New pill can beat allergies such as hay fever and thunderstorm asthma

Hayfever and allergy sufferers may soon have a handy treatment option that doesn’t require surgery or injections.

Melbourne research has found a daily tablet can induce changes in immune cell memory, reducing allergic ­reactions such as hay fever and thunderstorm asthma.

Hay fever, usually triggered by grass pollen, is a common allergic condition affecting one in five Australians.

Thunderstorm asthma can be fatal and is triggered by a combination of high levels of grass pollen and a certain type of thunderstorm.

Melbourne has been particularly susceptible to epidemic thunderstorm asthma.

In November 2016 it experienced the world’s biggest thunderstorm asthma event, which overwhelmed emergency services, produced a tenfold increase in public hospital asthma admissions and caused a number of deaths.

The Victorian Department of Health has since established an epidemic thunderstorm asthma risk forecasting ­system.

James Anderson, who used to struggle with hay fever, with his dog Archie. Picture: Tony Gough

Prescribed medication for four months pre-pollen season with a daily tablet infused with tiny doses of five grass pollens for three consecutive years was shown to provide long-term protection against allergic ­reactions including thunderstorm asthma.

The discovery by a team of Monash researchers found this treatment, known as sublingual immunotherapy, changed a patient’s immune memory cells already after four months in unexpected ways.

“Understanding these processes are key to developing new treatments and for producing ways to test whether these new treatments are working, by finding biomarkers of immunity,” said Menno van Zelm, who led the study at the Monash University Central Clinical School.

Researchers recruited 27 Victorians who were allergic to ryegrass pollen and experienced seasonal rhino conjunctivitis symptoms at least once a week.

The patients were divided into two groups – one received the tablet with micro doses of pollen that they dissolved daily under their tongues before swallowing for four months prior to the pollen season. The other received standard therapy including ­antihistamines and anti-­allergy nasal sprays.

Their study, published last week in the journal Allergy, found that most of those on the daily tablet continued to report benefits two years later.

To understand why the positive results remained for up to two years after a single course, the researchers studied immunological cells called B cells, which have the ­capacity to hold memories of immunity against foreign ­invaders such as allergens, finding that the B cells were reprogrammed and expressed new markers after four months of treatment.

“It takes patience,” Professor van Zelm said. “You need to take a daily tablet dissolved under the tongue for several months over the course of three years, so early markers of success are urgently needed to ensure the right patients ­receive the optimal treatment as quickly as possible.”

He said the team would test its effectiveness against other common allergies such as dust mite, and for food allergies for which the success rate of ­immunotherapy is lower.

The study, a collaboration of Monash University, The ­Alfred’s Allergy Clinic and the Burnett Institute, is part of ­research funded by a $1.2m National Health and Medical Research Council grant.