Cat allergy symptoms improve with holo beta-lactoglobulin lozenges

Key takeaways:

• Patients took two lozenges a day for 3 months.
• Total eye, nasal and bronchial symptom scores all improved.
• There were no late symptoms following exposure after the intervention period.

Patients with cat allergies experienced improvements in their symptoms with twice-daily use of a holo beta-lactoglobulin lozenge for 3 months, according to a pilot study published in Clinical and Translational Allergy.

The ingredients of the lozenge mimic the allergy protective farm effect, Karl-Christian Bergmann, MD, head of real-world research at Institute of Allergology, Charité-Universitätsmedizin Berlin, and colleagues wrote.

The innate immune cells of atopic patients have micronutritional deficiencies including ferric iron complexed with siderophores, vitamins and zinc, the researchers wrote, driving regulatory cells into an inflammatory state that negatively affects Th1 cell survival and results in Th2 hypersensitivity.

Researchers developed a holo beta-lactoglobulin (holoBLG) from cows to shuttle micronutrients into atopic immune cells, igniting regulatory immune mechanisms in an allergen-nonspecific manner.

The pilot study involved 35 adults (7 men; mean age, 39.5 years; age range, 24-65 years) with cat allergy who were provoked with cat allergen in an allergen exposure chamber (AEC) for 120 minutes before and after a 3-month intervention. Only five of these participants had a cat at home.

During the intervention, participants used a holoBLG lozenge (immunoBON; Biomedical Int. R + D GmbH) that included the whey protein BLG and iron complexed with catechins from cocoa extract, vitamin A and zinc twice a day.

Median changes of intra-individual differences from baseline to final exposure included a 33% reduction (95% CI, –51% to –7%) in total eye symptom score (TESS) including itchy-watery eyes, gritty feeling and eye redness score.

Patients also experienced a 50% reduction (95% CI, –60% to 7%) in total nasal symptom score (TNSS), including runny, itchy and blocked nose and sneezing, and a 50% reduction (95% CI, –59% to –32%) in total other symptom score (TOSS), including pruritis and itchy skin and palate.

However, the researchers found no significant reductions in total bronchial symptom scores (TBSS), including breathlessness, wheezing, cough and asthma. But the median total symptom score (TSS), defined as the sum of TESS, TNSS, TOSS and TBSS, fell by 50% (95% CI, –55% to –10%).

During the pre-intervention exposure in the AEC, TSS increased at an average rate of 0.193 per minute (95% CI, 0.114-0.272). But during the post-intervention exposure, TSS increased at an average rate of 0.083 per minute (95% CI, 0.017-0.15) for a difference of –0.11 per minute (95% CI, –0.183 to –0.037).

Patients also rated their personal well-being using a VAS after their sessions in the AEC, and their median scores fell by 42% (95% CI, –51% to 19%) from their first to their second exposure, which the researchers called a significant improvement.

Further, the researchers noted that the drop in Peak Nasal Inspiratory Flow Meter (PNIF; Clement Clarke International Ltd.) scores from baseline to the end of the intervention was less pronounced.

There was a median difference of 20 L per minute (95% CI, 5-31) at 120 minutes, which the researchers called significant, and a median intra-interval improvement of 17% (95% CI, 9%-37%), also at 120 minutes.

The researchers also conducted titrated nasal provocation tests (NPTs) before and after the exposures in the AEC and found significant reductions, with a median change in NPT total symptom score at the dose resulting in a positive test of –1 (P = .0091).

The PNIF assessed during the NPT displayed significant improvements as well, the researchers continued, with a median change of 25 L per minute (P = .0004) at the dose that resulted in a positive test at baseline.

After the intervention, 12 patients had negative NPT results despite receiving the highest dose of the allergen. To achieve results, eight patients needed a higher dose, 12 patients needed the same dose and three patients needed a lower dose (P = .0203).

Additionally, the researchers called participants 24 hours after each exposure. Following the first exposure, seven patients described late-phase symptoms including slight dyspnea, dry cough and blocked nose. But after the second exposure, none of the patients reported any late-phase reactions.

Using molecular profiling, the researchers further determined that 85% of the patients with IgE-class of 2 or higher were sensitized to Fel d 1, with sporadic sensitization to Fel d 2, Fel d 4 and Fel d 7.

Based on these findings, the researchers said that targeted micronutrition with a holoBLG lozenge can safely and effectively manage feline allergic rhinoconjunctivitis and improve quality of life.