Nanda Anil, O'connor Maeve, Anand Miriam, Dreskin Stephen C, Zhang Lening, Hines Brittany, Lane Diana, Wheat William, Routes John M, Sawyer Richard, Rosenwasser Lanny J, Nelson Harold S
Department of Medicine, National Jewish Medical Center, University of Colorado, Denver, CO 80206, USA.
J Allergy Clin Immunol. 2004 Dec;114(6):1339-44. doi: 10.1016/j.jaci.2004.08.049.
The immunologic response to allergen immunotherapy with 3 serial 5-fold doses of cat extract has been studied after approximately 5 weeks of immunotherapy. The highest dose containing 15 mug of Fel d 1 produced the most consistent and favorable response. It is unknown whether the comparative response on reaching a maintenance dose is maintained with long-term maintenance therapy.
The purpose of this investigation was to evaluate the immunologic responses with these 3 serial doses of cat hair and dander extract at baseline, after reaching the maintenance dose (approximately 5 weeks), and after 1 year of maintenance immunotherapy.
Twenty-eight patients with cat allergy randomized in a double-blind study were assigned to one of 4 treatment groups: placebo or cat hair and dander extract containing 0.6 mug of Fel d 1, 3 mug of Fel d 1, and 15 mug of Fel d 1 at maintenance. Studies included skin prick tests and late cutaneous reactions with cat hair and dander extract, titrated nasal challenges with the extract, serum cat allergen-specific IgG4 and IgE measurement, and flow cytometric and ELISA analysis of whole blood and intranasal cytokines (TGF-beta, IL-10, IFN-gamma, IL-4, and IL-5).
Twenty-six subjects completed the study. After both 5 weeks and 1 year, significant and dose-dependent differences were seen with total symptom scores on nasal challenge ( P < .0001), with titrated skin prick testing with cat dander extract at 5 weeks ( P = .014) and 1 year ( P < .0001), and with cat-specific IgG4 measurement at 5 weeks ( P = .004) and 1 year ( P = .003). At 1 year, neither flow cytometry of whole blood nor ELISA evaluation of nasal cytokines demonstrated any significant differences among the treatment groups.
The response to titrated nasal allergen challenge, titrated skin prick testing, and allergen-specific IgG4 measurement to cat immunotherapy at 5 weeks is predictive of the response at 1 year.
在进行约5周的变应原免疫疗法后，对连续3次给予5倍剂量猫提取物的变应原免疫疗法的免疫反应进行了研究。含有15μg猫Fel d 1的最高剂量产生了最一致且良好的反应。尚不清楚达到维持剂量时的比较反应在长期维持治疗中是否能保持。
本研究的目的是评估在基线时、达到维持剂量后（约5周）以及维持免疫疗法1年后，这3种连续剂量的猫毛和皮屑提取物的免疫反应。
28名猫过敏患者被随机分配到一项双盲研究中的4个治疗组之一：安慰剂组或维持剂量时含有0.6μg Fel d 1、3μg Fel d 1和15μg Fel d 1的猫毛和皮屑提取物组。研究包括皮肤点刺试验以及猫毛和皮屑提取物的迟发性皮肤反应、提取物的滴定鼻腔激发试验、血清猫变应原特异性IgG4和IgE测量，以及全血和鼻内细胞因子（转化生长因子-β、白细胞介素-10、干扰素-γ、白细胞介素-4和白细胞介素-5）的流式细胞术和酶联免疫吸附测定分析。
26名受试者完成了研究。在5周和1年后，鼻腔激发试验的总症状评分（P <.0001）、5周（P =.014）和1年（P <.0001）时用猫皮屑提取物进行的滴定皮肤点刺试验以及5周（P =.004）和1年（P =.003）时的猫特异性IgG4测量均出现了显著的剂量依赖性差异。在1年时，全血流式细胞术和鼻内细胞因子的酶联免疫吸附测定评估在各治疗组之间均未显示出任何显著差异。
5周时对滴定鼻腔变应原激发试验、滴定皮肤点刺试验和变应原特异性IgG4测量的反应可预测1年时的反应。
