Comparison of the <i>in‐vivo</i> and <i>in‐vitro</i> response to ragweed immunotherapy in children and adults with ragweed‐induced rhinitis

Hedlin, Gunilla; Silber, Glenn; Naclerio, Robert M.; Lamas, Ana; Eggleston, Peyton A.; Adkinson, N. Franklin

doi:10.1111/j.1365-2222.1990.tb03141.x

Cited by 33 publications

(17 citation statements)

References 26 publications

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“…This increase in specific IgE antibodies did however not reflect the clinical improve ment during 6 months of RIT. In agreement with other au thors [25,26], a significant clinical benefit was observed even after 3 months of immunotherapy; early changes in specific IgE concentration do not appear to be the principal mechanism of immunotherapy.…”

Section: Discussionsupporting

confidence: 91%

“…However, several possibilities have been proposed, which include altered regulation of IgE synthesis [23], production of blocking antibodies [9], and decreased reactivity of ef fector mechanisms [24], Our finding of a transient increment in specific IgE anti bodies during specific immunotherapy is in accord with the majority o f other studies [7,10,25]. This increase in specific IgE antibodies did however not reflect the clinical improve ment during 6 months of RIT.…”

Section: Discussionsupporting

confidence: 85%

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Decrease in CD23+ B Lymphocytes and Clinical Outcome in Asthmatic Patients Receiving Specific Rush Immunotherapy

Kljaić-Turkalj¹,

Čvoriščec²,

Tudorić³

et al. 1996

Int Arch Allergy Immunol

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Rush immunotherapy (RIT) has been documented as useful in the treatment of patients with allergic bronchial asthma. To investigate the mechanisms of its action, we studied changes in the serum levels of total IgE, allergen-specific IgE and IgG4, and expression of CD23 on peripheral blood B cells in patients receiving RIT. Twenty patients with perennial bronchial asthma were evaluated before the beginning of RIT, as well as 6 weeks and 6 months later. Compared to pre-treatment values, the level of Der-p-specific IgG4 and IgE significantly increased after 6 weeks and 6 months of RIT, while the total serum IgE remained unchanged. Furthermore, after 6 months of RIT, the percentage of CD23+ B cells and its CD23 receptor density significantly decreased. Since the symptom score improved and the need for medication decreased, we evaluated RIT as a useful procedure. After 6 months, 30% of patients did not have an asthma attack, with no medication in the last month, while 10% of them were asthma free for the last 3 months. No significant correlation between the clinical improvement, and in vitro changes was found. Furthermore, the observed in vitro changes were not significantly different in patients who responded with clinical improvement, compared to those with unchanged intensity of asthma. In conclusion, during specific RIT we found a significant increase in Der-p-specific IgE and IgG4 antibodies, as well as a moderate decrease in CD23+ B cells and its CD23 receptor density. These findings suggest a change in the lymphokine profile of patients receiving specific immunotherapy, and that the inhibition of IL-4-induced B cell stimulation may be hypothesized as the most important mechanism.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

Decrease in CD23+ B Lymphocytes and Clinical Outcome in Asthmatic Patients Receiving Specific Rush Immunotherapy

Kljaić-Turkalj¹,

Čvoriščec²,

Tudorić³

et al. 1996

Int Arch Allergy Immunol

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“…Specific immunotherapy (IT) administered by the subcutaneous route has been shown to be effective in the treatment of respiratory allergic disorders [1, 2, 3, 4]. However, subcutaneous IT has been associated with a certain risk of severe or even fatal systemic reactions [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Impact of Sublingual Immunotherapy on Specific Antibody Levels in Asthmatic Children Allergic to House Dust Mites

Bahceciler

Arıkan²,

Taylor³

et al. 2005

Int Arch Allergy Immunol

125

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Objective: To evaluate the clinical outcome and changes in allergen-specific antibodies during sublingual immunotherapy (SLIT) in house dust mite (HDM)-allergic asthma patients and to compare levels of allergen-specific antibodies in HDM-allergic patients before and after treatment with that of healthy controls. Method: Thirty-one asthma patients allergic to HDM were studied. Patients in groups I (n = 17) and II (n = 14) received SLIT with a standardized Dermatophagoides pteronyssinus plus Dermatophagoides farinae 50/50 extract for 6 and 12 months, respectively. A group of healthy children (n = 8) were enrolled as controls. Patients in both groups were evaluated at the start and at the end of treatment according to daily symptom and medication scores, lung function and skin prick tests, PC₂₀, blood eosinophil count, and Der-p-1-specific IgE, IgA, IgG1 and IgG4 levels. Results: Drug consumption decreased significantly in both groups. Furthermore, PC₂₀ and forced expiratory flow between 25 and 75% of vital capacity of patients in group II improved significantly. Although specific IgA, IgG1 and IgG4 levels did not change throughout the treatment period, total eosinophil count and specific IgE decreased significantly in both groups. According to baseline measurements, specific IgA levels of patients in groups I and II were significantly lower than that of controls. This difference disappeared at the end of the treatment period in both groups. Conclusion: SLIT seems to be effective in ameliorating clinical symptoms, drug consumption and bronchial hyperreactivity, and results in downregulation of Der-p-1-specific IgE production. Furthermore, at the end of SLIT, specific IgA levels, which were decreased compared to healthy controls initially, did no longer differ between patients and controls.

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“…While Creticos et al (13) found no significant correlations between the effect of immunotherapy on nasal mediator release and specific IgG response, Hedlin et al (1) found a correlation between the decline in TAMEesterase activity and the increase in ragweed IgG and ragweed IgG4 in children. In our study, we could show a significant correlation between the hyposensitization-determined decrease of the TAMEesterase activity and bradykinin concentration and the increase of the specific IgG (P<0.01 and P < 0.05, respectively).…”

Section: -Ementioning

confidence: 97%

“…A direct correlation has not yet been clearly demonstrated between the clinical effectiveness of immunotherapy and IgG antibody production poor reproducibility) part of both the physician and the patient (1)(2)(3). Zn vivo measurement of mediator release in the nasal secretion of allergic patients after nasal allergen challenge now permits an objective evaluation of hyposensitization independently of the subjective parameters mentioned.…”

mentioning

confidence: 99%

Mediator release is altered in immunotherapy‐treated patients: a 4‐ear study

Dokic

Nethe

Kleine‐Tebbe

et al. 1996

Allergy

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In recent years, it has been possible to demonstrate mediator release into the nasal secretion after nasal allergen challenge in patients with allergic rhinitis. Using the nasal provocation model, we determined whether the mediator release was altered in immunotherapy-treated patients. Seventeen grass-pollen-allergic patients were examined under controlled, reproducible conditions. Serial challenges with increasing doses of grass pollen produced increasing numbers of clinical symptoms and release of mediators such as kinins, TAME-esterase activity, and histamine. Ten patients received a semidepot perennial grass-pollen extract for 4 years. Seven patients served as controls and did not receive immunotherapy during the observation period. Data from the group of patients receiving immunotherapy over the first year already showed a partially significant decline in the maximal mediator release after nasal allergen challenges compared to the results of pretreated challenges, whereas controls did not show any significant changes. Nasal allergen challenges after termination of 4 years' immunotherapy significantly modified the mediator release compared to pretreatment values (TAME-esterase activity P < 0.05, kinins P < 0.01, and histamine P < 0.01).Decrease of mediator release paralleled the symptom-medication scores and quantitative skin prick test. Finally, we could demonstrate a significant correlation between specific IgG increase and mediator decrease in the treated group.Immunotherapy in patients with pollen allergy has been evaluated by the following criteria: 1) clinical parameters (symptom/medication scores) 2) rhinomanometry (difficult to assess because of 3) direct inquiry, which is highly subjective on the 4) the quantitative skin prick test (QST).Better reproducibility of results was achieved with immunoglobulin measurements (specific IgG and specific IgE), although a statistically significant relation has so far been detectable only between the applied cumulative dose during immunotherapy and the production of IgG antibodies. A direct correlation has not yet been clearly demonstrated between the clinical effectiveness of immunotherapy and IgG antibody production poor reproducibility) part of both the physician and the patient

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Comparison of the in‐vivo and in‐vitro response to ragweed immunotherapy in children and adults with ragweed‐induced rhinitis

Cited by 33 publications

References 26 publications

Decrease in CD23+ B Lymphocytes and Clinical Outcome in Asthmatic Patients Receiving Specific Rush Immunotherapy

Decrease in CD23+ B Lymphocytes and Clinical Outcome in Asthmatic Patients Receiving Specific Rush Immunotherapy

Impact of Sublingual Immunotherapy on Specific Antibody Levels in Asthmatic Children Allergic to House Dust Mites

Mediator release is altered in immunotherapy‐treated patients: a 4‐ear study

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