A Randomized Double-Blind Comparative Study of Sublingual Immunotherapy for Cedar Pollinosis

Okubo, Kimihiro; Gotoh, Minoru; Fujieda, Shigeharu; Okano, Mitsuhiro; Yoshida, Hirokazu; Morikawa, Hiroshi; Masuyama, Keisuke; Okamoto, Yoshitaka; Kobayashi, Makoto

doi:10.2332/allergolint.o-07-514

Cited by 87 publications

(44 citation statements)

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“…A randomized double-blind study reported that efficacy variable scores in an active treatment group were significantly lower than those in a placebo group, and the quality of life (QOL) symptom score of the active group was almost half that of the placebo group [3]. We also previously reported that active treatment significantly ameliorated symptom scores and symptom-medication scores compared with placebo in a randomized controlled trial.…”

Section: Introductionmentioning

confidence: 98%

“…Recently, two reports have described the positive clinical effects of sublingual immunotherapy (SLIT) against Japanese cedar pollinosis [3,4]. A randomized double-blind study reported that efficacy variable scores in an active treatment group were significantly lower than those in a placebo group, and the quality of life (QOL) symptom score of the active group was almost half that of the placebo group [3].…”

Section: Introductionmentioning

confidence: 99%

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The Induced Regulatory T Cell Level, Defined as the Proportion of IL-10+Foxp3+ Cells among CD25+CD4+ Leukocytes, Is a Potential Therapeutic Biomarker for Sublingual Immunotherapy: A Preliminary Report

Fujimura

Yonekura²,

Taniguchi³

et al. 2010

Int Arch Allergy Immunol

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Background:Japanese cedar (Cryptomeria japonica) pollinosis is one of the most prevalent allergies in Japan. Recently, two reports described the positive effects of sublingual immunotherapy (SLIT) against Japanese cedar pollinosis. However, the therapeutic biomarkers for SLIT are still unclear. We performed this unblinded, nonrandomized, open-label study to identify therapeutic biomarkers for SLIT against Japanese cedar pollinosis. Methods:We performed an open-label study during one pollinosis season in 2007, enrolling 19 patients from in-house volunteers suffering from Japanese cedar pollinosis. Peripheral blood was obtained from all participants before SLIT treatment as well as before and after the pollen season. The plasma levels of an immunoglobulin specific to a major allergen (Cry j 1) were determined. We analyzed the induction of regulatory T cells (iTregs), namely IL-10⁺Foxp3⁺ cells in CD25⁺CD4⁺ leukocytes, by flow cytometry. The Th2-type responses were analyzed by cytokine production from peripheral blood mononuclear cells after stimulation with Cry j 1. Clinical symptoms were estimated using a quality of life questionnaire in the middle of the pollen season. Results: The difference in numbers of iTregs between the medium-only control cell culture and cells stimulat- ed with Cry j 1 was significantly decreased in the non-SLIT group but was unchanged in the SLIT group after the pollen season. The subgroup of the SLIT group with increased iTregs showed more attenuated Th2-type cytokine profiles, and symptom scores in the subgroup with increased iTregs were significantly lower than those in the subgroup with decreased iTregs. Conclusion:The antigen-specific iTreg level is a potential therapeutic biomarker that correlates with clinical pollinosis symptoms and may be involved in the therapeutic mechanisms of SLIT.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

The Induced Regulatory T Cell Level, Defined as the Proportion of IL-10+Foxp3+ Cells among CD25+CD4+ Leukocytes, Is a Potential Therapeutic Biomarker for Sublingual Immunotherapy: A Preliminary Report

Fujimura

Yonekura²,

Taniguchi³

et al. 2010

Int Arch Allergy Immunol

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“…[1][2][3][4][5] Currently SIT may be administered as subcutaneous (SCIT) or sublingual (SLIT). SLIT appears to be associated with lower incidence of systemic reactions.…”

Section: Introductionmentioning

confidence: 99%

Sublingual Immunotherapy for Asthma: Affects T-Cells but Does not Impact Basophil Activation

Ciepiela

Zawadzka-Krajewska

Kotuła

et al. 2014

Pediatric Allergy, Immunology, and Pulmonology

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Objective: Allergen-specific immunotherapy (SIT) is the unique modifying treatment of atopic diseases. Dysregulation of T-cell apoptosis plays a crucial role in the in the development of asthma. Nevertheless, the effect of sublingual immunotherapy (SLIT) on T-cell apoptosis has not been elucidated. The aim of the study was to evaluate the influence of 1 year of SIT in atopic children on the frequency of Th1 and Th2 cells in peripheral blood, on T-cell apoptosis, and on the response of basophils to allergen challenge. Methods: Children suffering from bronchial asthma were treated with SLIT for 12 months (Staloral 300). Basophil activation was evaluated by measurement of CD203c antigen expression. Th1 and Th2 cells frequencies and their associated frequencies of apoptosis by the expression of Bcl-2 were evaluated with flow cytometry. Results: Basophil activation showed no difference in response before and after therapy. The frequency of Th1 cells increased ( p = 0.01, n = 19), whereas the frequency of Th2 cells remained stable. Additionally, a significant increase of Bcl-2 positive Th1 cells was found ( p = 0.0465, n = 19). Conclusions: We conclude that the increase in frequency of Th1 cells secondary to SLIT might be associated with increased resistance to apoptotic signals. The basophil activation is not useful in evaluation of patient desensitization.

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“…In fact, the total pollen count in Chiyoda Ward of Tokyo (the closest location to Nippon Medical School hospital) was approximately 1250/cm 2 by the Durham method. In 2005, Okubo et al [13] investigated SLIT for cedar pollen allergy using a symptom diary to determine scores for symptoms. The pollen count was high that year and the total pollen count in Chiyoda Ward was 10625/cm 2 .…”

Section: Igg4/iggmentioning

confidence: 99%

Sublingual immunotherapy for Japanese cedar pollinosis: potential biomarkers predicting therapeutic responses

Masuno¹,

Okubo²

2016

Otorhinolaryngol Head Neck Surg

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Objective: Sublingual immunotherapy (SLIT) for allergic rhinitis due to Japanese cedar ( JC) pollisosis was investigated to examine its clinical efficacy and adverse effects, as well as the changes of serum antibodies.Research design and methods: A placebo-controlled, double-blind study was performed with 12 patients in the SLIT group and 16 patients in the placebo group. Treatment was started before the JC pollen season and was continued until after the pollen season. The SLIT group received daily up-titration of a JC pollen allergen extract over 2 weeks, followed by maintenance therapy twice weekly. The placebo group received the vehicle of the allergen extract at the same dosage. Subjects kept symptom diaries during the JC pollen season.Main outcome measures: Scores were assigned for nasal symptoms (sneezing, itching, rhinorrhea, and obstruction) and the total nasal symptom score (TNSS) was calculated during the pollen season. Immunoglobulin levels were measured before and after treatment.Results: During the 90-day period from February 1 to April 30, the sneezing score, nasal itching score, rhinorrhea score, nasal congestion score, and TNSS were significantly lower in the SLIT group than the placebo group for 15, 15, 33, 22, and 37 days, respectively. Serum levels of JC allergen-specific IgG and IgE showed no significant difference between the 2 groups before treatment, but were significantly higher in the SLIT group than the placebo group after the pollen season. Although JC allergen-specific IgG4 was also higher in the SLIT group after the pollen season, there was no significant difference. The IgG4/IgG ratio showed no significant difference between the two groups either before treatment or after the pollen season. Adverse events were only Grade 1 in both groups and resolved spontaneously.Conclusions: SLIT suppressed symptoms of JC pollinosis and increased the JC-specific IgG4/IgG ratio in the first season of treatment.

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A Randomized Double-Blind Comparative Study of Sublingual Immunotherapy for Cedar Pollinosis

Abstract: SLIT was effective and safe in the treatment of cedar pollinosis.

Cited by 87 publications

References 24 publications

The Induced Regulatory T Cell Level, Defined as the Proportion of IL-10<sup>+</sup>Foxp3<sup>+</sup> Cells among CD25<sup>+</sup>CD4<sup>+</sup> Leukocytes, Is a Potential Therapeutic Biomarker for Sublingual Immunotherapy: A Preliminary Report

The Induced Regulatory T Cell Level, Defined as the Proportion of IL-10<sup>+</sup>Foxp3<sup>+</sup> Cells among CD25<sup>+</sup>CD4<sup>+</sup> Leukocytes, Is a Potential Therapeutic Biomarker for Sublingual Immunotherapy: A Preliminary Report

Sublingual Immunotherapy for Asthma: Affects T-Cells but Does not Impact Basophil Activation

Sublingual immunotherapy for Japanese cedar pollinosis: potential biomarkers predicting therapeutic responses

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