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**Autovaccine Symbiopharm** is a patient-specific autologous bacterial immunotherapy developed and manufactured by SymbioPharm for allergic disease, including house dust mite-associated asthma. Each preparation is made from nonpathogenic *Escherichia coli* isolated from the individual patient's intestinal microbiota and processed into an inactivated bacterial preparation for parenteral administration. The proposed mechanism is broad innate and adaptive immune stimulation with induction of a T-helper 1-skewed immune response, intended to counterbalance the T-helper 2-predominant allergic phenotype. In a small prospective open study in intermittent or mild persistent house dust mite asthma, subcutaneous dose-escalation treatment over nine months was associated with reduced allergen-challenge-related exhaled nitric oxide responses and mainly mild local injection-site reactions; efficacy requires confirmation in adequately powered controlled studies.
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