The Department of Infection and Immunity of the Luxembourg Institute of Health (LIH), in collaboration with national partners, is launching a new research project to better assess the future success of allergy immunotherapy (or desensitisation) so that treatment can be tailored to the profile of each patient, representing a major advance in the field of personalised medicine. They are still looking for volunteers for the study. 

Allergic responses continue to grow in Luxembourg, with an increasing number of people reporting allergies.

To counter these exaggerated pathological reactions of the immune system, a treatment called immunotherapy is used in order to "desensitise" patients. This is particularly the case for allergies to pollen and insect bites. 

Immunotherapy makes the immune system of tolerant patients to agents that cause allergies, allergens. However, the effectiveness of this treatment varies greatly from one patient to another and can not be predicted in advance by the attending physician.

The SYS-T-Act project funded by the Personalised Medicine Consortium and initiated by the LIH's Department of Infection and Immunity, in collaboration with the IBBL (Integrated BioBank of Luxembourg), the Immunology-Allergology Service The Centre Hospitalier de Luxembourg (CHL) and the Luxembourg Centre for Systems Biomedicine (LCSB) at the University of Luxembourg, aims to better predict the response of our immune system to immunotherapy against allergies.

In the allergist's office, immunotherapy consists of an increasing administration of allergens, that is, molecules against which the patient has an allergy. To desensitise the body, the dose administered is gradually increased until the dose called maintenance dose is reached, allowing long-term tolerance to the allergen.

The project involves researchers studying the activation of a population of immune cells involved in allergic disorders: T lymphocytes. Advanced methods will allow for the analysis and comparison of blood samples from patients allergic to pollen and Venom of insect before and during immunotherapy.

"We want to identify biological markers in the blood of patients that would predict the response of the immune system to anti-allergic treatment even before it starts. Our project could have a significant impact on clinical practice. With a simple blood test, physicians could then specifically tailor the type, dosage and duration of treatment for each patient,” explained project coordinator Prof. Markus Ollert, himself an expert in dermatology and allergology, and director of Department of Infection and Immunity.

After a preparatory phase to define the experimental protocols and to obtain the agreement of the national authorities in charge of verifying compliance with the rules of ethics and confidentiality of the data, physicians of the CHL's Immunology-Allergology department began to include The first voluntary patients in the SYS-T-Act project.

The first is to recruit fifteen patients with a pollen allergy and fifteen others with an allergy to bee or wasp venom for which immunotherapy is expected. Blood samples will be taken at different times, before and during immunotherapy.

To date, about ten patients have yet to be recruited for the study.

Subsequently, a broader follow-up project aims to include more than 100 patients to achieve more representative results. The study will also be extended to allergy to peanuts and nuts.

Within the project, the LIH will bring its expertise in immunology and computational biology.

The CHL's Immunology-Allergology department regularly treats patients allergic to pollen and bee and wasp venom by immunotherapy. This service is therefore the ideal clinical partner for the collection of samples in this project.

"We take care of patients referred for severe allergic reaction after bee sting or wasp stings, seasonal asthma and / or rhinoconjunctivitis, commonly known as hay fever, and resistant to the usual treatment," explained Dr. Martine Morisset, specialist in allergology and principal clinical investigator of SYS-T-Act at CHL. 

"The entire team hopes that the study will help to identify early markers of response to treatment, The duration of desensitisation which is three to five years for pollen and at least five years for venoms.” 

IBBL, biobank specialising in the preparation and conservation of biological samples, also has an important role in the project. In close collaboration with the clinicians, the biobank organises the collection of blood and stool samples voluntarily donated by the patients participating in the project. After transporting the samples to the biobank, laboratory technicians isolate various components of the samples, including immune cells and DNA. Then, they prepare the samples for their final use by the researchers, doing a first part of the analyses and ensuring their long - term preservation. 

"As a biobank, we establish a bridge between science and medicine, One side with the clinicians and the other with the researchers,” said Dr. Fay Betsou, Chief Scientific Officer of IBBL. 

"It is this collaborative aspect that gives such a project a real chance to have a direct impact on the care of patients.” The LCSB will leverage its expertise in systems biology and systematically analyse the role of immune cells involved in the allergic reaction. The analysis will include not only T lymphocytes but also other types of immune cells (B lymphocytes, mast cells etc.) in order to define the systematism of their interaction in the process. 

"This is an innovative project that will allow us, in the long term, to offer personalised treatments to patients suffering from different allergies. The participants will allow us to develop improved treatment regimens for all in the very near future,” said Dr. Sebastian Bode, LIH clinician-researcher, paediatric specialist and responsible for the practical realisation of the study. 

Funding by the Personalised Medicine Consortium The SYS-T-Act project is funded by a Pump Prime Fund of the Personalised Medicine Consortium (PMC). This consortium, composed of national institutions active in the field of biomedical research (LCSB, LIH, IBBL and LNS) aims to build new synergies between clinicians and researchers in Luxembourg and to initiate innovative projects. It exclusively promotes translational research projects, that is, the results generated in the laboratory can be directly applied in a clinical setting for the benefit of patients. In addition, the project is funded by a long-term fellowship for Dr. Sebastian Bode from the European Academy of Allergy and Clinical Immunology EACCI.