**John Foerster \* and Aleksandra Mol ˛eda \***

Department of Molecular and Clinical Medicine, University of Dundee, Medical School, Ninewells Hospital, Jacquie Woods Centre, Ninewells Drive, Dundee DD1 9SY, UK

**\*** Correspondence: j.foerster@dundee.ac.uk (J.F.); a.moleda@dundee.ac.uk (A.M.)

Received: 6 March 2020; Accepted: 9 April 2020; Published: 13 April 2020

**Abstract:** Virus-like particle (VLP)-based anti-infective prophylactic vaccination has been established in clinical use. Although validated in proof-of-concept clinical trials in humans, no VLP-based therapeutic vaccination against self-proteins to modulate chronic disease has yet been licensed. The present review summarises recent scientific advances, identifying interleukin-13 as an excellent candidate to validate the concept of anti-cytokine vaccination. Based on numerous clinical studies, long-term elimination of IL-13 is not expected to trigger target-related serious adverse effects and is likely to be safer than combined targeting of IL-4/IL-13. Furthermore, recently published results from large-scale trials confirm that elimination of IL-13 is highly effective in atopic dermatitis, an exceedingly common condition, as well as eosinophilic esophagitis. The distinctly different mode of action of a polyclonal vaccine response is discussed in detail, suggesting that anti-IL-13 vaccination has the potential of outperforming monoclonal antibody-based approaches. Finally, recent data have identified a subset of follicular T helper cells dependent on IL-13 which selectively trigger massive IgE accumulation in response to anaphylactoid allergens. Thus, prophylactic IL-13 vaccination may have broad application in a number of allergic conditions.

**Keywords:** VLP; IL-13; interleukin-13; vaccine; Tfh cells
