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Immunotherapy and allergic inflammation.

S R Durham1, V Varney, M Gaga

  • 1Department of Allergy and Clinical Immunology, National Heart & Lung Institute, London.

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
|January 1, 1991
PubMed
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Allergen injection immunotherapy significantly reduced severe hayfever symptoms and medication needs in adults. This treatment effectively decreased allergic sensitivity and altered immune cell responses in the skin.

Area of Science:

  • Immunology
  • Allergy and Clinical Immunology

Background:

  • Severe summer hayfever significantly impacts adult quality of life.
  • Current treatments often provide only symptomatic relief.

Purpose of the Study:

  • To evaluate the efficacy and safety of grass pollen allergen injection immunotherapy in adults with severe hayfever.
  • To investigate the immunological changes associated with successful immunotherapy.

Main Methods:

  • A double-blind, placebo-controlled trial using a standardized grass pollen depot preparation (Alutard SQ).
  • Assessment of clinical symptoms, medication requirements, skin and conjunctival sensitivity.
  • Skin biopsy analysis using specific immunostaining for cellular infiltrates (CD4+ T cells, EG2+ eosinophils, CD25+ cells).

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Main Results:

  • Immunotherapy was highly effective in reducing hayfever symptoms and the need for medication.
  • Clinical improvement correlated with decreased skin and conjunctival sensitivity.
  • Successful immunotherapy suppressed the late cutaneous allergic response, characterized by reduced CD4+ T cell and eosinophil infiltration.
  • A notable increase in CD25+ (interleukin-2 receptor positive) cells was observed, suggesting a potential shift in T-cell response.

Conclusions:

  • Allergen injection immunotherapy is an effective and well-tolerated treatment for severe summer hayfever in adults.
  • Immunotherapy modulates the immune response by reducing inflammatory cell infiltration in allergic reactions.
  • Findings suggest a potential shift from a TH2- to a TH1-like lymphocyte response following immunotherapy.