Immunological analogues of drug-receptor interaction.
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The prevalence of allergic reactions to insuline has decreased during the last few years. Probably this is due to the use of the newly-developed recombinant human insuline. At present, adverse reactions to insuline occur in 5-10% of patients on therapy with insuline. Adverse reactions may be local (more frequent) or systemic (rare). Insuline resistance consists in a different type of immunological reaction. Diagnosis of allergy to insuline is based on clinical history and cutaneous and serological tests. Treatment depends upon the severity of the reaction. When insuline is indispensable despite a previous allergic reaction, a desensitization protocol may be implemented.
Immunological tolerance induced by intradermal administration of a peptide from a major milk protein antigen, alpha s1-casein, was investigated. When the peptide corresponding to amino acid residues 91-110 of alpha s1-casein, which included the dominant T cell determinant, was administered intradermally to mice which were subsequently immunized with alpha s1-casein, immunological tolerance in T cell response against alpha s1-casein was induced. Furthermore, intradermal administration of P91-110 induced profound immunological tolerance in the antibody response against native whole protein alpha s1-casein. The anti-alpha s1-casein antibody responses of IgG2a and IgG2b (the subclasses induced by Th1) and of IgG1 (the subclass induced by Th2) were all greatly suppressed by injecting P91-110 or alpha s1-casein. Our study is the first to demonstrate that intradermal administration of a dominant T cell determinant induces profound immunological tolerance in the antibody response against the native protein antigen.
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The degree and strength of the binding of radioactively labelled allergen by antibodies in the sera of birch pollen-sensitive individuals was studied during the course of hyposensitization with alun-precipitated aqueous-pyridine extracted birch pollen antigens using the ammonium-sulphate precipitation technique originally described by FARR. The allergen binding was measured before and after absorption of the sera with anti-human IgE antibodies conjugated to Sepharose. It was noted that IgE antibodies of low avidity caused clinical sensitivity as well as IgE antibodies of higher avidity. The nasal sensitivity to birch pollen allergen of six of the seven patients studied significantly decreased by the treatment without any quite uniform change of serum-binding capacity for the allergen. Thus the clinical improvement was accompanied either by disappearance of the specific IgE antibodies, concomitant with formation of antigen-binding non-IgE antibodies, or by increased formation of IgE antibodies with very slight contribution by non-IgE antibodies to the totally increased antigen-binding efficiency. It is felt that the serological antibody changes may not reflect the most relevant immunological events during successful hyposensitization therapy.
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