New therapy offers a whisker of hope for allergic cat owners

Posted: March 24, 2014

For 17 years, Scarlett Glueck suffered for love. Her sinuses felt like they were packed with fiberglass, she had trouble breathing, her eyes watered, and rashes regularly bloomed on her skin.

The 55-year-old homemaker from Horsham never suspected that her cat, Furball, was the source of all this misery.

Not that it would have made a difference.

"I loved him," Glueck said. "He was a member of our family."

Allergists have a joke about cat owners, said Robert Anolik, an asthma and allergy specialist in Blue Bell. "When you tell patients they are allergic to their cat, half will say they'll get rid of it. The other half will lie."

Cats are the number-one cause of indoor allergies, affecting 17 percent of the population, an estimated 50 million people. Yet 33 percent of American households own at least one cat, and more than half of those cat owners bend to the feline whims of two or more.

Hope for better immunotherapy may be gently padding across the horizon.

Anolik's office is one of 119 centers testing a new cat-allergy medicine that may require as few as four inoculations - one a month - to provide the same, if not greater, relief than years of traditional treatments.

The clinical study is now in Phase 3, which means it has already been shown to be safe and well-tolerated.

The treatment, Cat-SPIRE, was developed by Circassia, a biopharmaceutical company based in England. Participants must currently be living with a cat and not have any other indoor allergies that would muddy the test results. Representatives of the company declined to comment, but U.S. Food and Drug Administration records show that the research is expected to be done in April 2016. There is no estimate yet of when the vaccine might become available to the public or how much it would cost.

Current allergy vaccines provide relief from symptoms, but use a biologically scattershot approach, said S. Michael Phillips, clinical director of allergy and immunology at the University of Pennsylvania.

"The ones currently in existence are crude extracts of the pelt or the blood of the animal," said Phillips. The new vaccines, he explained, have isolated the specific allergy-causing molecules, so that the shots promise to be more finely tuned, have fewer side effects, and require fewer doses.

The primary target is Fel d 1 glycoprotein, which cats secrete through their skin and saliva.

"The immune system is a delicate balance of reinforcing and competing components," said Phillips. "So if you expose someone to something, they can have various responses. One is allergies."

An allergic reaction is the immune system's attempt to protect the body against parasites by literally washing invaders away.

"Things run," he explained - noses, eyes, mucous membranes in the throat.

"A lot of studies have been done with Fel d antigen," Phillips said. "We don't know if it will have a more lasting effect, but at least initially, it looks safer, it is more predictable, and it works just as well."

Other doctors agree that it is too soon for allergy sufferers to plan on nuzzling kitties to their mutual hearts' content.

Preliminary data show that the new vaccine seems safe and "has potential," said Jonathan Spergel, chief of the section and codirector of the Center for Pediatric Eosinophilic Disorders at Children's Hospital of Philadelphia. "But you really need the data."

That will not be available until a few months after the clinical trials are finished in the spring of 2016, Spergel said. "It's promising, but we don't know if it works yet."

Theoretically, the older vaccines are like shooting paintballs at the allergies, while the new one tries to act more like a laser.

"But sometimes, paintballs cover the wall better," Spergel said. "It has to be the right laser beam."

If and when the vaccine becomes available, there is little doubt that patients will come clamoring.

"People are looking for anything that will allow them to keep their cats," said Anolik, who is being paid by Circassia for his participation in the study.

In 2006, a company named Allerca began marketing what it claimed was a genetically modified, nonallergenic cat, sold for $8,000 to $30,000.

There is no scientific evidence supporting the existence of such a creature, said Phillips.

Some cats, however, really are more allergy-provoking than others, he said, because, in this case, size does matter. The smaller the cat and the shorter the hair, Phillips said, the fewer allergens it carries.

What makes cats so allergenic is that the molecular culprits that cause sneezing, itching, and asthma are contained in their saliva. And because they groom themselves by licking their fur, head to paw, nose to tail, their whole body is constantly basted with allergens.

It is not unusual, Anolik added, for people who do not even own a cat to suffer from allergies. Not long ago, a mother brought in her toddler who tested positive for cat allergies. With a little detective work, they discovered that the child's day-care teacher had five cats.

"He really loved his teacher," Anolik said, "but they had to move him to another classroom."

Patients' symptoms, Anolik noted, are worse in winter, when windows and doors are closed. For those who cannot bear to part with their cats, he advises keeping them out of the bedroom and bathing them twice a week.

He acknowledges that, while bathing a cat makes it less likely to cause allergies, the undertaking can cause other, potentially serious injuries from all the clawing and hissing and snapping of teeth.

"If you start when they are kittens, though," he said, "they get used to it."

Glueck never tried bathing Furball. But she did everything else her allergist suggested, short of giving the cat away.

Ever since her sons had found the forlorn kitten wandering around their house in Cincinnati, Furball had been part of the family. Good-natured and affectionate, with a smooth, smoky gray coat and hazel eyes, the cat tolerated everything the boys subjected her to - including the time they tied a G.I. Joe parachute to her back and pushed her off a ledge. She would scamper down the stairs every morning with Glueck and keep her company while she made coffee.

After the boys left for college, and she and her husband moved to Horsham, Glueck's symptoms worsened. She became addicted to nasal sprays, she said, and finally went to the doctor for a skin test.

Within seconds, the painful truth presented itself in an itchy, red patch.

Putting the cat up for adoption was not going to happen. Not only was Furball 15 years old and being treated for cancer, "but she wasn't a cat," Glueck said. "She was part of the family."

No one was surprised, she said, when she flat-out refused to even consider the suggestion that it would be more humane to euthanize Furball.

Instead, Glueck, who loathes needles, volunteered to be a pincushion once or twice a week for two years to get the old vaccine. At each visit to her allergist, she was injected, in both arms, with a moderately effective serum.

"To be honest with you, I was scared," she said. "You can have all these bad reactions." After each shot, she had to wait 30 minutes until the doctor was sure she was OK.

The shots allowed Glueck to coexist with Furball, although she had to banish the cat from her bedroom and could no longer snuggle with her or accept her sweet, scratchy licks on the cheek.

When Furball died, Glueck stopped the allergy shots. Recently, she started up again because one of her sons has adopted a cat.

He lives in Santa Monica.

She has heard whispers about the new short-course immunotherapy.

"I would love," she said, "to be part of that study."



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