Sustained Symptom Relief in Cat-Allergic Patients Following One Year of Combined Immunotherapy and Tezepelumab Treatment
Cat allergy is a prevalent IgE-mediated hypersensitivity condition that significantly impairs quality of life in affected individuals. Allergen-specific immunotherapy (AIT) is an established treatment for allergic rhinitis and asthma, yet its long-term efficacy varies. Tezepelumab, a monoclonal antibody targeting thymic stromal lymphopoietin (TSLP), has shown promise in severe asthma management by reducing type 2 inflammation. Emerging evidence suggests that combining AIT with Tezepelumab for one year may induce prolonged symptom remission even after discontinuation.
Allergic sensitization to Fel d 1, the primary cat allergen, leads to persistent respiratory symptoms, including nasal congestion, rhinorrhea, and asthma exacerbations. Standard treatment includes allergen avoidance, pharmacotherapy (antihistamines, corticosteroids, and leukotriene receptor antagonists), and subcutaneous or sublingual immunotherapy (SCIT/SLIT). However, AIT alone requires prolonged administration (3–5 years) for sustained benefits. Tezepelumab, an anti-TSLP biologic, modulates the immune cascade upstream, offering a potential synergistic effect when combined with AIT.
A recent study evaluated patients with moderate-to-severe cat allergy who underwent one year of SCIT combined with Tezepelumab. Participants received standard allergen immunotherapy protocols alongside Tezepelumab (210 mg subcutaneously every four weeks). Symptom severity, lung function (FEV1), eosinophilic inflammation, and serum IgE levels were monitored pre- and post-treatment.
After one year of combined therapy, patients discontinued both AIT and Tezepelumab. Follow-up assessments over the subsequent 12 months demonstrated sustained remission of allergic symptoms. Notably, total and allergen-specific IgE levels remained significantly reduced, while regulatory T-cell (Treg) expansion suggested lasting immunomodulation. Bronchial hyperresponsiveness and eosinophilic counts remained suppressed, indicating a durable effect on allergic inflammation.
These findings suggest that Tezepelumab enhances AIT efficacy by mitigating type 2 cytokine-driven inflammation at an earlier stage. TSLP inhibition likely facilitates long-term immune tolerance, reducing the need for prolonged AIT. The ability to achieve one-year symptom-free remission post-treatment represents a paradigm shift in allergy management, potentially shortening therapy duration while maintaining efficacy.
The implications of this approach extend to other aeroallergen sensitivities, warranting further trials to determine the generalizability of Tezepelumab-augmented immunotherapy. Future studies should assess long-term immune markers and explore potential re-sensitization risks beyond the one-year post-treatment period.
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