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RecruitingNCT06876506Updated Sep 17, 2026

Identification of B Regulatory Cells by Flow Cytometry

An observational study in Pollen Allergy and Venom Allergy, sponsored by Hull University Teaching Hospitals NHS Trust. Recruiting at 1 site in United Kingdom. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-09-17.

Sponsored by Hull University Teaching Hospitals NHS Trust · Observational

From the registry’s dates

  • Started Jan 2026; still recruiting 9 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
80
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this laboratory and observational study is to develop a test to quantify B-regulatory cells in blood. This will be used to detect changes in B-regulatory cell populations in pollen and insect venom allergic patients who are receiving routine allergen immunotherapy treatment. The primary question this study aims to answer is;

1). Are changes in blood B-regulatory cells associated with successful allergen immunotherapy treatment, and therefore do these changes suggest patients have developed a suitable level of allergen tolerance and reduction in their allergic symptoms upon re-exposure to the causal allergen.

Patients will also be asked to complete quality of life questionnaire periodically throughout the study to determine if there are associations between variation in B-regulatory cell populations in blood and allergic symptoms experienced.

Read the detailed description

Allergen immunotherapy (AIT) is a disease-modifying treatment for allergic disease which promotes immune system tolerance, i.e. reduces clinical manifestations of allergy and is the only known effective treatment to prevent anaphylaxis in patients who have previously had serious reactions to insect venoms. AIT induces a variety of immune system changes to facilitate this process, one mechanism of which is the production of a population of white blood cells called B-regulatory cells (BREGs). These cells release a chemical called interleukin-10 (IL-10) which inhibits (controls) the allergic immune response. The success of AIT is difficult to establish/monitor during treatment. Often treatment success can only be established at the end of a long treatment period (typically 3 years) and currently clinicians rely on patient symptoms upon re-exposure to further allergen post-treatment. Therefore there is a requirement to identify a marker (biomarker) which can be tested for during treatment to help clinicians establish at an earlier time, if the AIT is showing success or if a change to treatment is required. This research will measure the BREG and IL-10 production in patients before and at multiple points during AIT, to establish if there is a relationship between the BREG/IL-10 concentration and the success or failure of AIT in controlling patient symptoms of allergy. The hope is that BREG measurement could be used in the future as a biomarker for AIT efficacy, and therefore provide evidence of AIT success sooner than current protocols, or establishing failure of AIT and therefore expediting a change in treatment. The latter will likely result in saving time in pursuing a treatment which is not working, but also for understanding when the treatment has already reached optimal effectiveness and can be stopped.

Overall Aim:

To develop a flow cytometry assay for the identification and quantitation of human B regulatory cells to allow evaluation of their potential role as a treatment efficacy biomarker in allergen-specific immunotherapy.

Primary Objectives:

  1. Identification of a biomarker that defines success of allergen immunotherapy
  2. Development of a novel flow cytometry assay to detect and quantify B-regulatory cells in whole blood/peripheral blood mononuclear cell (PBMC) isolate
  3. Determine the reference intervals for BREG cell quantitation in the test and control groups using conventional parametric or non-parametric measures, depending on the characteristics of the data obtained

Secondary Objectives:

  1. Evaluation of the performance of the flow cytometry methods as per usual laboratory protocol
  2. Comparison of BREG cell quantitation in the control group verses the test group, and the test group at baseline verses on AIT
  3. Comparison of BREG cell quantitation in patients receiving subcutaneous and sublingual AIT
  4. Comparison of allergen-specific blocking antibodies (allergen-specific IgG4) in the test group at baseline and in those on AIT
  5. Assess correlation of allergen-specific blocking antibody quantitation with changes in whole blood B regulatory cell concentrations
02

Conditions studied

  • Pollen Allergy
  • Venom Allergy

Keywords

  • Pollen Allergy
  • Venom Allergy
  • Allergen Immunotherapy
  • B-regulatory cells
  • dust mite allergy
03

In context

Rhinitis, Allergic, Seasonal

404 studies on the registry are indexed under Rhinitis, Allergic, Seasonal; 24 are open to participants now.

This study's planned enrollment of 80 is close to the median of 86 across 32 observational studies indexed under Rhinitis, Allergic, Seasonal.

Browse Rhinitis, Allergic, Seasonal studies →

Lead sponsor

Hull University Teaching Hospitals NHS Trust is the lead sponsor of 95 studies on the registry; 15 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Participants routinely attending the Immunology and Allergy Clinical at Hull University Teaching Hospitals Test cohort patients - selected from patients who meet eligibility criteria of the study, and who are starting routine allergen immunotherapy as part of their routine care outside of the study Allergen immunotherapy candidates to receive venom (bee/wasp), house dust mite or pollen immunotherapy only to be included in the study

Eligibility criteria

Control cohort - Participants with:

  • No clinical and laboratory findings of IgE-mediated (i.e. no clinical history of specific allergies to pollens, house dust mite or insect venoms
  • Negative serological testing for specific IgE to pollens, house dust mite and insect venoms
  • Patients aged 18 years or older

Test cohort:

  • Participants over the age of 18 years
  • Participants with physician-diagnosed IgE-mediated allergic disease to pollens, house dust mite or insect venoms

Exclusion Criteria:

  • Patients under the age of 18 years
  • Samples from patients with IgE-mediated allergic disease, treated or untreated, specific to allergens other than pollens, house dust mite and insect venom
  • Participants who are pregnant
  • Participants who cannot adequately understand verbal and / or written explanations given in English
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
80 participants (estimated)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • Control Cohort

    * Participants routinely attending the Immunology and Allergy Clinical at Hull University Teaching Hospitals * Participants over the age of 18 years * Participants with no clinical and laboratory findings of IgE-mediated hypersensitivity (i.e. no clinical history of specific allergies to pollens, house dust mite or insect venoms, negative serological testing for specific IgE to pollens, house dust mite and insect venoms)

    Diagnostic Test: Venepuncture

  • Test Cohort

    1. Participants routinely attending the Immunology and Allergy Clinical at Hull University Teaching Hospitals 2. Participants over the age of 18 years 3. Participants with physician-diagnosed IgE-mediated allergic disease to pollens, house dust mite or insect venoms 4. Participants who are eligible to commence allergen immunotherapy (AIT). AIT will comprise; * Sublingual immunotherapy (SLIT) Grazax for grass pollen allergy or Acarizax for house dust mite allergy * Subcutaneous immunotherapy (SCIT) Venom immunotherapy involving subcutaneous injections against bee or wasp venoms (as per schedule following conventional or modified rush protocols) AIT eligibility decided upon through combination of clinical assessment, multi-disciplinary team (MDT) meeting discussion and BSACI guidance.

    Diagnostic Test: Venepuncture · Drug: Allergen Specific Immunotherapy

Interventions

  • Diagnostic testVenepuncture

    Whole blood flow cytometry analysis of T-/B-lymphocyte subsets, regulatory B cells and regulatory T cells. Serological detection (immunoassay) of allergen-specific IgE and IgG4

  • DrugAllergen Specific Immunotherapy

    Test group receiving venom allergen immunotherapy as part of standard and routine care pathway (treatment commencement NOT for study purposes, cohort selected of those who are routinely commencing treatment).

  • DrugAllergen Specific Immunotherapy

    Test group receiving pollen allergen immunotherapy as part of standard and routine care pathway (treatment commencement NOT for study purposes, cohort selected of those who are routinely commencing treatment).

06

What researchers measure

Primary outcomes

  1. Utility of B regulatory cells as a biomarker of AIT treatment sucess

    To assess whether an increase in regulatory B cell concentration is a useful biomarker to indicate AIT treatment success and specific allergen de-sensitisation.

    Time frame: From enrolment to 1 year post commencing allergen-specific immunotherapy treatment

Secondary outcomes

  1. Develop a flow cytometry laboratory assay for the detection of B regulatory cells

    Development of a flow cytometry protocol that accurately detects and quantifies the regulatory B cell populations

    Time frame: From study commencement (planned May 2025) to end of study data collection (planned May 2027)

07

Study locations

1 of 1 sites recruiting
  • Hull Teaching Hospital NHS Trust
    Hull, East Yorkshire HU3 2JZ, United Kingdom
    Recruiting
08

References and documents

Publications

  • Durham SR, Shamji MH. Allergen immunotherapy: past, present and future. Nat Rev Immunol. 2023 May;23(5):317-328. doi: 10.1038/s41577-022-00786-1. Epub 2022 Oct 17. PubMed 36253555 ↗
  • Sahiner UM, Giovannini M, Escribese MM, Paoletti G, Heffler E, Alvaro Lozano M, Barber D, Canonica GW, Pfaar O. Mechanisms of Allergen Immunotherapy and Potential Biomarkers for Clinical Evaluation. J Pers Med. 2023 May 17;13(5):845. doi: 10.3390/jpm13050845. PubMed 37241015 ↗
  • Alvaro-Lozano M, Akdis CA, Akdis M, Alviani C, Angier E, Arasi S, Arzt-Gradwohl L, Barber D, Bazire R, Cavkaytar O, Comberiati P, Dramburg S, Durham SR, Eifan AO, Forchert L, Halken S, Kirtland M, Kucuksezer UC, Layhadi JA, Matricardi PM, Muraro A, Ozdemir C, Pajno GB, Pfaar O, Potapova E, Riggioni C, Roberts G, Rodriguez Del Rio P, Shamji MH, Sturm GJ, Vazquez-Ortiz M. EAACI Allergen Immunotherapy User's Guide. Pediatr Allergy Immunol. 2020 May;31 Suppl 25(Suppl 25):1-101. doi: 10.1111/pai.13189. PubMed 32436290 ↗

Individual participant data

Plan to share: No — No current plans to make IPD fully available to other researches at this time

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Jan 2026 (actual). Primary completion is estimated for May 2027, 16 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 10, 2025
First posted
Mar 14, 2025
StartActual
Jan 21, 2026
Primary completionEst.
May 31, 2027
CompletionEst.
Sep 30, 2027
Last update
Sep 17, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 17, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06876506
Lead sponsor
Hull University Teaching Hospitals NHS Trust
Collaborators
Health Education England, Wessex, University of Manchester
Responsible party
Sponsor
First posted
Mar 14, 2025
Start date
Jan 21, 2026
Primary completion
May 31, 2027 (estimated)
Completion
Sep 30, 2027 (estimated)
Last update
Sep 17, 2026

Study contacts

Kristina Emsell-Needham, BSc, MSc
Contact
Kristina.Emsell-Needham@nhs.net
+441482607813
Sujoy Khan, MD, MBBS, FRCPE
Contact
sujoy.Khan@nhs.net
Kristina Emsell-Needham, BSc, MSc
principal investigator · Hull University Teaching Hospitals NHS Trust

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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