Abstract
INTRODUCTION: Polymerized allergen extracts are widely used in allergen immunotherapy (AIT) to reduce allergenicity and enhance safety. However, the impact of cross-linking stoichiometry on the structural and allergenic properties of these polymers remains insufficiently characterized. This study systematically investigates how varying glutaraldehyde-to-protein ratios influence the resulting polymers and their potential relevance for AIT. METHODS: Pollen extracts from Phleum pratense and Betula verrucosa were polymerized using five different glutaraldehyde-to-protein ratios. The resulting polymers were structurally characterized using SDS-PAGE, nuclear magnetic resonance (NMR), transmission electron microscopy (TEM), and mass spectrometry (MS). Allergenicity was evaluated by measuring the immunoglobulin E (IgE) reactivity through enzyme-linked immunosorbent assay (ELISA), Western blotting, and mast cell activation test (MAT). Immunogenicity was assessed by analyzing the serum-specific IgG and ex vivo lymphocyte responses in mice immunized with the least allergenic polymer formulation. RESULTS: All cross-linking conditions produced polymers with distinct differences in size, morphology, and yield. Despite retaining similar peptide profiles to native allergens, as confirmed by MS, the polymers exhibited increased stability, as shown by NMR, and significantly reduced allergenicity, according to ELISA and MAT. Notably, increased polymer size and density, as determined by NMR and TEM, correlated with lower allergenicity. The most extensively cross-linked high-density polymers, optimized for minimal allergenicity, elicited immunogenic responses comparable to those induced by native extracts when tested against unmodified allergens. CONCLUSION: Cross-linking stoichiometry critically shapes the structural and immunological properties of polymerized allergen extracts. Adjusting the glutaraldehyde-to-protein ratio to produce highly polymerized, dense polymers enables a well-balanced profile of safety and efficacy for use in AIT.