Clin Exp Allergy. 2014 Mar;44(3):417-28. doi: 10.1111/cea.12241.
IgE-mediated allergic rhinitis to grass pollen can successfully be treated with either allergen immunotherapy tablets (SLIT tablet) or SQ-standardized subcutaneous immunotherapy (SCIT). The efficacy of these two treatment modalities for grass allergy is comparable, but the immunological mechanisms may differ. ClinicalTrials.gov ID: NCT01889875.
To compare the immunological changes induced by SQ-standardized SCIT and SLIT tablet.
We randomized 40 individuals with grass pollen rhinitis into groups receiving SCIT, SLIT tablet, or neither and followed them for 15 months with regular serum measurements of specific IgE, IgG4, IgE-blocking factor, facilitated antigen presentation (FAP), and basophil activation test (BAT). Nasal challenges were used to assess changes in nasal sensitivity.
After 15 months of treatment IgG4, IgE-blocking factor, FAP, and BAT values differed significantly in both SCIT and SLIT-tablet treatment groups when compared to the control group. Both SCIT and SLIT-tablet groups were significantly different from the control group after 1–3 months of treatment. In general, the changes induced by SCIT reached twice that of SLIT tablet, with the exception of specific IgE where SLIT tablet induced initial threefold increase compared with SCIT. A slight but significant increase in IgE and BAT after season was seen only in the control group. Significant differences between SCIT and SLIT tablet were observed early, but the differences diminished with the length of treatment, especially for FAP inhibition.
Both SCIT and SLIT tablet induce significant changes in specific antibodies (IgE and IgG4) and competition assays (IgE-blocking factor, FAP, and BAT). Overall, SCIT induced larger (two- to threefold) changes than SLIT tablet, with the exception of FAP, where SLIT tablet showed a gradual increase ending at the same level as SCIT. Maximal change was generally reached after 3 months' treatment.
针对花粉过敏的 IgE 介导的过敏性鼻炎，可以通过过敏原免疫治疗片剂（SLIT 片剂）或皮下标准化免疫治疗（SCIT）成功治疗。这两种治疗方法对草过敏的疗效相当，但免疫机制可能不同。临床试验.gov 标识符：NCT01889875。
比较皮下标准化免疫治疗和 SLIT 片剂引起的免疫学变化。
我们将 40 名花粉过敏的个体随机分为接受 SCIT、SLIT 片剂或两者都不接受的治疗组，并在 15 个月内定期测量特异性 IgE、IgG4、IgE 阻断因子、促进抗原呈递（FAP）和嗜碱性粒细胞激活试验（BAT）。使用鼻挑战来评估鼻敏感性的变化。
经过 15 个月的治疗，与对照组相比，SCIT 和 SLIT 片剂治疗组的 IgG4、IgE 阻断因子、FAP 和 BAT 值在治疗后 1-3 个月时均有显著差异。与对照组相比，SCIT 和 SLIT 片剂组均有显著差异。一般来说，SCIT 引起的变化是 SLIT 片剂的两倍，除了特异性 IgE，SLIT 片剂引起的初始增加是 SCIT 的三倍。仅在对照组中观察到季节性后 IgE 和 BAT 略有但显著增加。SCIT 和 SLIT 片剂之间的差异很早就观察到，但随着治疗时间的延长，差异逐渐缩小，尤其是 FAP 抑制。
SCIT 和 SLIT 片剂均会引起特异性抗体（IgE 和 IgG4）和竞争测定（IgE 阻断因子、FAP 和 BAT）的显著变化。总体而言，SCIT 引起的变化比 SLIT 片剂大（两到三倍），但 FAP 除外，SLIT 片剂呈逐渐增加趋势，最终达到与 SCIT 相同的水平。最大变化通常在治疗 3 个月后达到。
