Fling J A, Ruff M E, Parker W A, Whisman B A, Martin M E, Moss R B, Reid M J
Division of Medicine, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, TX 78236.
J Allergy Clin Immunol. 1989 Jan;83(1):101-9. doi: 10.1016/0091-6749(89)90483-1.
In a prospective, double-blind, placebo-controlled study, we examined the effect of mountain cedar (MC) immunotherapy on the MC-induced late cutaneous response (LCR). Fourteen MC-sensitive patients were intradermally skin tested before and after immunotherapy with MC extract. We measured the size of the wheal at 15 minutes and the area of tissue swelling at 6 hours. Patients were matched by the size of the LCR and started receiving either MC immunotherapy or placebo immunotherapy. MC-specific immunoglobulins (MC sIgG, MC sIgG1, MC sIgG4, and MC sIgE) were measured by ELISA. Symptom-medication scores (SMSs) were recorded on a daily basis during the MC season and tabulated at the end of the study. Comparison of the 14 paired patients revealed no significant differences between MC-treated and placebo-treated groups in preimmunotherapy MC sIgG1 and SIgG4. However, when MC immunotherapy was compared to placebo immunotherapy, patients receiving MC immunotherapy developed significantly higher MC sIgG1 (p less than 0.04) and MC sIgG4 (p less than 0.01) after immunotherapy. Patients receiving MC immunotherapy also demonstrated significantly greater suppression of the LCR after immunotherapy (p less than 0.005) with the postimmunotherapy LCR correlating significantly with both MC sIgG4 (rs = 0.715; p = 0.008) and cumulative dose of MC received (rs = 0.808; p = 0.004). MC sIgE was similar in both groups after immunotherapy. The reduction in SMSs in the MC-treated group did not reach significance, nor was there a correlation of SMSs with MC sIgE, sIgG, sIgG1, or sIgG4.(ABSTRACT TRUNCATED AT 250 WORDS)
在一项前瞻性、双盲、安慰剂对照研究中，我们检测了山地雪松（MC）免疫疗法对MC诱发的迟发性皮肤反应（LCR）的影响。14名对MC敏感的患者在接受MC提取物免疫治疗前后进行了皮内皮肤试验。我们在15分钟时测量风团大小，在6小时时测量组织肿胀面积。根据LCR大小对患者进行匹配，然后开始接受MC免疫疗法或安慰剂免疫疗法。通过酶联免疫吸附测定法（ELISA）检测MC特异性免疫球蛋白（MC sIgG、MC sIgG1、MC sIgG4和MC sIgE）。在MC季节期间每天记录症状-用药评分（SMSs），并在研究结束时制成表格。对14对配对患者的比较显示，在免疫治疗前，MC治疗组和安慰剂治疗组的MC sIgG1和SIgG4无显著差异。然而，将MC免疫疗法与安慰剂免疫疗法进行比较时，接受MC免疫疗法的患者在免疫治疗后产生的MC sIgG1（p<0.04）和MC sIgG4（p<0.01）显著更高。接受MC免疫疗法的患者在免疫治疗后对LCR的抑制也显著更强（p<0.005），免疫治疗后的LCR与MC sIgG4（rs = 0.715；p = 0.008）和接受的MC累积剂量（rs = 0.808；p = 0.004）均显著相关。免疫治疗后两组的MC sIgE相似。MC治疗组中SMSs的降低未达到显著水平，且SMSs与MC sIgE、sIgG、sIgG1或sIgG4也无相关性。（摘要截短于250字）
