Pałgan Krzysztof, Żbikowska-Götz Magdalena, Bartuzi Zbigniew
Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Postepy Dermatol Alergol. 2020 Aug;37(4):590-596. doi: 10.5114/ada.2019.83655. Epub 2019 Apr 1.
Venom immunotherapy (VIT) can protect against severe anaphylactic reactions (SR) in 80-100% of subjects allergic to Hymenoptera venom. The mechanisms of induction of immunological tolerance produced by VIT are still little known. It has been shown that VIT modulates Treg activity, Th2 or Th1 cells or both, increases production of IL-10, decreases secretion of IL-13, and causes an IgG4/IgE ratio shift.
To investigate the blood eosinophil count, CCL5/RANTES and IL-17E/IL-25 concentrations before and after the initial phases of the rush protocol of VIT.
Forty individuals (14 males, 26 females) of mean age 41.03 ±12.43 years were included in the study. The peripheral eosinophils and the concentration of serum interleukin IL-17E/IL-25 and RANTES were determined before and after the initial phase of VIT.
Paired sample t-test revealed that all patients after VIT had significantly higher eosinophil levels compared to the baseline (mean: 0.42 vs. 0.64, p < 0.05). Moreover, in subjects treated with bee venom, RANTES levels proved to rise significantly (51 × 103 vs. 62 × 103, < 0.05) while IL-17E/IL-25 dropped with near-marginal significance (916 vs. 650, = 0.069).
Our immunological study on the early phase of venom immunotherapy suggested that eosinophils, cytokines such as CCL5/RANTES and IL-17E/IL-25 contribute to the immunological response.
毒液免疫疗法(VIT)可使80%至100%对膜翅目毒液过敏的受试者预防严重过敏反应(SR)。VIT诱导免疫耐受的机制仍鲜为人知。已表明VIT可调节调节性T细胞(Treg)活性、辅助性T细胞2(Th2)或辅助性T细胞1(Th1)或两者的活性,增加白细胞介素10(IL-10)的产生,减少白细胞介素13(IL-13)的分泌,并导致免疫球蛋白G4/免疫球蛋白E(IgG4/IgE)比值发生变化。
研究VIT快速方案初始阶段前后的血液嗜酸性粒细胞计数、趋化因子配体5/调节激活正常T细胞表达和分泌因子(CCL5/RANTES)以及白细胞介素17E/白细胞介素25(IL-17E/IL-25)浓度。
40名个体(14名男性,26名女性)纳入研究,平均年龄为41.03±12.43岁。在VIT初始阶段前后测定外周血嗜酸性粒细胞以及血清白细胞介素IL-17E/IL-25和RANTES的浓度。
配对样本t检验显示,所有接受VIT治疗后的患者嗜酸性粒细胞水平均显著高于基线水平(平均值:0.42对0.64,p<0.05)。此外,在用蜂毒治疗的受试者中,RANTES水平显著升高(51×103对62×103,<0.05),而IL-17E/IL-25下降,接近临界显著性(916对650,=0.069)。
我们对毒液免疫疗法早期阶段的免疫学研究表明,嗜酸性粒细胞、诸如CCL5/RANTES和IL-17E/IL-25等细胞因子有助于免疫反应。