AUTHOR=Hervé Pierre-Louis , Dioszeghy Vincent , Matthews Katie , Bee Katharine J. , Campbell Dianne E. , Sampson Hugh A. 

TITLE=Recent advances in epicutaneous immunotherapy and potential applications in food allergy

JOURNAL=Frontiers in Allergy

VOLUME=Volume 4 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2023.1290003

DOI=10.3389/falgy.2023.1290003

ISSN=2673-6101

ABSTRACT=Given the potent immunological proper�es of the skin, epicutaneous immunotherapy (EPIT) is emerging as a promising treatment approach for the induction of immune tolerance, in particular for food allergy. Targeting the highly immunocompetent, non-vascularized epidermis allows for the application of microgram amounts of allergen while significantly reducing the risk of allergen passage into the bloodstream, thus limiting systemic allergen exposure and distribution. These characteristics makes EPIT highly suitable for the treatment of potentially life-threatening allergies such as food allergies. Multiple approaches to EPIT are currently under investigation for the treatment of food allergy, and include the use of allergen-coated microneedles, application of allergen on skin pretreated by tape-stripping, abrasion or laser-mediated microperforation, or the application of allergen on intact skin using an occlusive epicutaneous system. To date, the most clinically advanced approach to EPIT is the Viaskin TM technology pla�orm. Viaskin is an occlusive epicutaneous system (patch) containing dried native allergen extracts, without adjuvants, which relies on frequent applica�on for the progressive passage of small amounts of allergen to the epidermis through occlusion of intact skin. Numerous preclinical studies of Viaskin have demonstrated that this par�cular approach to EPIT can induce potent and long-las�ng T-regulatory cells with broad homing capabili�es, able to exert their suppressive effects in mul�ple organs and to ameliorate immune responses from different routes of allergen exposure. Clinical trials of the Viaskin patch have studied the efficacy and safety for the treatment of life-threatening allergies in younger pa�ents, at an age when allergic diseases start to occur. Moreover, this treatment approach is designed to provide a noninvasive therapy with no restric�ons on daily ac�vi�es. Taken together, the preclinical and clinical data on the use of EPIT support the con�nued inves�ga�on of this therapeu�c approach, with the goal of providing improved treatment op�ons for pa�ents with allergic disorders in the near future.