[Immunologic control parameters during specific immunotherapy]

In vivo-methods used for clinical follow-up control during specific immunotherapy (SIT) are associated with the risk of potentially severe reactions. As a safe diagnostic alternative, several in vitro-methods are currently available permitting the evaluation of immunomodulatory SIT effects. The basophil activation test, the lymphocyte transformation test and fluorescence immunoassays detecting allergen-specific IgG- and IgG4-antibodies have been utilized for this purpose. However, a reliable correlation of an immunological follow-up parameter with clinical efficacy of SIT has not been established. Therefore, further controlled studies are needed to evaluate the clinical usefulness of the described in vitro-techniques. In the future, a combination of different diagnostic methods defining sequential immunological modifications could lead to the identification of an in vitro profile characteristic of a successful SIT.