Recombinant allergens for immunotherapy. Where do we stand?

Purpose of review This review is an update regarding the development of recombinant allergens from the laboratory bench to clinical applications. Special attention will be given to the potential improvement of allergen-specific immunotherapy through the use of recombinant allergens. Recent findings Currently used therapeutic allergen extracts suffer from several important disadvantages and therefore may be replaced by recombinant allergens in the near future. Recent studies indicate that recombinant allergen-based diagnostic tests can be used for selection of patients for immunotherapy and to analyse the mechanisms underlying immunotherapy. Furthermore, recombinant and peptide technologies have been used for the generation of allergy vaccines with reduced allergenic activity. Applying the new technologies, the vaccines can be formulated to target either B cells or T cells, or both cell types. Very recently, encouraging results were obtained in an immunotherapy trial performed with genetically engineered allergens. Summary Recombinant allergen-based diagnostic tests will improve the selection of patients for immunotherapy. The first immunotherapy trial with recombinant allergens provides information about mechanisms underlying immunotherapy and holds promise that new types of allergy vaccines based on recombinant allergens will become available soon.