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Immunotherapy update: mechanisms of action
1Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Allergy and Asthma Proceedings
|January 17, 2003
Summary
Allergen immunotherapy effectively reduces allergic rhinitis and asthma symptoms by altering immune responses. Key changes include increased IgG and IgA antibodies and a shift from TH2 to TH1 immune responses.
Area of Science:
- Immunology
- Allergy Research
Background:
- Allergen immunotherapy (IT) is used to treat allergic rhinitis and asthma.
- The precise immunological markers predicting clinical response to IT remain unclear.
Purpose of the Study:
- To investigate the immunological changes associated with allergen immunotherapy.
- To identify potential markers of clinical response to IT.
Main Methods:
- Analysis of clinical symptoms and immunological markers (antibodies, cytokines, cellular responses) in patients undergoing IT.
- Assessment of early and late-phase responses to allergen challenge.
- Skin biopsy analysis to evaluate cellular changes post-allergen injection.
Main Results:
- IT reduces early and late nasal, bronchial, and cutaneous allergic responses.
- Significant increases in allergen-specific IgG and IgG4 antibodies observed.
- Decreased allergen-specific IgE antibodies, reduced mast cells, eosinophils, and CD4+ T-helper 2 (TH2) lymphocytes.
- Shift in cytokine profile with reduced IL-4 and increased IL-12, promoting TH1 responses.
Conclusions:
- Allergen immunotherapy induces significant humoral and cellular immune changes.
- IT leads to a down-regulation of TH2 responses and a potential up-regulation of TH1 responses.
- These immunological shifts correlate with clinical improvements in allergic diseases.