Better allergy treatment through collaboration

Our immune system protects us from pathogens, such as bacteria and viruses. Sometimes, however, the system responds to relatively harmless foreign substances such as dust mites or pollen. This may then spark an allergic reaction such as itching, nausea or difficulty breathing. These substances are called allergens, as they prompt an allergic reaction. Occasionally, allergic reactions may be fatal.

‘In the west, particularly, the number of people suffering from allergic reactions increased dramatically until the year 2010’, says extraordinary professor Joost van Neerven. ‘We see a similar trend in Asia at the moment, where the western lifestyle is being adopted, and urbanisation is on the rise. In an urban environment, people are less likely to encounter viruses and bacteria in, for example, soils. This may prevent proper regulation of the immune system and over-active responses to surrounding factors.’

Rijnstate Hospital and the Cell-Biology and Immunology Group pool their knowledge to improve diagnostics and treatment of allergies. Professor Huub Savelkoul: ‘Rijstate’s strength lies in their clinical knowledge and experience in diagnostics and the treatment of patients with allergies. There is already extensive diagnostic data available on a large number of clinically defined allergic patients. The Cell-Biology and Immunology Group has expertise in characterising new allergens in living environments, and in food in particular, and in the relationship between these allergens and their ability to prompt allergic reactions. All this knowledge will now be pooled.’

Basophil Activation Test

A significant new development in diagnostics is the BAT test for food allergies, which WUR and Rijstate are working on. During this Basophil Activation Test (BAT), a nutritional substance is added to a patient’s blood sample that contains basophils. Like mast cells, basophils are involved in the occurrence of allergic reactions.

The test then measures the activation of these basophile granulocytes when they are exposed to the allergens. Savelkoul: ‘The test is highly accurate and has far less impact n the patient than the traditional provocation test. In the traditional provocation test, the patient is given increasing amounts of a certain food component to determine what amount prompts an allergic reaction.’

Immunotherapy for (food) allergies

The researchers also study the effect of immunotherapy on patients with allergies. This therapy is already available for people with hayfever. The patient is given a small dose of the substance to which he is allergic through tablets or through injections into the skin. This will allow the immune system to become accustomed to the substance. In time, the response is reduced or even disappears entirely. Thus, the symptoms of the allergy are mitigated or disappear entirely.

Van Neerven: ‘We aim to develop new therapies based on knowledge of those small parts of the allergens that spark an allergic reaction in the patient. Therapies such as these have been proven safe for people with severe allergies. We want to know how we can implement new forms of individual immunotherapies (for example through food) in people with food allergies. There are some risks, because patients treated thus may experience side effects such as nausea or stomach pains.’

Van Neerven: ‘At present, it takes several months before we know whether immunotherapy is successful in hay fever patients. If we are able to assess the effect of immunotherapy more rapidly using improved diagnostics (the BAT test, for example), these treatments will become more attractive. Ultimately, patients will benefit from the collaboration between WUR and the Rijstate Allergy Centre, through the development of better, standardised diagnostics and treatments.’