Ohashi Y, Nakai Y, Tanaka A, Kakinoki Y, Washio Y, Kato A, Masamoto T, Yamada K, Hayashi M
Department of Otolaryngology, Osaka City University Medical School, Abeno, Osaka, Japan.
Arch Otolaryngol Head Neck Surg. 1998 Dec;124(12):1337-46. doi: 10.1001/archotol.124.12.1337.
Recent double-blind placebo-controlled trials have clearly shown the efficacy of immunotherapy for perennial allergic rhinitis. However, the exact working mechanisms related to the clinical effect of immunotherapy remain unclear.
To monitor the changes over time in immunologic parameters in children who received immunotherapy for perennial allergic rhinitis, and to elucidate the working mechanisms of immunotherapy related to its clinical efficacy.
Nineteen children with perennial allergic rhinitis due to Dermatophagoides farinae enrolled in this prospective open study. Venous blood was collected to determine levels of specific IgE, specific IgG4, soluble interleukin 2 receptor, interleukin 4, soluble intercellular adhesion molecule 1, and soluble vascular cell adhesion molecule 1 at enrollment and 1, 2, 3, 5, and 10 years after enrollment.
Immunotherapy affected serum levels of specific IgE, specific IgG4, soluble interleukin 2 receptor, interleukin 4, and soluble intercellular adhesion molecule 1, but not soluble vascular cell adhesion molecule 1. The rates of increase of levels of specific IgG4 and the rates of decrease of levels of soluble interleukin 2 receptor were correlated with the rates of decrease of symptom scores during the first 3 years of treatment, but not after 5 years. The rates of decrease in levels of soluble intercellular adhesion molecule 1 were correlated with the rates of decrease in symptom scores at 3 and 5 years after the beginning of the course of immunotherapy. The rates of decrease in levels of specific IgE and interleukin 4 were correlated with the rates of decrease in symptom scores after 5 and 10 years of treatment, but not during the first 3 years.
Each modulation in levels of specific IgE, specific IgG4, soluble interleukin 2 receptor, interleukin 4, and soluble intercellular adhesion molecule 1 contributed to the clinical effect of immunotherapy in particular phases of treatment for children with perennial allergic rhinitis.
近期的双盲安慰剂对照试验已明确显示免疫疗法对常年性变应性鼻炎的疗效。然而，与免疫疗法临床效果相关的确切作用机制仍不清楚。
监测接受常年性变应性鼻炎免疫疗法的儿童免疫参数随时间的变化，并阐明免疫疗法与其临床疗效相关的作用机制。
19名因粉尘螨引起的常年性变应性鼻炎儿童纳入了这项前瞻性开放性研究。在入组时以及入组后1、2、3、5和10年采集静脉血，以测定特异性IgE、特异性IgG4、可溶性白细胞介素2受体、白细胞介素4、可溶性细胞间黏附分子1和可溶性血管细胞黏附分子1的水平。
免疫疗法影响特异性IgE、特异性IgG4、可溶性白细胞介素2受体、白细胞介素4和可溶性细胞间黏附分子1的血清水平，但不影响可溶性血管细胞黏附分子1。特异性IgG4水平的升高率和可溶性白细胞介素2受体水平的降低率与治疗前3年症状评分的降低率相关，但与5年后无关。可溶性细胞间黏附分子1水平的降低率与免疫治疗疗程开始后3年和5年症状评分的降低率相关。特异性IgE和白细胞介素4水平的降低率与治疗5年和10年后症状评分的降低率相关，但与前3年无关。
特异性IgE、特异性IgG4、可溶性白细胞介素2受体、白细胞介素4和可溶性细胞间黏附分子1水平的每种调节在常年性变应性鼻炎儿童治疗的特定阶段都对免疫疗法的临床效果有贡献。
