergens, the more effective is the preparation. "But if we use traditional allergens, it is risky," explains Thum-Oltmer. "That is because the higher the dosage, the stronger the side effects of the therapy could be. Of course nobody wants that, so we modify the active ingredients by chemical means."

Through this procedure, the protein fibers of the allergen develop a new three-dimensional structure. Immunoglobulin E (IgE), which triggers the allergic reactions, normally docks on the outside of the folded protein. "But when you twist the entire structure, these IgE molecules can no longer find their binding sites. That enables us to give our patients high doses of allergens without the IgE reactions — that is, without increasing the undesirable side effects," she says. In this way, the immunological characteristics of the protein remain and only its allergenicity is strongly reduced. 

As a rule, the therapy with allergens and allergoids last three years, during which the patient initially receives an injection once a week, then once a month, and finally once every two months. "Even though in many cases the therapy seems successful as early as the first year, sticking with the therapy is the key factor," Thum-Oltmer warns. She points out that patients who complete the full three-year therapy have good prospects of being able to breathe freely once again outdoors in the spring and summer and lie back peacefully in bed without being plagued by allergy symptoms.    

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