Humoral response to subcutaneous, oral, and nasal immunotherapy for allergic rhinitis due to Dermatophagoides pteronyssinus.

We investigated variations in total IgE, and specific IgE, IgG, and IgG4 for Dermatophagoides pteronyssinus in 57 patients with perennial rhinitis due to house dust mite allergy in an open controlled study: 43 subjects received immunotherapy (17 subcutaneous, 14 sublingual, and 12 local immunotherapy) and 14 were controls. The results were compared with the clinical course to determine possible associations between serum and clinical changes. Subcutaneous, but not sublingual and nasal, immunotherapy induced a significant clinical benefit (P < .001). Specific antibody behavior in patients receiving subcutaneous immunotherapy was similar to literature reports. Specific IgE levels fell starting from the 6th month of therapy, and specific IgG and IgG4 levels rose significantly, but there was no correlation with the clinical course. The other two forms of immunotherapy did not induce significant specific antibody modifications. We conclude that the specific IgG4 rise induced by subcutaneous immunotherapy was the most important variation observed. This change, however, was not correlated with the clinical outcome.