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Clustoid MM09 is a subcutaneous immunotherapy (SCIT) product developed by Inmunotek S.L. for the treatment of allergic rhinitis, rhinoconjunctivitis, and mild-to-moderate asthma triggered by house dust mite (HDM) allergens. The product utilizes allergoid technology, where allergens from *Dermatophagoides pteronyssinus* and *Dermatophagoides farinae* are chemically modified with glutaraldehyde. This modification reduces the allergens' IgE-binding capacity, thereby minimizing the risk of systemic allergic reactions during administration, while preserving their ability to stimulate T-cells and induce immune tolerance. Clustoid MM09 is formulated as a suspension adsorbed onto aluminum hydroxide, which acts as an adjuvant to promote a shift from a Th2-mediated allergic response to a Th1 and regulatory T-cell (Treg) response. This shift is characterized by the induction of regulatory cytokines like IL-10 and the production of allergen-specific IgG4 blocking antibodies, which compete with IgE for allergen binding.
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