ALK, Hoersholm, Denmark.
Department of Dermatology and Allergology, Technical University of Munich, Munich, Germany.
Clin Exp Allergy. 2021 Feb;51(2):284-295. doi: 10.1111/cea.13788. Epub 2020 Dec 8.
The SQ tree SLIT-tablet (containing birch extract) proved clinically significant effects during the pollen season for birch as well as alder/hazel. Immune outcomes of this treatment for allergens from multiple birch homologous trees need further investigation. We hypothesize that birch pollen extract AIT modulates a highly cross-reactive immune response and that this may be the basis for the observed clinical cross-protection.
Blood samples were collected from 397 birch allergic patients during SQ tree SLIT-tablet or placebo treatment (1:1) for up to 40 weeks. Serum IgE and IgG specific to birch, and birch homologous tree pollens from alder, hazel, hornbeam, beech and chestnut were measured by ImmunoCAP. IgE-Blocking Factor (IgE-BF) for alder, birch and hazel during treatment was measured by Advia Centaur and blocking effects for birch and all these birch homologous tree pollens were further investigated by basophil activation (BAT). Antibody readouts were investigated in patient subsets. T-cell responses (proliferation) to allergen extracts and peptide pools (group 1 allergens) were investigated in T-cell lines from 29 untreated birch pollen-allergic individuals.
Significant Pearson correlations between serum IgE towards birch, alder, hazel, hornbeam and beech were observed (r-values > .86). T-cell reactivity was observed throughout the birch homologous group. Almost identical kinetics for changes in IgE towards birch, alder and hazel were observed during treatment and similar species-specific changes were seen for serum-IgG . IgG reactivity towards birch and alder, hazel, hornbeam and beech correlated significantly at end-of-treatment (r-values > .72). Treatment resulted in similar IgE-BF kinetics for alder, birch, and hazel and blocking of BAT for multiple trees in most actively treated patients investigated.
Systematic analyses of T-cell and antibody cross-reactivities before and during birch pollen extract AIT provide the immunological basis for the observed clinical effect of SQ tree SLIT-tablet treatment of tree pollen allergy induced by multiple trees in the birch homologous group.
在花粉季节，SQ 树 SLIT 片剂（含有桦树提取物）对桦树以及桤木/榛树均显示出显著的临床疗效。这种治疗方法对多种桦树同源树过敏原的免疫效果仍需进一步研究。我们假设桦树花粉提取物 AIT 可调节高度交叉反应性的免疫应答，这可能是观察到的临床交叉保护作用的基础。
在 SQ 树 SLIT 片剂或安慰剂（1:1）治疗的 40 周内，共收集了 397 名桦树过敏患者的血液样本。通过 ImmunoCAP 检测血清中桦树、桤木、榛树、山毛榉、山毛榉和栗树花粉的特异性 IgE 和 IgG。通过 Advia Centaur 检测治疗期间的桤木、桦树和榛树 IgE-Blocking Factor（IgE-BF），并通过嗜碱性粒细胞活化（BAT）进一步研究桦树和所有这些桦树同源花粉的阻断作用。在患者亚组中研究了抗体检测结果。从 29 名未经治疗的桦树花粉过敏个体的 T 细胞系中研究了过敏原提取物和肽池（第 1 组过敏原）的 T 细胞反应（增殖）。
观察到血清中针对桦树、桤木、榛树、山毛榉和山毛榉的 IgE 之间存在显著的 Pearson 相关性（r 值>.86）。在桦树同源组中观察到 T 细胞反应。在治疗期间，桦树、桤木和榛树的 IgE 变化具有几乎相同的动力学，并且在治疗结束时观察到针对血清-IgG 的相似的种特异性变化。桦树和桤木、榛树、山毛榉和山毛榉的 IgG 反应在治疗结束时呈显著相关（r 值>.72）。在大多数积极治疗的患者中，治疗导致桤木、桦树和榛树的 IgE-BF 动力学相似，并且针对多种树木的 BAT 阻断。
在桦树花粉提取物 AIT 之前和期间进行的 T 细胞和抗体交叉反应性的系统分析为观察到的 SQ 树 SLIT 片剂治疗桦树同源组中多种树木引起的树木花粉过敏的临床效果提供了免疫学基础。
