Park Kyung Hee, Lee Sang Chul, Son Young Woong, Jeong Kyoung Yong, Shin Yoo Seob, Shin Jung U, Sim Da Woon, Park Hye Jung, Lee Jae Hyun, Lee Kwang Hoon, Park Jung Won
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2016 Nov;57(6):1427-34. doi: 10.3349/ymj.2016.57.6.1427.
Specific immunoglobulin G4 (sIgG4) and immunoglobulin E (IgE)-blocking factors produced by subcutaneous immunotherapy (SCIT) play a critical role in the induction of allergen tolerance. However, comparative studies of available SCIT reagents on the induction of sIgG4 are limited. We compared increases in sIgG4 for three different house dust mite (HDM) SCIT reagents.
Seventy-two HDM sensitized allergic patients were enrolled and classified into four groups: 1) control (n=27), 2) SCIT with Hollister-Stier® (n=19), 3) Tyrosine S® (n=16), and 4) Novo-Helisen® (n=10). Levels of specific IgE (sIgE), sIgG4, and IgE blocking factor to Dermatophagoides farinae (D. farinae) were measured using ImmunoCAP (sIgE, sIgG4) and enzyme-linked immunosorbent assay (ELISA) (IgE-blocking factors). Levels were measured before and 13.9±6.6 months after the SCIT. The allergen specificity and the induction levels of sIgE and sIgG4 were confirmed by immunoblot analysis.
After SCIT, sIgG4 levels to D. farinae increased significantly; however, the increases differed significantly among the SCIT groups (p<0.001). Specific IgG4 levels to D. farinae were highest in Hollister-Stier® (3.7±4.1 mg/L), followed by Novo-Helisen® (2.2±2.3 mg/L) and Tyrosine S® (0.7±0.5 mg/L). In addition, patients who were administered using Hollister-Stier® showed the most significant decrease in IgE/IgG4 ratio (p<0.001) and increase in blocking factor (p=0.009). Finally, according to IgE immunoblot results, the Hollister-Stier® group showed the most significant attenuation of IgE binding patterns among others.
Currently available SCIT reagents induce different levels of specific IgG4, IgE/IgG4 ratio, and IgE-blocking factor.
皮下免疫疗法（SCIT）产生的特异性免疫球蛋白G4（sIgG4）和免疫球蛋白E（IgE）阻断因子在诱导过敏原耐受性方面发挥着关键作用。然而，关于现有SCIT试剂诱导sIgG4的比较研究有限。我们比较了三种不同的屋尘螨（HDM）SCIT试剂诱导的sIgG4增加情况。
纳入72例HDM致敏的过敏患者，并分为四组：1）对照组（n = 27），2）使用Hollister-Stier®进行SCIT组（n = 19），3）Tyrosine S®组（n = 16），4）Novo-Helisen®组（n = 10）。使用免疫捕获法（sIgE、sIgG4）和酶联免疫吸附测定法（ELISA）（IgE阻断因子）测量针对粉尘螨（D. farinae）的特异性IgE（sIgE）、sIgG4和IgE阻断因子水平。在SCIT前和SCIT后13.9±6.6个月测量水平。通过免疫印迹分析确认过敏原特异性以及sIgE和sIgG4的诱导水平。
SCIT后，针对D. farinae的sIgG4水平显著升高；然而，SCIT组之间的升高差异显著（p<0.001）。针对D. farinae的特异性IgG4水平在Hollister-Stier®组中最高（3.7±4.1 mg/L），其次是Novo-Helisen®组（2.2±2.3 mg/L）和Tyrosine S®组（0.7±0.5 mg/L）。此外，使用Hollister-Stier®给药的患者IgE/IgG4比值下降最为显著（p<0.001），阻断因子增加最为显著（p = 0.009）。最后，根据IgE免疫印迹结果，Hollister-Stier®组在其他组中显示出最显著的IgE结合模式减弱。
目前可用的SCIT试剂诱导不同水平的特异性IgG4、IgE/IgG4比值和IgE阻断因子。
