Iron supplement lozenges reduce birch and grass pollen allergy symptoms


Disclosures: Roth-Walter reports co-inventor of EP2894478 and EP14150965.3, January 2014, U.S. Patent 14/204,570, underlying holoBLG wafer, owned by Biomedical International R+D GmbH, and receives fee lecturer from Allergy Therapeutics, Association for the Advancement of Human Allergy and Endoscopy Research (VAEM eV), Bencard Allergie GmbH and Forum for Medical Education. Please see the study for relevant financial information from all other authors.


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According to a study published in The Journal of Allergy and Clinical Immunology: In Practice.

“We discovered almost 10 years ago that the majority of allergens can affect the iron status of allergic subjects and that iron deficiency alone is not only sufficient to facilitate allergic sensitization, but is also associated with inflammation. and an exaggerated immune response.” Franziska Roth-Walter, PhD, head of the working group at the Messerli Research Institute in Vienna, Healio told.


Data are from Bartosik T, et al. J Allergy Clin Immunol Practice. 2022; doi:10.1016/j.anai.2022.04.032.

Additionally, Roth-Walter said researchers know that not everyone is prone to allergies, but people with so-called atopy have an inherent tendency to produce IgE antibodies and be hypersensitive to allergens.

Franziska Roth-Walter

“We therefore set out to investigate whether treating functional iron deficiency, or iron deficiency that affects immune cells, could improve atopy,” Roth-Walter said.

The researchers chose beta-lactoglobulin, a whey protein, to transport micronutrients directly to immune cells to prevent atopic responses due to iron deficiency.

“For beta-lactoglobulin, dietary absorption would pass through the lymphatic system and therefore precisely through immune cells,” Roth-Walter said.

Study design, results

The randomized, double-blind study involved 47 premenopausal women (mean age 31) allergic to birch or grass pollen.

In the test arm (n=25), 68% were allergic to birch and 88% were allergic to grass pollen. In the placebo arm (n=22), 77% were allergic to birch and 81% were allergic to grass pollen.

The researchers took blood and stool samples from each participant and performed nasal provocations at the start and end of the study. Additionally, the researchers had the participants consume two lozenges daily for 6 months and record their daily symptoms and medication use in a pollen diary.

The holoBLG lozenge (Biomedical International R+D GmbH) included whey concentrate, less than 1mg iron, catechins, retinoic acid, zinc and sorbitol as carrier material, with mountain herbs for flavor. The placebo lozenges did not contain any active ingredient.

Total nasal symptom scores (TNSS) did not differ between the groups at the start of the study, but participants taking the holoBLG lozenge had significantly lower scores after 6 months compared to the placebo group. The placebo group’s TNSS scores fell from a mean of 4.37 to 3.82, an average individual improvement of 12.9%, while the holoBLG group’s scores fell from a mean of 4.78 to 2.58, an average individual improvement of 42.4% (P = .0005).

Additionally, the researchers found that both groups had significantly less runny nose after 6 months, but the holoBLG group had a significantly greater reduction in runny nose (reduced nasal symptom burden, 42% vs. 13 %; P = 0.04).

Symptom burden analyzes showed that the holoBLG group experienced statistically significant mean improvements over placebo of 45% in their Combined Symptom Treatment Score (CSMS), 39% in their Daily Symptom Score (dSS ) and 41% of their Symptom Treatment Score (SMS; all, P

Throughout the grass pollen season, the holoBLG group experienced improvements of 40% in CSMS and 26% in dSS and SMS compared to the placebo group (all, P

“While all of our preclinical data was very encouraging, we were still surprised by the degree of improvement in symptoms because the improvements were completely independent of allergens,” Roth-Walter said.

At baseline, both groups had comparable levels of allergen-specific IgE and total IgE. Allergen-specific IgE increased in both groups without statistically significant differences between them over the study period, but total IgE increased only in the placebo group.

The placebo group also had significantly higher C-reactive protein values ​​and a trend toward lower absolute lymphocyte counts compared to the holoBLG group at the end of the study period, the researchers said.

Additionally, the holoBLG group had significantly improved hematocrit levels and a reduced width of red blood cell distribution. Supplementation also appears to boost cellular components of the myeloid lineage, the researchers said.

“Although the lozenge only contained a very low amount of iron, we were indeed able to measure improvement in iron parameters in white blood cells, and even some red blood cell parameters improved slightly,” Roth said. – Walter.

The researchers found no significant difference in the relative numbers of monocyte CD14s+ cells before or supplementation in either group, but the holoBLG group showed increases in intracellular labile iron content in circulating CD14+ monocytes after the study.

Overall, the researchers found that the holoBLG pellet efficiently delivered its micronutrient cargo to monocytes but not to lymphocytes. The researchers also found the lozenges tolerable with no reported adverse effects. Only two participants disliked the taste, the researchers continued, and adherence was generally high.

The implications of the study

“The most important finding is that indeed, micronutrient deficiencies are important and should be addressed because they can worsen symptom burden,” Roth-Walter said.

“The fatigue of an atopic patient may not only be due to their disease, but also to an iron deficiency. In current practice, micronutrient dietary recommendations should be included,” she continued.

Although allergen immunotherapy is considered the only causative treatment option for improving atopic diseases, Roth-Walter said, delivering micronutrients to immune cells appears to have similar efficacy and may be another causative remedy for allergies.

“The lozenge calms the immune system more generally. As such, it may be particularly useful when the specific allergen is not known or when specific allergen immunotherapy is not feasible,” Roth-Walter said. “Since it’s mostly food, it could also be taken alongside specific allergen immunotherapy.”

The researchers plan to continue their studies.

“Currently, a clinical study with people with cat allergies is being completed, and another with people with pollen allergies is planned,” Roth-Walter said. “As animals also suffer from atopic diseases, we also plan to conduct a study in canine patients with atopic dermatitis.”

Reference:

For more information:

Franziska Roth-Walter, PhD, can be contacted at [email protected]

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