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Immunologic changes associated with allergen immunotherapy

S R Durham1, S J Till

  • 1Department of Upper Respiratory Medicine, Imperial College School of Medicine at National Heart & Lung Institute, London, United Kingdom.

The Journal of Allergy and Clinical Immunology
|September 2, 1998
PubMed
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Specific allergen immunotherapy effectively treats IgE-mediated allergies by reducing symptoms and inflammatory mediators. It works by shifting T-cell responses, offering insights for developing targeted allergy treatments.

Area of Science:

  • Immunology
  • Allergy Research
  • Immunotherapy

Background:

  • Specific allergen injection immunotherapy is a proven treatment for IgE-mediated allergic diseases like respiratory allergies and venom anaphylaxis.
  • Understanding the immunologic mechanisms of immunotherapy is crucial for developing more targeted and effective treatments.

Purpose of the Study:

  • To investigate the immunologic basis of allergen immunotherapy's effectiveness.
  • To explore how immunotherapy modifies T-lymphocyte responses and impacts allergic disease markers.

Main Methods:

  • Analysis of clinical outcomes, inflammatory mediators (histamine, prostaglandin D2), and cellular changes (mast cells, eosinophils) in patients undergoing immunotherapy.
  • Assessment of serum immunoglobulin levels (IgE, IgG) and T-lymphocyte subset balance (TH1/TH2 shift, IFN-gamma production) in peripheral blood and target organs.

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Main Results:

  • Immunotherapy significantly reduces immediate allergic symptoms and inflammatory mediators, decreases mast cell and eosinophil counts, and inhibits late-phase responses.
  • Serum analysis shows initial IgE increase followed by blunting of seasonal rises and a decline in allergen-specific IgE, with a rise in allergen-specific IgG.
  • A key finding is the shift in T-lymphocyte balance from TH2 towards TH1, indicated by increased IFN-gamma production, suggesting immune deviation.

Conclusions:

  • Allergen immunotherapy is effective in selected allergic patients by modulating immune responses, including a TH1-type shift.
  • Further research into mechanisms like T-cell anergy or suppressor cell amplification may refine immunotherapy strategies.
  • Novel approaches using T-cell peptides or adjuvants are being explored to enhance immunotherapy's efficacy and safety.