Pastorello E A, Incorvaia C, Gerosa A, Vassellatti D, Italia M, Pravettoni V
2nd Department of Internal Medicine, University of Milan, School of Medicine, Milano, Italy.
N Engl Reg Allergy Proc. 1987 Nov-Dec;8(6):417-21. doi: 10.2500/108854187778999630.
Most of the controlled trials of specific immunotherapy (SIT) with house dust mite showed a good clinical efficacy of different kinds of extract after variable periods of treatment. However, few of them looked at all the parameters available to monitor this therapy, such as threshold dose of specific provocation test, end point titration and immunological variations. In particular, the behaviour of specific IgE antibodies is not completely known, while, in more recent studies, mite specific IgG antibodies have been shown to increase even in the early stages of treatment. Few data are available on mite specific IgG1-4 subclasses. The preliminary results of a double blind placebo controlled trial we performed with alginate conjugated Dermatophagoides pteronyssinus extract seem to indicate a good clinical and immunological response to this kind of extract. Moreover, we observed a significant increase of specific IgG antibodies, total and subclasses IgG1.2.4, with a prevalence of IgG4 subclass after three months of SIT. After two years of SIT mite specific IgG1 antibodies showed a tendency to decrease, while IgG4 antibodies maintained a constantly high level.
大多数针对屋尘螨的特异性免疫疗法(SIT)对照试验表明,经过不同疗程的治疗后,不同种类的提取物均具有良好的临床疗效。然而,其中很少有试验研究监测该疗法的所有可用参数,例如特异性激发试验的阈值剂量、终点滴定和免疫学变化。特别是,特异性IgE抗体的行为尚不完全清楚,而在最近的研究中,已表明螨特异性IgG抗体即使在治疗早期也会增加。关于螨特异性IgG1-4亚类的数据很少。我们用藻酸盐结合的粉尘螨提取物进行的一项双盲安慰剂对照试验的初步结果似乎表明,对这种提取物有良好的临床和免疫反应。此外,我们观察到在特异性免疫疗法三个月后,特异性IgG抗体、总IgG及IgG1、IgG2、IgG4亚类均显著增加,其中IgG4亚类占优势。经过两年的特异性免疫疗法,螨特异性IgG1抗体呈下降趋势,而IgG4抗体则持续保持高水平。