Sublingual immunotherapy for allergic rhinitis: subjective versus objective tools to evaluate its success

Sakurai, Daiju; Yonekura, Syuji; Iinuma, Tomohisa; Sakurai, Takeshi; Morimoto, Yuki; Mita, Yukiyoshi; Arai, Toshiyasu; Suzuki, Satoshi; Okuma, Yusuke; Kaneko, Shinya; Okamoto, Yoshitaka

doi:10.4193/rhin15.223

Cited by 19 publications

(9 citation statements)

References 21 publications

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“…Furthermore, in the placebo‐controlled clinical studies of SLIT for AR induced by cedar pollen using cedar pollen extract, the seasonal increase in cedar pollen‐reactive Th2 cytokine‐producing cells was suppressed by SLIT, while the number of IL‐10‐producing Treg cells increased after SLIT . These changes were associated with the clinical efficacy of SLIT . The difference between the results of the present study and those of previous studies might be due to the difference in allergen exposure or in the dispersal periods.…”

Section: Discussioncontrasting

confidence: 59%

Identification of specifically reduced Th2 cell subsets in allergic rhinitis patients after sublingual immunotherapy

Ihara

Sakurai

Yonekura

et al. 2018

Allergy

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Section: Discussioncontrasting

confidence: 59%

Identification of specifically reduced Th2 cell subsets in allergic rhinitis patients after sublingual immunotherapy

Ihara

Sakurai

Yonekura

et al. 2018

Allergy

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“…Cedar pollenspecific IgE levels did not decrease with SLIT treatment for at least 18 months [10,12,26]. Allergen-specific immunotherapy does not improve allergic rhinitis induced by other allergens, demonstrating that SLIT does not inhibit the mast cell responses, which play important roles in allergic rhinitis, particularly in the early phase [27].…”

Section: Discussionmentioning

confidence: 90%

“…Furthermore, these studies did not determine the potential interference of IgG4 in binding cedar pollen and pollen-specific IgE [29]. We previously showed that SLIT did not eliminate Th2 cells but instead inhibited the seasonal increase in cedar pollen-specific Th2 effector cells, which normally enhance allergic inflammation at the start of the dispersal season [11,26,30]. Although SLIT inhibited this enhancement, a longer period of suppression might be required to reduce the inflammation [11].…”

Section: Discussionmentioning

confidence: 99%

The Relationship of Pollen Dispersal with Allergy Symptoms and Immunotherapy: Allergen Immunotherapy Improves Symptoms in the Late Period of Japanese Cedar Pollen Dispersal

Sakurai

Yonekura

Iinuma

et al. 2018

Int Arch Allergy Immunol

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Background: The severity of symptoms of pollen-induced allergic rhinitis is affected by the amount of scattered pollen. However, the relationships between the pollen dispersal pattern, symptom severity, and treatment efficacy are not clear. Methods: Between 2007 and 2012, we performed 4 randomized, placebo-controlled studies of sublingual immunotherapy (SLIT) on patients with Japanese cedar-induced allergic rhinitis who lived in or around Chiba, Japan. The participants were asked to avoid using rescue medicines during the cedar pollen season as much as possible and to record their nasal symptoms in allergy diaries. The amount of pollen dispersed daily was quantified using the Durham method, and the season was divided into early and late periods based on the pollen count. Results: A total of 721 patients were enrolled in the 4 studies during the 6-year study period. In the placebo group (n = 349), a correlation was observed between the amount of pollen dispersed and the severity of symptoms in the early but not late period of pollen dispersal. Treatment with SLIT (n = 372) significantly improved symptom severity in the late but not early period. Conclusion: For patients with Japanese cedar pollen-induced allergic rhinitis, the fluctuation of daily pollen dispersal had a minimal effect on the severity of symptoms during the late period. SLIT was remarkably effective in alleviating symptoms during this period but not in the early period.

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“…But it seems that not all allergen sIgG4s inhibit IgE binding to allergens, the epitope specificity and affinity of IgGs but not their isotype are decisive for their protective activity [28]. Maybe this could explain to certain extent why serum levels of allergen sIgG4s had no relationship with the clinical benefits [10,25,29]. Further, its bispecific activity makes it possible that allergen sIgG4 could oligomerize allergen molecules.…”

Section: Discussionmentioning

confidence: 99%

Relationship between serum inhibitory activity for IgE and efficacy of Artemisia pollen subcutaneous immunotherapy for allergic rhinitis: a preliminary self-controlled study

Wang

Yin

Wang

et al. 2020

Allergy Asthma Clin Immunol

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Background: Biomarkers of clinical efficacy for subcutaneous immunotherapy (SCIT) on allergic rhinitis (AR) have not been identified yet. This study aims to assess the clinical relevance of serum inhibitory activity for IgE by the method of enzyme-linked immunosorbent facilitated antigen binding (ELIFAB) during SCIT for Artemisia-sensitized AR patients. Methods: 19 AR patients were studied who had undergone Artemisia-specific SCIT for more than 8 months (19.68 months on average, ranging from 9 to 33 months). Peripheral bloods were collected before and after treatment. The serum inhibitory activity for IgE was tested by ELIFAB and the level of Artemisia-specific IgG4 (Artemisia-sIgG4) was determined by ELISA. Clinical improvement was evaluated based on the symptom scores and rescue medication use (SMS). The 2-tailed Wilcoxon signed-rank test and the Spearman rank test (two-tailed) were used to analyze data by using SPSS 20.0, with P values of less than 0.05 considered as significant. Results: The SMS decreased significantly after SCIT (before: 12.79 ± 4.250, after: 6.11 ± 3.828, P = 0.000 < 0.01), the treatment was remarkably effective for 6 patients, effective for 10 and ineffective for 3, along with a total effective rate 84.21%. The serum inhibitory activity for IgE increased significantly after SCIT (P < 0.05) and was correlated with the levels of Artemisia-sIgG4 (r = − 0.501, P = 0.002 < 0.01). The levels of Artemisia-sIgG4 elevated dramatically after treatment (P < 0.01) and were related with the duration of treatment (r = 0.558, P = 0.000 < 0.01). But there was no relationship between clinical improvements and the serum inhibitory activity for IgE. Conclusions: The serum inhibitory activity for IgE increased significantly after SCIT, however, there was no correlation between it and clinical improvements by statistics analysis. So whether the serum inhibitory activity for IgE can act as biomarker of efficacy for SCIT or not needs to be studied further.

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Sublingual immunotherapy for allergic rhinitis: subjective versus objective tools to evaluate its success

Abstract: Changes in levels of allergen-specific Th2 cytokine-producing cells and IL-10+Foxp3+ cells could be objective biomarkers for SLIT.

Cited by 19 publications

References 21 publications

Identification of specifically reduced Th2 cell subsets in allergic rhinitis patients after sublingual immunotherapy

Identification of specifically reduced Th2 cell subsets in allergic rhinitis patients after sublingual immunotherapy

The Relationship of Pollen Dispersal with Allergy Symptoms and Immunotherapy: Allergen Immunotherapy Improves Symptoms in the Late Period of Japanese Cedar Pollen Dispersal

Relationship between serum inhibitory activity for IgE and efficacy of Artemisia pollen subcutaneous immunotherapy for allergic rhinitis: a preliminary self-controlled study

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