When daily pills aren’t enough, can advanced medicines play a role in allergy management?
Maryam Mahdi | | Interview
Small molecule drugs are the old faithful solution to the treatment of allergies – and they tend to work well for mild and moderate symptoms. But for those suffering from chronic and severe allergic diseases – a small but growing percentage of patients – they are not enough.
The dearth of appropriate treatment options led a small group of scientists to spin out of SmithKline Beecham in 1999 to launch Allergy Therapeutics. The aim? To explore how adjuvant therapies could be used to alleviate the often debilitating symptoms experienced by patients.
The Medicine Maker spoke to the company’s Chief Executive Officer, Manuel Llobet, about the extent of the allergy crisis – and how he and his colleagues are working to put an end to the suffering of millions of patients worldwide.
Why are allergies on the rise?
The way we interact with the world around us has drastically changed in the last fifty years. From the ways we eat to our modes of transportation (and the frequency of their use), our lives, both in developed and developing countries, would hardly be recognizable to our ancestors from previous generations. As a result of our societal and economic evolution, we have been offered huge benefits – but we have simultaneously been dealt a hand of drawbacks.
In the healthcare space, one significant ramification of our modern lifestyle is the rising allergy burden worldwide. Our choices have had an impact on our immune systems; from an early age, children are exposed to fewer microbes than their counterparts from years gone by, and decreased exposure negatively impacts their immune response to foreign substances.
In fact, between 40–50 percent of school-aged children worldwide are sensitized to one or more allergens – underscoring the prevalence of the issue. The problem is also worsening, and the rapidly growing number of allergy cases is now considered a global health concern by the CDC.
Why aren’t conventional allergy treatments enough?
Though antihistamines and other traditional anti-allergies medicines can be used to treat most symptoms, people living with severe allergies still struggle to manage their illnesses. Besides, even patients living with manageable symptoms are affected by the daily burden of medicine administration. For the most part, and to date, convenience hasn’t been at the forefront of treatment regimens for this large and growing patient group.
But to thoroughly address allergies, we must take a closer look at their causes rather than their symptoms. At the heart of the issue is the fact that allergies are immunological conditions. The immune system reacts abnormally to something that would otherwise be considered normal (an allergen) – degranulating a mast cell response and liberating histamine. This mechanism has the potential to trigger a cascade response that could be fatal.
If we train the immune system to correctly modulate the response, then we can avoid this and improve patients’ quality of life. There is an obvious area of need that must be addressed, and immunotherapies are emerging as promising solutions to the problem for the corrective capabilities.
How can immunotherapies be used to deal with the problem?
Immunotherapies work on a similar principle to vaccination. They can be used to desensitize the immune system to allergens – preventing the most serious allergic symptoms from occurring. Increasing doses of allergens can be introduced to the immune system through subcutaneous or sublingual administration – reprogramming it to better manage foreign substances. This approach to allergy management is arguably most appropriate for patients with severe and chronic allergies.