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Results for “Desensitization, Immunologic”

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PubMedDate not supplied

Effect of allergen specific immunotherapy (IT) on natural killer cell activity (NK), IgE, IFN-gamma levels and clinical response in patients with allergic rhinitis and asthma.

Allergen specific immunotherapy (IT) has been widely used for many years as a specific treatment of allergic diseases. A variety of changes in immunological parameters have been described but it still remains uncertain as to which of them is responsible for the improvement of symptoms. The aim of our study was to evaluate the effect of IT on natural killer (NK) cell activity, IL-4, IFN-gamma, IgE levels and skin test reactivity in addition to clinical efficacy. Thirty-one patients with allergic rhinitis and asthma were selected according to positive history, skin prick tests to Dermatophagoides pteronyssinus (Der p) or grass pollens, presence of specific IgE antibodies in sera and clinical findings, and were submitted to one year of placebo-controlled IT. Total IgE, specific IgE, IL-4 and IFN-gamma levels were measured by using ELISA method. Standard chromium 51 release assay was used to measure NK cell cytotoxic activity against the human leukemic cell line, K562 target cells. Mean symptom and medication scores, skin test reactivity and histamine sensitivity were significantly decreased in the patients given IT at the end of the first year when compared with the placebo group. However, there was neither a significant reduction in total and specific IgE levels nor a significant increase in IFN-gamma levels at the first year of IT. IL-4 levels were only measured at the beginning of the study because of the very low levels. A decrease in NK cell activity was found in patients treated with grass pollen extracts after 12 months when compared with Der p and placebo group. No signs of major local or systemic side effects due to IT were seen in patients during the study. Although significant clinical efficacy of specific IT with standardized extracts has been demonstrated in allergic rhinitis and asthmatic patients at the end of the first year of IT, no significant changes in immunological parameters were observed. However we conclude that a decrease in NK cell cytotoxic activity during IT has to be taken into account in the follow-up of patients.

Adolescent↗
PubMed1983

Immunologic studies of poisonous Anacardiaceae: oral desensitization to poison ivy and oak urushiols in guinea pigs.

Poison ivy and oak urushiols or their components were compared with the respective esterified derivatives for efficacy in oral desensitization of Hartley guinea pigs sensitized to urushiols. The esterified derivatives produced a significantly greater degree of hyposensitization than did free urushiol counterparts. Suppression produced by esterified urushiols was of longer duration than that produced by free urushiols. Groups of sensitized guinea pigs were given high (100 mg/kg) or low (10 mg/kg) doses of a mixture of acetylated, saturated urushiol congeners over a 1-, 2-, or 3-week period. High doses produced a greater degree of hyposensitization regardless of the dosage schedule used. Low doses did not produce significant hyposensitization unless given over a shorter (1 week) schedule. Large single booster doses (33 mg/kg/week) of the acetate derivatives produced a rebound in responsiveness when given, 2 weeks following the last dose of the initial series, to animals hyposensitized with 10 mg/kg. No such rebound in sensitivity occurred in animals given a series of high initial doses.

Administration, Oral↗
PubMed1977

[New immunologic perspectives on specific desensitization].

The development of objective techniques for the quantitative evaluation of synthesis and production of IgE in man and experimental animals and the sensitivity of basophils in interaction with allergen has made it possible to initiate studies on desensitization on a scientific and objective basis. Several new mechanisms influencing the regulation of antibody formation, including the production of IgE, have recently been discovered, such as suppressor T lymphocytes and autoanti-idiotypic antibodies. Although present empirical methods used for desensitization therapy provide appreciable results, it is to be expected that the emerging immunological knowledge about regulation of IgE production will markedly influence therapeutic approaches in the foreseeable future.

Antibody Formation↗
PubMed2006

Management of stinging insect hypersensitivity: a 5-year retrospective medical record review.

BACKGROUND: The Joint Task Force on Practice Parameters for Allergy and Immunology recommends that patients with a history of a systemic reaction to an insect sting be educated on ways to avoid insect stings, carry injectable epinephrine for emergency self-treatment, undergo specific IgE testing for stinging insect sensitivity, and be considered for immunotherapy. OBJECTIVE: To review frontline providers' documented care and recommendations for imported fire ant and flying insect hypersensitivity reactions. METHODS: A retrospective medical record review was performed of emergency department and primary care clinic visits between November 1, 1999, and November 30, 2004. Using International Classification of Diseases, Ninth Revision, codes, medical records were selected for review to identify patients with potential insect hypersensitivity. RESULTS: A total of 769 medical records from patients who experienced an insect sting were reviewed. Of 120 patients with a systemic reaction, 66 (55.0%) received a prescription for injectable epinephrine, and 14 (11.7%) were given information regarding avoidance of the offending insect. Forty-seven patients with systemic reactions (39.2%) were referred to an allergist. Of 28 patients who kept their appointments and underwent skin testing, 3 had negative results and 25 (89%) had positive results and were advised to start immunotherapy. CONCLUSION: Adherence to the stinging insect hypersensitivity practice parameter recommendations is poor. Many patients who have experienced a systemic reaction after an insect sting and have sought medical care are not afforded an opportunity for potentially lifesaving therapy.

Adolescent↗
PubMed1990

A double-blind study of hyposensitization with an alginate-conjugated extract of Dermatophagoides pteronyssinus (Conjuvac) in patients with perennial rhinitis. II. Immunological aspects.

In a 2-year double-blind placebo controlled study an immunological evaluation was carried out on 33 patients (15 males, 18 females, mean age 29.2 years) with mite-induced perennial rhinitis who were submitted to specific immunotherapy (IT) with an alginate-conjugated extract of D. pteronyssinus. The behaviour of IgE, IgG, IgG1 and IgG4 antibodies specific to D. pteronyssinus and its major allergen Der p1 was characterized by assessment of their changes in serum, and changes in IgG in nasal secretions during the treatment. The placebo-treated patients did not show any significant variation in the levels of specific antibodies, while in the actively treated patients we found: a statistically significant decrease (P less than 0.005) of specific IgE, a statistically significant increase of specific IgG (P less than 0.005), IgG1 (P less than 0.005) and IgG4 (P less than 0.005) in serum and a statistically significant increase (P less than 0.001) of specific IgG in nasal secretions. The IgG response showed an early relative predominance of the IgG1 subclass and a late absolute predominance of IgG4 subclass, that confirmed the model of IgG4 restriction in prolonged allergen stimulation. No correlation was found between immunological and clinical data.

Adjuvants, Immunologic↗
PubMedDate not supplied

Medical-legal considerations in the practice of allergy: personal reflections on lessons learned from an immunotherapy fatality.

Fatalities after administration of specific allergen immunotherapy are rare occurrences in a general allergy practice, as is medical negligence litigation. The author has experienced both and now relates his personal reflections on the lessons that were learned from the experiences. The twelve lessons that are reviewed encompass observations that are relevant not only to immunotherapy litigation but also to any general medical negligence litigation that one might encounter. Three principles of practice that are specific for allergen immunotherapy administration and that were closely scrutinized during the litigation are also reviewed.

Adult↗