Novel immunopharmacological drugs for the treatment Of Allergic Diseases (KEY IJP************172)

• P.irfan Khan

Abstract

ABSTRACT Allergic diseases result from IgE-mediated immune responses to foreign protein (allergens).The majority of such reactions are IgE-mediated (type I) reactions. Individuals who develop such reactions are allergic. Those predisposed on a genetic basis to synthesize IgE to environmental allergens are atopic. Most allergic reactions are precipitated when a specific allergen aggregates several IgE molecules attached to IgE receptors on the surfaces of mast cells and basophils. Chemical mediators are released which lead to the immediate signs and symptoms associated with allergic diseases including hives, asthma, and anaphylaxis. More prolonged reactions follow if significant numbers of other cells including eosinophils, macrophages, and lymphocytes are drawn into sites of mast cell activation. Therefore, allergic diseases result from a complex interplay of immune cells, foreign proteins, and tissue inflammation.Allergy diseases, including asthma, allergic rhinitis, atopic dermatitis, and food allergies, impact millions worldwide and are often resistant to conventional treatments, leading to a pressing need for novel therapeutic strategies. Advances in immunopharmacological have led to the development of new drug classes that specifically target immune pathways involved in allergic responses. KEY WORDS :Allergic rhinitis, dermatitis, allergic conjunctivitis, cromolyn sodium, Corticosteroids , leukotriene inhibitors.1. INTRODUCTION The most common manifestations of allergic diseases are IgE-mediated hypersensitivity reactions which in the last decades have become a major health Problem as already more than one quarter of the population in industrialized countries is affected And prevalence is further rising Allergen sources include a wide variety of environmental Substances such as pollen, house dust mites, animal dander, foods, drugs or insect venoms and the Disease can manifest itself e.g. as rhinitis, conjunctivitis, chronic asthma, urticaria or even life-Threatening anaphylaxis ). Long before the availability of anti-allergic drugs, Leonard Noon Demonstrated in 1911 that prophylactic inoculation with grass pollen extract was efficient in Suppressing symptoms of hay fewer . Since that time, allergen-specific immunotherapy (AIT)Remains the only available curative treatment for allergic patients. Nevertheless, in recent times, Several novel approaches aiming at enhancing therapeutic efficacy and diagnostic accuracy have Been developed. Moreover, the ongoing elucidation of immunological mechanisms of allergic Sensitization, disease progression and tolerance induction to allergens will facilitate the development Of new preventive and therapeutic strategies against allergy Although AIT is a well-established disease-modulating treatment for IgE-mediated allergic diseases, The induction of immune tolerance is involving area that is still not sufficiently understood. Allergen tolerance depends on multiple mechanisms across different immune cell and tissue Compartments. Hence, it is likely that only combinations or ratios of gene expression levels are Promising to achieve predictive value and definition of helpful biomarkers. Outstanding effective Tolerance induction can be achieved by AIT of Hymenoptera venom-allergic patients. Describe how the classification of venom-allergic patients into different disease endotypes and Phenotypes applying available biomarkers and diagnostic tolls can provide therapeutic guidance and Strengthen personalized treatment strategies and precision medicines. Allergy and hypersensitivity are chronic non communicable diseases related to environmental ex-Posure and lifestyle . Based on 2019 global burden of disease data, the prevalence of asthma And atopic dermatitis (AD) is more than 260 and 170 million cases, respectively . The World Health Organizations International Classification of Diseases 11 dedicated pioneer sections to allergic and hypersensitivity disorders in the immune system chapter . Allergy and hypersensitivity Comprise numerous disorders, including urticaria (hives), asthma, allergirhinitis (AR; hay fever),(rhino)conjunctivitis, chronic rhino sinusitis with nasal polyps (Crown), AD (eczema), drug And food allergy, and anaphylaxis, which is an acute, life-threatening medical emergency. These Disorders are an abnormal duration andor intensity of type 2 (T2) immune responses to a stimulus normally tolerated by no affected individuals. Unresolved chronic HI allergic inflammation(ALLINF) creates detrimental changes to the structure and function of the affected organs ALLINF develops in response to noninfectious, often innocuous, environmental insults and Involves a diverse array of cells . Allergen crosslinking of adjacent immunoglobulin (Ig)E molecules bound to their high-affinity receptors on sensitized mast cells (MCs) and Basophils generates downstream activation signals . After MC activation, three distinct con-Seductive phases are typically observed. The early phase occurs within seconds to minutes and is Characterized by the release of predominantly preformed mediators and newly synthesized arachidonic acid metabolites. The late phase takes place after a few hours and involves the migration And infiltration of eosinophils (Eos), macrophages, lymphocytes, and other immune cells to The site of MC activation.