Shim J-Y, Kim B-S, Cho S-H, Min K-U, Hong S-J
Department of Pediatrics, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Exp Allergy. 2003 Jan;33(1):52-7. doi: 10.1046/j.1365-2222.2003.01567.x.
Allergen-specific immunotherapy has proven to be clinically effective in the treatment of patients with atopic asthma; however, the mechanisms are still unclear. Several noted immunological changes include an increase of the allergen-specific IgG antibody, a reduction in the allergen-specific IgE antibody subsequent to transient increase, an allergen-specific T cell shift in cytokine production from Th2 to Th1, and a decrease in quantity and activity of basophils and mast cells.
To analyse the changes of basophil histamine release in response to IgE-mediated and non-IgE-mediated stimuli before and after conventional house-dust mite immunotherapy in children who suffer from atopic asthma.
Fourteen Dermatophagoides farinae (Df) sensitive asthmatic children with conventional immunotherapy were examined. Basophil histamine releasability was measured 0 months (just before immunotherapy), 4 months and 9 months after immunotherapy. Basophils were stimulated with Df and goat anti-human IgE antibody as IgE-mediated stimuli; and formyl-Met-Leu-Phe (fMLP) and calcium ionophore A23187 as non-IgE-mediated stimuli. Accordingly, the asthma symptom score was used to assess clinical outcome and the skin test reactivity to Df was measured.
In contrast to pre-immunotherapy activity, 4 and 9 months after immunotherapy there were significant decreases in histamine release by Df and by anti-IgE antibody. The histamine release by fMLP and by calcium ionophore showed no significant changes after immunotherapy. Histamine release by Df demonstrated significant correlation to that by anti-IgE antibody and by fMLP, yet there was no observable correlation between histamine release by Df and by calcium ionophore. The asthma symptom score decreased significantly 4 and 9 months after immunotherapy and showed significant correlation with histamine release by Df. The skin test reactivity (allergen/histamine ratio) remained constant 4 months after immunotherapy, but decreased significantly 9 months after immunotherapy.
Basophils have the potential to play an important role in the early clinical improvement of conventional immunotherapy in children with atopic asthma, which may be a result of the decreased IgE-mediated histamine releasability during immunotherapy.
变应原特异性免疫疗法已被证明在治疗特应性哮喘患者方面具有临床疗效；然而，其机制仍不清楚。一些显著的免疫变化包括变应原特异性IgG抗体增加、变应原特异性IgE抗体在短暂升高后降低、变应原特异性T细胞细胞因子产生从Th2向Th1转变，以及嗜碱性粒细胞和肥大细胞数量及活性降低。
分析患有特应性哮喘的儿童在进行常规屋尘螨免疫治疗前后，嗜碱性粒细胞组胺释放对IgE介导和非IgE介导刺激的变化。
对14名接受常规免疫治疗的对粉尘螨（Df）敏感的哮喘儿童进行检查。在免疫治疗前0个月（即将进行免疫治疗时）、免疫治疗后4个月和9个月测量嗜碱性粒细胞组胺释放能力。用Df和山羊抗人IgE抗体作为IgE介导的刺激物刺激嗜碱性粒细胞；用甲酰甲硫氨酸亮氨酸苯丙氨酸（fMLP）和钙离子载体A23187作为非IgE介导的刺激物。相应地，使用哮喘症状评分评估临床结果，并测量对Df的皮肤试验反应性。
与免疫治疗前的活性相比，免疫治疗后4个月和9个月，Df和抗IgE抗体诱导的组胺释放显著降低。免疫治疗后，fMLP和钙离子载体诱导的组胺释放无显著变化。Df诱导的组胺释放与抗IgE抗体和fMLP诱导的组胺释放显著相关，但Df诱导的组胺释放与钙离子载体诱导的组胺释放之间未观察到相关性。免疫治疗后4个月和9个月，哮喘症状评分显著降低，且与Df诱导的组胺释放显著相关。免疫治疗后4个月皮肤试验反应性（变应原/组胺比值）保持不变，但免疫治疗后9个月显著降低。
嗜碱性粒细胞在患有特应性哮喘的儿童常规免疫治疗的早期临床改善中可能发挥重要作用，这可能是免疫治疗期间IgE介导的组胺释放能力降低的结果。
