State-of-the-art in marketed adjuvants and formulations in Allergen Immunotherapy: a position paper of the European Academy of Allergy and Clinical Immunology (EAACI).

Since the introduction of allergen immunotherapy (AIT) over 100 years ago, focus has been on standardization of allergen extracts, with reliable molecular composition of allergens receiving the highest attention. While adjuvants play a major role in European AIT, they have been less well studied.

In this Position Paper we summarize current unmet needs of adjuvants in AIT citing current evidence. Four adjuvants are used in products marketed in Europe: aluminium hydroxide (Al(OH)3) is the most frequently used adjuvant, with microcrystalline tyrosine (MCT), monophosphoryl lipid A (MPLA) and calcium phosphate (CaP) used less frequently.

Recent studies on humans, and using mouse models, have characterized in part the mechanisms of action of adjuvants on pre-existing immune responses. AIT differs from prophylactic vaccines that provoke immunity to infectious agents, as in allergy the patient is pre-sensitized to the allergen.

The intended mode of action of adjuvants is to simultaneously enhance the immunogenicity of the allergen, while precipitating the allergen at the injection site to reduce the risk of anaphylaxis. Contrasting immune effects are seen with different adjuvants. Aluminium hydroxide initially boosts Th2 responses, while the other adjuvants utilised in AIT redirect the Th2 immune response toward Th1 immunity.

Sheep IgG-Fc ELISA Kit, 96 tests, Quantitative
7615-Fc	Alpha Diagnostics	1 kit	EUR 712

Horse IgG-Fc ELISA Kit, 96 tests, Quantitative
7715-Fc	Alpha Diagnostics	1 kit	EUR 712

Dog IgG (Fc) fragment (isotype control, non-immune), purified
20016-FC	Alpha Diagnostics	0.5 mg	EUR 250

Human IgG (Fc) fragment, purified
20007-1-FC	Alpha Diagnostics	0.5 mg	EUR 208

Mouse IgG (Fc) fragment, purified
20008-1-FC	Alpha Diagnostics	0.5 mg	EUR 250

Rabbit IgG (Fc) fragment, purified
20009-1-FC	Alpha Diagnostics	0.5 mg	EUR 250

Goat IgG (Fc) fragment, purified
20011-1-FC	Alpha Diagnostics	0.5 mg	EUR 250

Block
BSH100-02	BenchMark	1 PC	EUR 137.21
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BSH100-1232	BenchMark	1 PC	EUR 137.21
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BSH100-15	BenchMark	1 PC	EUR 137.21
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BSH100-1520	BenchMark	1 PC	EUR 137.21
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BSW15	BenchMark	1 PC	EUR 151.93
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BSW50	BenchMark	1 PC	EUR 151.93
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BSWHEM	BenchMark	1 PC	EUR 237.26
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BSWNMR	BenchMark	1 PC	EUR 481.73
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Rat IgG (Fc) fragment, purified (isotype control)
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Goat IgG (fc)-Biotin conjugate (isotype control)
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Goat IgG (fc)-HRP conjugate (isotype control)
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Dog IgG (Fc) fragment (isotype control, non-immune), purified
20016-3-FC	Alpha Diagnostics	0.5 mg	EUR 250

Dog IgG Fc-Biotin Conjugate (isotype control, non-immune), purified
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Dog IgG Fc-HRP Conjugate (isotype control, non-immune), purified
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Human IgG (Fc) fragment, purified (>95%, low endotoxin)
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Recombinant (HEK) Human IgG1 Fc (103Cys/Ser, 99-330aa, His-tag, >95%, low endotoxin)
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Recombinant (HEK) Human IgG4-Fc (108Ser/Pro, 99-327aa, His-tag, >95%, low endotoxin)
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Recombinant (HEK) Mouse IgG2a-Fc (98-330aa, ~34 kda, His-tag, >95%, low endotoxin)
20102-102-FC	Alpha Diagnostics	50 ug	EUR 286

Recombinant (HEK) Mouse IgG2b-Fc (97-335aa, ~37 kda, His-tag, >95%, low endotoxin)
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Recombinant (HEK) Mouse IgG3-Fc (97-329aa, ~33 kda, His-tag, >95%, low endotoxin)
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Recombinant Human CD47 Protein, His-Fc (IgG), Insect-10ug
QP11336-HIS-Fc-10ug	EnQuireBio	10ug	EUR 201

Block, PCR plate, For 1-block dry bath
BCM1412-BSWPCR1	Bio Basic	1 pcs, 1 UNIT	EUR 363.2
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Biotin Block Kit
B3810-002	GenDepot	30ml	EUR 219

Biotin Block Kit
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Block Wash Buffer
I044	Cygnus Technologies	1000 ml	EUR 527
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HiQTM Immuno Block
I3211-010	GenDepot	100ml	EUR 134

HiQTM Immuno Block
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Recombinant (HEK) Mouse IgG1-Fc (98-321aa, 102Cys/Ser, ~32 kda, His-tag, >95%, low endotoxin)
20102-101-FC	Alpha Diagnostics	50	EUR 286

Human IgG Fc-Biotin conjugate (isotype control, non-immune), purified
20007-1-Fc-B	Alpha Diagnostics	0.1 mg	EUR 164

Human IgG Fc-FITC conjugate (isotype control, non-immune), purified
20007-1-Fc-F	Alpha Diagnostics	0.1 mg	EUR 164

Human IgG Fc-HRP conjugate (isotype control, non-immune), purified
20007-1-Fc-HP	Alpha Diagnostics	0.1 mg	EUR 164

Human IgG (Fc) fragment-Biotin purified (>95%, low endotoxin)
20007-1-FC-LE-B	Alpha Diagnostics	25 ug	EUR 286

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WSC-2610　MyMini BLOCK
4002610	Atto	1unit	EUR 655
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LC4001	GenDepot	Ea	EUR 273

After varying lengths of time, each of the adjuvants supports tolerance. Further studies of the mechanisms of action of adjuvants may advise shorter treatment periods than the current three-to-five-year regimens, enhancing patient adherence. Improved lead compounds from the adjuvant pipeline are under development and are explored for their capacity to fill this unmet need.