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Kinetics and dynamic evaluation of specific immunotherapy.

C Pereira1, F Botelho, B Tavares

  • 1Immunoallergology Department, Coimbra University Hospital, Pneumology Center, Coimbra University, Portugal.

European Annals of Allergy and Clinical Immunology
|January 25, 2005
PubMed
Summary

Specific immunotherapy (SIT) involves injecting radiolabeled white blood cells to track immune responses. This study reveals prompt inflammatory involvement of the immune system during SIT, with variations based on allergen type and administration route.

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Area of Science:

  • Immunology
  • Nuclear Medicine
  • Allergology

Background:

  • Specific immunotherapy (SIT) is a common treatment for allergic diseases, but its precise mechanisms remain incompletely understood.
  • Investigating the in vivo kinetics of SIT is crucial for elucidating its clinical efficacy.

Purpose of the Study:

  • To investigate the in vivo kinetics of specific immunotherapy (SIT) using a nuclear medicine approach.
  • To understand the immune system's inflammatory involvement during SIT in patients with allergic diseases.

Main Methods:

  • 13 allergic patients received various SIT schedules (subcutaneous aqueous, depot, modified allergens; sublingual extract).
  • Autologous leukocytes labeled with 99mTc-HMPAO were injected intravenously, followed by dynamic and static scintigraphic imaging.

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  • Local erythema and lymphatic drainage patterns were monitored.

    • Main Results:

    • Subcutaneous SIT (except modified allergens) showed time-dependent inflammatory activity at the injection site, persisting even after visible reactions subsided.
    • Ascendant lymphatic drainage to axillary and mediastinal regions was observed.
    • Sublingual SIT did not induce axillary or intestinal inflammatory focalizations.

    Conclusions:

    • Subcutaneous SIT, particularly with aqueous and depot extracts, elicits a prompt and sustained inflammatory immune response.
    • The route of administration and type of allergenic extract significantly influence the observed inflammatory patterns.
    • These findings highlight an unexpected, early inflammatory involvement of the immune system in SIT.