Immunoregulatory function of specific IgG. II. Clinical evaluation of combined active and passive immunotherapy.

Based upon previous clinical data suggesting that the potential therapeutic benefits of hyperimmune specific IgG could involve neutralization and regulatory effects, this cooperative study evaluated the efficacy and safety of combined active and passive immunotherapy in previously untreated ragweed-sensitive patients. Symptom scores and indices of patients receiving ragweed-specific globulin plus rush desensitization with ragweed extract were significantly reduced (p less than 0.05), as compared to control patients treated with albumin and active rush immunotherapy. Postseasonal RAST levels were either unchanged or decreased in 28 of 33 patients receiving hyperimmune gamma-globulin. These data were significantly different from those in albumin-treated patients (p less than 0.002). The usual anamnestic rise of ragweed-specific IgE was modified without affecting the ongoing synthesis of ragweed specific IgG. Mild constitutional symptoms were observed in patients undergoing rush immunization, but the overall procedure was relatively well tolerated and no serious or treatment-refractory constitutional problems were encountered. This clinical trial suggests that ragweed immune gamma-globulin might be a useful therapeutic adjunct when administered in close association with optimal amounts of allergen.