Tamir R, Pick A I
Division of Clinical Immunology and Allergy, Beilinson Medical Center, Petach Tikvah, Israel.
Immunol Res. 1988;7(3):256-64. doi: 10.1007/BF02918141.
Immunotherapy, also called desensitization, is effective in treating allergic rhinitis, insect sting venom hypersensitivity and probably allergic asthma. Administration of gradually increasing doses of the sensitizing antigen induces several immunological changes. The humoral responses include an increase in specific IgG titer, a decrease in specific IgE titer with blunting of its seasonal rise, and an increase in the specific anti-idiotype antibody titer. Cellular changes include diminished responsiveness of the patient's lymphocytes to stimulation by allergen as measured by thymidine incorporation. This is accounted for by the generation of suppressor cells specific for the allergen. These suppressor cells also induce suppression of IgE production by mononuclear cells. An additional effect that is attributed to IT is a decrease in basophil sensitivity to the allergen as measured by histamine release. The clinical correlates of these changes are not clear. Currently, none of the responses can be used as a tool for assessing the response in the treated individual patient. Although the increase in specific IgG was shown to correlate with the clinical response in patient groups, it is not applicable to the individual patient. Currently the best parameter for assessing clinical response is probably the increase in the ratio between the specific IgG and the specific IgE. However further studies are warranted to evaluate the significance of the change in anti-idiotype antibodies, basophil histamine release and perhaps immunological changes yet to be discovered.
免疫疗法，也称为脱敏疗法，在治疗过敏性鼻炎、昆虫叮咬毒液过敏以及可能的过敏性哮喘方面是有效的。给予逐渐增加剂量的致敏抗原会引发多种免疫变化。体液反应包括特异性IgG滴度增加、特异性IgE滴度降低及其季节性升高变平缓，以及特异性抗独特型抗体滴度增加。细胞变化包括通过胸腺嘧啶核苷掺入测量，患者淋巴细胞对变应原刺激的反应性降低。这是由针对变应原的抑制细胞的产生所导致的。这些抑制细胞还诱导单核细胞对IgE产生的抑制。归因于免疫疗法的另一个效应是通过组胺释放测量，嗜碱性粒细胞对变应原的敏感性降低。这些变化的临床相关性尚不清楚。目前，没有一种反应可作为评估个体患者治疗反应的工具。虽然特异性IgG的增加在患者群体中显示与临床反应相关，但它不适用于个体患者。目前评估临床反应的最佳参数可能是特异性IgG与特异性IgE之间比值的增加。然而，有必要进行进一步研究以评估抗独特型抗体变化、嗜碱性粒细胞组胺释放以及可能尚未发现的免疫变化的意义。
