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Mannan-conjugated Dermatophagoides pteronyssinus + Dermatophagoides farinae allergoid vaccine (also known as MM09-HDM) is a next-generation allergen immunotherapy (AIT) developed by Inmunotek S.L. for the treatment of house dust mite-induced allergic rhinitis, rhinoconjunctivitis, and asthma. The vaccine consists of glutaraldehyde-polymerized allergoids from two house dust mite species, *Dermatophagoides pteronyssinus* and *Dermatophagoides farinae*, which are covalently linked to mannan derived from *Saccharomyces cerevisiae*. This mannan conjugation serves as a biological adjuvant that specifically targets C-type lectin receptors, particularly the mannose receptor (CD206), on dendritic cells. This targeted delivery enhances the capture and processing of the allergens, promoting a shift from a Th2-mediated allergic response toward a protective Th1 and T-regulatory (Treg) cell response. The polymerization of the allergens into allergoids reduces their IgE-binding capacity, thereby improving the safety profile by minimizing the risk of systemic allergic reactions during administration.
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