Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey.
Department of Biology, Hacettepe University, School of Medicine, Ankara, Turkey.
Eur Ann Allergy Clin Immunol. 2023 May;55(3):122-130. doi: 10.23822/EurAnnACI.1764-1489.252. Epub 2022 Apr 22.
The effectiveness of pre-seasonal allergoid immunotherapy in polysensitized patients are not well-known. The aim of the present study was to compare the clinical efficacy and immunological changes of pre-seasonal allergoid immunotherapy in mono and polysensitized patients with grass pollen allergy. Fourty six patients with seasonal allergic rhinitis undergoing pre-seasonal grass pollen immunotherapy and 28 cases followed by conventional drug treatment were included. These groups were divided into monosensitized and polysensitized ones. All patients were followed between March-September with symptom-medication scores, and visual analogue scale (VAS). The quality of life was assessed using the Mini-RQLQ questionnaire. (Phl p) specific IgE and IgG4 (UNI-CAP 100, Phadia) measurements were performed before and after 7 weeks of immunotherapy. In the immunotherapy group, 15 weekly symptom-medication scores and VAS scores between May and August were found to be significantly lower than those in the control group (p < 0.05). Phl p specific IgE and IgG4 levels were significantly higher after immunotherapy compared to those before immunotherapy (p = 0.001). Furthermore, Phl p specific IgG4 levels after immunotherapy were also significantly higher than in the control group (p = 0.001). Improvements in activities-practical problems and non-nose/eye symptoms quality of life scores were significantly different between two groups (p < 0.05). There was no difference in terms of clinical and immunological parameters in mono- and polysensitized patients (p > 0.05). This study indicates that clinical improvement with pre-seasonal grass pollen immunotherapy is accompanied by important increase in specific IgG4 blocking antibodies. Furthermore, a single-allergen immunotherapy can lead to similar clinical efficacy and immunological changes in polysensitized as well as monosensitized patients with grass pollen allergy.
preseason 变应原免疫疗法在多敏患者中的有效性尚不清楚。本研究旨在比较 preseason 变应原免疫疗法在单敏和多敏的花粉过敏患者中的临床疗效和免疫学变化。
46 例季节性过敏性鼻炎患者行 preseason 草花粉免疫治疗，28 例采用常规药物治疗。这些患者分为单敏组和多敏组。所有患者均于 3 月至 9 月进行症状药物评分和视觉模拟评分（VAS），并采用 mini-rqlq 问卷评估生活质量。在免疫治疗前后 7 周内，用 Phl p 特异性 IgE 和 IgG4（UNI-CAP 100，Phadia）测量。
在免疫治疗组中，5 月至 8 月间的 15 项每周症状药物评分和 VAS 评分明显低于对照组（p<0.05）。与免疫治疗前相比，免疫治疗后 Phl p 特异性 IgE 和 IgG4 水平显著升高（p=0.001）。此外，免疫治疗后 Phl p 特异性 IgG4 水平也明显高于对照组（p=0.001）。两组间活动-实际问题和非鼻/眼症状生活质量评分的改善有显著差异（p<0.05）。单敏和多敏患者在临床和免疫学参数方面无差异（p>0.05）。
本研究表明， preseason 草花粉免疫治疗的临床改善伴随着特异性 IgG4 阻断抗体的显著增加。此外，单一过敏原免疫疗法可导致花粉过敏的多敏和单敏患者具有相似的临床疗效和免疫学变化。
