Eva Stylianou1, Thor Ueland2,3,4, Fredrik Borchsenius1, Annika E Michelsen2,3, Reidun Øvstebø5, Tom Eirik Mollnes3,4,6,7,8, Ole H Skjønsberg1,3, Pål Aukrust2,3,4,9. 1. a Department of Pulmonary Medicine , Oslo University Hospital Ullevål , Oslo ; 2. b Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet , Oslo ; 3. c Faculty of Medicine , University of Oslo , Oslo ; 4. d K.G. Jebsen Inflammatory Research Center, University of Oslo , Oslo ; 5. e Blood Cell Research Group, Section for Research, Department of Medical Biochemistry , Oslo University Hospital Ullevål , Oslo ; 6. f Department of Immunology , Oslo University Hospital Rikshospitalet, University of Oslo , Oslo ; 7. g Research Laboratory , Nordland Hospital Bodø, University of Tromsø , Tromsø ; 8. h Center of Molecular Inflammation Research, Norwegian University of Science and Technology , Trondheim ; 9. i Section of Clinical Immunology and Infectious Diseases , Oslo University Hospital, Rikshospitalet , Oslo , Norway.
Abstract
BACKGROUND:Allergen-specific immunotherapy (SIT) is considered as the most effective treatment for Immunoglobulin E (IgE)-mediated allergies. However, how specific immunotherapy attenuates allergic responses is still not clear, but could potentially involve cytokines as well as IgG4-mediated responses. Based on the role of chemokines in IgE-mediated inflammation, we examined the SIT-induced chemokine response in patients with allergic rhinitis. METHODS: We included 35 patients with allergic rhinitis; 20 patients received SIT and 15 patients were not treated withspecific immunotherapy. The patients were followed for 3 years. Blood samples were collected before SIT and 3, 5, 7 and 21 weeks and 1, 2 and 3 years after the start of therapy. Total IgE, specific IgE, IgG4 and chemokine levels were assessed. RESULTS: Our main findings were: (i) SIT was associated with an early increase in total and specific IgE during the first 7 weeks, with a subsequent decline, accompanied by a marked increase in specific IgG4 when IgE started to decline; (ii) these SIT-induced responses were accompanied by and in some degree correlated with increased plasma concentrations of the chemokines, monocyte chemoattractant protein (MCP)-1, and eotaxin; and (iii) within the SIT group, these correlations with chemokines were restricted to IgE and IgG4 against birch tree pollen. CONCLUSION: Our findings further support a role for IgG4-mediated mechanisms in the beneficial effects of SIT in patients with allergic rhinitis (AR) and that increased levels of certain chemokines also could be of importance for the effect of such therapy.
RCT Entities:
BACKGROUND: Allergen-specific immunotherapy (SIT) is considered as the most effective treatment for Immunoglobulin E (IgE)-mediated allergies. However, how specific immunotherapy attenuates allergic responses is still not clear, but could potentially involve cytokines as well as IgG4-mediated responses. Based on the role of chemokines in IgE-mediated inflammation, we examined the SIT-induced chemokine response in patients with allergic rhinitis. METHODS: We included 35 patients with allergic rhinitis; 20 patients received SIT and 15 patients were not treated with specific immunotherapy. The patients were followed for 3 years. Blood samples were collected before SIT and 3, 5, 7 and 21 weeks and 1, 2 and 3 years after the start of therapy. Total IgE, specific IgE, IgG4 and chemokine levels were assessed. RESULTS: Our main findings were: (i) SIT was associated with an early increase in total and specific IgE during the first 7 weeks, with a subsequent decline, accompanied by a marked increase in specific IgG4 when IgE started to decline; (ii) these SIT-induced responses were accompanied by and in some degree correlated with increased plasma concentrations of the chemokines, monocyte chemoattractant protein (MCP)-1, and eotaxin; and (iii) within the SIT group, these correlations with chemokines were restricted to IgE and IgG4 against birch tree pollen. CONCLUSION: Our findings further support a role for IgG4-mediated mechanisms in the beneficial effects of SIT in patients with allergic rhinitis (AR) and that increased levels of certain chemokines also could be of importance for the effect of such therapy.
Entities:
Keywords:
Cytokines; allergy; hypersensitivity; immunoglobulins; interleukins; medical immunology