Molecular therapy versus standard treatment in allergy (Review)

The increasing knowledge concerning pathomechanism of allergy creates new perspectives for treatment. Standard methods currently applied in allergy act multidirectional, usually being crude and unselective. Moreover, such therapy does not eliminate the cause of hyperresponse reaction and often fails to restore the immunological balance. It is also noteworthy that the conventional therapy frequently affects different tissues not directly involved in allergic reaction and thus it may exert numerous side effects. The hypersensitivity was found to be related to some cytokines network abnormalities. Among cytokines, there are a few, well-recognized factors e.g., interleukin-4 (IL-4), IL-5 and IL-13, which play a pivotal role in allergy. Thus, the major goal for causal allergy treatment should be restoration of the balance in cytokine-mediated regulation of allergen-driven immunological response. It could be achieved by administration of missing cytokines, e.g., interferon-γ (IFN-γ) and/or down regulation of excessive one, e.g., IL-4, IL-13. Such a therapy, directed towards only specific, allergy-involved molecules, should not affect the other by-standing particles or reactions. Obviously, a good target for this kind of treatment could be immunoglobulin E (IgE) that is causally related to anaphylactic response. Furthermore, especially promising objectives for molecular therapy seem to be some cytokine receptors and signal transduction pathways and some adhesion molecules. The most recent therapeutical strategies attempting to restore immunological balance in allergy are presented. They include, among others, anti-cytokine antibodies, their soluble receptors, antisense oligonucleotides and small interfering RNA. Although many of these topical methods are still in the trial phase, we suppose they will become a clinical reality in the near future.