Machiels J J, Somville M A, Lebrun P M, Lebecque S J, Jacquemin M G, Saint-Remy J M
Internal Medicine Department, Clinique Saint-Pierre, Ottignies, Belgium.
J Clin Invest. 1990 Apr;85(4):1024-35. doi: 10.1172/JCI114532.
Antigen-antibody complexes were made from allergens of the common house dust mite, Dermatophagoides pteronyssinus (Dpt) and an excess of purified autologous specific antibodies. These complexes have been used to treat Dpt-hypersensitive patients who suffered from chronic bronchial asthma. Clinical symptoms and medication intake were followed by filling in diary cards. Peak expiratory flow, measured four times a day, was also followed. Intradermal skin tests and bronchial challenge tests were performed with allergen together with an evaluation of nonspecific bronchial reactivity. Specific IgE and IgG antibodies were assayed after separation from the bulk of serum immunoglobulins by immunoadsorption. The study was carried out over two years according to a double-blind protocol. Intradermal inoculation of antigen-antibody complexes resulted in a marked reduction of both clinical and medication scores. No systemic side-effects were observed and only mild wheal and flare reactions were noted at the injection site. The treatment showed a drastic reduction of specific skin and bronchial reactivities with only marginal effects on nonspecific bronchial reactivity. Concentrations of specific IgE antibodies decreased significantly during the first weeks of treatment and remained at these lower values throughout the study. Specific IgG antibodies actually decreased in the majority of treated patients. The total amount of allergen used in this study was less than 1% of the amount currently used for conventional hyposensitization with the same allergen. These findings show that antigen-antibody complex inoculation is an efficient and safe means of treating allergic bronchial asthma and that the mechanism of action is likely to differ from conventional hyposensitization.
抗原 - 抗体复合物由常见屋尘螨(粉尘螨)的变应原和过量纯化的自体特异性抗体制成。这些复合物已用于治疗患有慢性支气管哮喘的粉尘螨过敏患者。通过填写日记卡来跟踪临床症状和药物摄入量。每天测量四次的呼气峰值流速也进行跟踪。用变应原进行皮内皮肤试验和支气管激发试验,并评估非特异性支气管反应性。通过免疫吸附从大量血清免疫球蛋白中分离后,测定特异性IgE和IgG抗体。该研究按照双盲方案进行了两年。皮内接种抗原 - 抗体复合物导致临床和药物评分显著降低。未观察到全身副作用,仅在注射部位注意到轻微的风团和红晕反应。该治疗显示特异性皮肤和支气管反应性急剧降低,对非特异性支气管反应性仅有轻微影响。在治疗的最初几周内,特异性IgE抗体浓度显著下降,并在整个研究过程中保持在这些较低水平。在大多数接受治疗的患者中,特异性IgG抗体实际上有所下降。本研究中使用的变应原总量不到目前使用相同变应原进行传统减敏治疗用量的1%。这些发现表明,接种抗原 - 抗体复合物是治疗过敏性支气管哮喘的一种有效且安全的方法,其作用机制可能与传统减敏治疗不同。