Benjaponpitak S, Oro A, Maguire P, Marinkovich V, DeKruyff R H, Umetsu D T
Division of Immunology and Transplantation Biology, Department of Pediatrics, Stanford University, Stanford, Calif. 94305-5208, USA.
J Allergy Clin Immunol. 1999 Mar;103(3 Pt 1):468-75. doi: 10.1016/s0091-6749(99)70473-2.
The effect of conventional allergen immunotherapy on allergen-specific T lymphocyte cytokine production is incompletely understood, particularly during the initial phase of treatment.
The purpose of this study was to prospectively follow the kinetics of change in CD4(+) T cell cytokine secretion during the course of conventional immunotherapy.
Six allergic individuals were treated with extracts of Dermatophagoides farinae/Dermatophagoides pteronyssinus or with rye grass pollen (Lolium perenne) allergen, but not both, by using an internally controlled conventional immunotherapy protocol. CD4(+) T cells from peripheral blood were examined in vitro at varying intervals after the initiation of immunotherapy by stimulation with D farinae or L perenne group I antigen. The quantity of IL-4 and IFN-gamma produced and its relationship to clinical improvement was determined.
The ratio of allergen-specific IL-4/IFN-gamma production by CD4(+) T cells from 4 of 6 individuals receiving immunotherapy greatly increased during the period when the dose of allergen was increasing. However, after high-dose maintenance therapy was achieved, this ratio decreased in subjects responding clinically to, but not in those failing, immunotherapy. In addition, late-phase skin reactions and allergen-specific IgE levels in responding, but not in nonresponding, subjects diminished over the course of immunotherapy.
Conventional immunotherapy may initially exacerbate allergic disease by increasing allergen-specific IL-4 and allergen-specific IgE production. Later clinical improvement is associated with a reduction in allergen-specific IL-4 production and in allergen-specific serum IgE.
传统变应原免疫疗法对变应原特异性T淋巴细胞细胞因子产生的影响尚未完全明确，尤其是在治疗初期。
本研究旨在前瞻性地追踪传统免疫疗法过程中CD4(+) T细胞细胞因子分泌的变化动力学。
6名过敏个体采用内部对照的传统免疫疗法方案，接受粉尘螨/屋尘螨提取物或黑麦草花粉（多年生黑麦草）变应原治疗，但不同时接受两种治疗。免疫疗法开始后，在不同时间间隔对来自外周血的CD4(+) T细胞进行体外检测，用粉尘螨或多年生黑麦草I组抗原刺激。测定产生的白细胞介素-4（IL-4）和γ干扰素（IFN-γ）的量及其与临床改善的关系。
在接受免疫疗法的6名个体中，有4名个体的CD4(+) T细胞产生的变应原特异性IL-4/IFN-γ比值在变应原剂量增加期间大幅升高。然而，在达到高剂量维持治疗后，该比值在对免疫疗法有临床反应的受试者中下降，而在无反应的受试者中则未下降。此外，在有反应的受试者中，晚期皮肤反应和变应原特异性IgE水平在免疫疗法过程中降低，而在无反应的受试者中则未降低。
传统免疫疗法最初可能通过增加变应原特异性IL-4和变应原特异性IgE的产生而加重过敏性疾病。后期的临床改善与变应原特异性IL-4产生和变应原特异性血清IgE的降低有关。
