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PubMed1982

[Immunological mechanisms of specific hyposensitization in allergic diseases of an infectious nature. IV. The comparative characteristics of the changes in the immunological processes in nonspecific (dekaris) and specific (autovaccine) immunotherapy of infectious-allergic bronchial asthma].

The data based on the comparative evaluation of changes in immunological processes due to the effect of decaris, autovaccine and standard staphylococcal allergens are presented. These data indicate that such changes resulting from the clinical effectiveness of different kinds of immunotherapy are accompanied by identical changes in the immune system of patients with infectious allergic bronchial asthma. At the same time the results of this study point out that the therapeutic effectiveness of autovaccine is higher than that of decaris.

Adult↗
PubMed1989

Analysis of differing patterns of cross-reactivity of honeybee and yellow jacket venom-specific IgE: use of purified venom fractions.

Prior studies of sera from insect sting-allergic patients have analyzed the relationship of coexisting honeybee venom- and yellow jacket venom-specific IgE. Radioallergosorbent (RAST)-inhibition tests with these venoms revealed four different patterns of activity. In this present study, purified fractions prepared from these venoms were used to analyze these varying patterns. The hyaluronidases of yellow jacket venom and honeybee venom showed extensive cross-reaction. The phospholipases from these venoms showed minimal cross-reactivity; antigen 5 was restricted to yellow jacket venom. There was a high molecular weight component in yellow jacket venom with immunologic properties similar to honeybee venom acid phosphatase. Sera from individual patients showed quantitative and qualitative differences in the reactions to the major components of both venoms. The differences in the RAST-inhibition patterns in patients with elevated levels of both honeybee venom- and yellow jacket venom-specific IgE are accounted for by these differences as well as by differences in the cross-reactivity between the individual components.

Animals↗
PubMed1995

Humoral immunological response in patients with venom allergy during specific immunotherapy.

It was found that successful VIT (the negative challenge test) is associated with an increase in serum venom-specific IgG4 and a decrease in specific IgE. Also skin reactivity was significantly decreased in 9 patients with effective VIT. Or results confirmed that continuation of maintenance of VIT, 100 micrograms monthly for 2 years, is enough to protect most of venom allergic patients for systemic reaction to subsequent stings. The high prior level of venom-specific IgG4 can prognosticate a worse toleration of the rush VIT schedule.

Adolescent↗
PubMedDate not supplied

Effect of hyposensitization for tree pollinosis on associated apple allergy.

Twenty patients suffering from birch pollen allergy received two or three courses of immunotherapy in successive years. In 9 patients, the fruit allergy improved; 4 patients reported no improvement. In 3 patients, the fruit allergy developed after beginning the immunotherapy. At the end of the 3 years, 16 of these patients were allergic to fruit, 13 of them to apple. After each preseasonal course of immunotherapy with tree pollen extract, a temporal and parallel increase in the titers of IgE antibodies to birch pollen allergens and apple allergens were observed. In contrast, only the titers of birch pollen allergen specific IgG and IgG4 increased, whereas apple allergen specific IgG and IgG4 did not, or only very slightly. In Western blot studies, IgG4 antibodies bound to more components of apple extract than birch pollen extract. On the average, IgG4 antibodies recognize more components of apple and birch pollen extracts than do IgE antibodies. In histamine release studies, the sensitivity of washed leukocytes to birch pollen extract decreased significantly during the observation time. However, the difference between apple extract-induced histamine release before and after immunotherapy was not significant. None of the immunological parameters investigated here correlate well with severity or prognosis of the fruit (apple) allergy. The clinical improvement of pollinosis was associated with a rise in birch pollen specific IgG4 antibody titers and a decrease of allergen-induced histamine liberation. Beside improvement of the fruit allergy in 56% of the cases, the courses of apple specific IgE and IgG4 antibody titers seem to indicate a slight sensitization against apple allergens.

Adult↗
PubMed1989

Conventional and new approaches to hyposensitization.

Hyposensitization in IgE-mediated allergic diseases has traditionally been induced by immunotherapy in which increasing amounts of allergens have been injected until a maximal tolerated dose has been achieved. Among the most obvious immunological effects of immunotherapy have been the production of allergen-specific IgG and some impairment in the synthesis of allergen-specific IgE. In addition to allergen-specific IgG (sometimes described as blocking antibodies) anti-idiotypic and anti-isotypic (IgG anti-IgE) have recently attracted attention as possibly being involved in hyposensitization. The effects of immunotherapy at the cellular level (either as T cell control of IgE synthesis or as modulation of mediator release by effector cells) also deserve further investigation.

Desensitization, Immunologic↗
PubMed2004

High-affinity IgG to a major A. fumigatus allergen, Asp f 2, retards allergic response.

BACKGROUND: Allergic diseases represent a major health threat to humans. Allergen-specific immunotherapy (SIT) is one of the significant approaches to the treatment of IgE-mediated allergy and its control. The mechanisms involved in SIT-induced responses are complex and still speculative. Immunological events associated with successful SIT include an increase in allergen-specific "blocking" IgG, reduction in cytokine production, and induction of regulatory or suppressor cells. The aim of this study was to estimate the effect of SIT using a single major allergen of A. fumigatus, Asp f 2, or its dominant B-cell epitope, aa254-268, in a murine model of allergic aspergillosis. It is known that A. fumigatus (Af), a ubiquitous fungus, is implicated in the pathogenesis of a number of clinically different allergic diseases. MATERIAL/METHODS: BALB/c and C57BL/6 mice were immunized with Asp f 2, its proteolytic fragments or the recombinant peptide aa254-268 to induce high-affinity IgG to Asp f 2. Allergy to Af was induced by subcutaneous and intranasal immunization of previously SIT-treated animals with an Af crude extract. RESULTS: The results of immunological and lung histological studies demonstrate a simultaneous increase in Asp f 2-specific IgG and amelioration of allergic inflammatory symptoms in mice immunized with Asp f 2 or its peptides before exposure to Af crude allergen. CONCLUSIONS: Thus it was shown that the induction of IgG specific to major allergens or even to their B-cell epitopes induces protection from allergy provoked by natural allergens.

Allergens↗
PubMed2005

Biotherapies of chronic diseases in the inter-war period: from Witte's peptone to Penicillium extract.

In the inter-war period physicians elaborated numerous 'biotherapies' grounded in the complex interactions between physiology, bacteriology and immunology. The elaboration of these non-specific biological treatments was stimulated by the theory of generalized anaphylaxis that linked the violent reaction to a foreign protein to a broad array of chronic diseases, from asthma and urticaria to rheumatism or chronic colitis. Such diseases were perceived as the result of an 'abnormal reactivity' to a sensitisation of tissues and organs by bacteria and by foreign proteins, a view that provided an effective bridge between new concepts derived from bacteriology and immunology and the long-standing pathological tradition. Accordingly, physicians attempted to treat these conditions through specific desensitisation and non-specific biological therapies: peptone treatment, protein therapy, haemotherapy, 'antivirus' or 'opotherapy'. Therapies that attempted to neutralise the harmful effects of chronic infections through 'desensitisation' were not seen as marginal medical practices, but were promoted by leading advocates of the 'Pasteurian sciences', such as Richet, Widal, Vallery-Radot, Wright and Fleming. They also led to development of new products by the pharmaceutical industry.

Anaphylaxis↗
PubMed1987

Specific immunological therapy with the sulfite chemicals.

Provocative oral tests with 1000 mg of the sulfite chemicals produced allergic reactions in 10% of the patients tested. Parenteral therapy with an Allpyral extract of the sulfite chemicals was instituted. After 3 months' therapy three patients were challenged with 1000 mg of the sulfite chemicals and modified attacks of asthma were produced. After 6 months' therapy the same three patients failed to react. Therefore, I rechecked all patients after 6 or more months of therapy. Thirty-five patients were retested; 29 failed to react and six reacted with allergic symptoms. The 29 patients no longer reacted to foods treated with the sulfite chemicals.

Child↗
PubMed1976

Immunology of Allergy.

Immune reactions, presumably developed to rid organisms of troublesome invaders, are rather frequently associated with responses that result in injury to host tissue. Such responses are manifestations of allergy or hypersensitivity, and involve antibodies of certain immunoglobulin classes, complement components, mast cells and basophils, lymphocytes, macrophages, and various pharmacologic mediators and other soluble substances in an exuberant array of possible combinations. An understanding of clinical hypersensitivity diseases is aided by classifying basic allergic mechanisms into four main types: anaphylactic (Type I), cytotoxic (Type II), complex-mediated (Type III), and cell-mediated (Type IV), which may participate in various combinations in disease states.

Allergens↗
PubMedDate not supplied

Significant decrease of IgE antibodies after a three-year controlled study of specific immunotherapy to pollen allergens in children with allergic asthma.

BACKGROUND: Specific immunotherapy (SIT) in children being not an optional treatment should be administered as soon as possible, also in children aged 2-3 years, due to the very early asthma and rhinitis onset, contrarily to opponents continuing to stress the danger of anaphylactic reactions without displaying reliable data. MATERIALS AND METHODS: We report 56 children who underwent SIT and 56 controls seen consecutevely at the Allergy and Immunology Division, Department of Pediatrics, University of Rome "La Sapienza". The control group was treated with all appropriate medications. RESULTS: They were highly in favor of SIT with statistically significant differences. We stress that IgE antibodies significantly decreased after treatment only in the study group, and IgG antibodies very significantly increased after treatment only in the study group. DISCUSSION: We demonstrate that SIT is the only treatment which can alter the natural course of respiratory diseases, whereas drugs represent only a symptomatic treatment.

Allergens↗
PubMed1984

[Immunologic principles of allergic contact eczema].

Epicutaneous sensitization against contact allergens is mediated by T lymphocytes. For activation of these T lymphocytes antigen has to be presented in association with Ia by Langerhans cells. A further signal for activation of this cell is provided by interleukin 2. The production of interleukin 2 is induced by interleukin 1, which can be also produced by keratinocytes (epidermal T-cell activating factor, ETAF). The activated T-effector lymphocyte is controlled by T-suppressor lymphocyte subpopulations. The interaction between these cells is genetically controlled. A defect in this genetic control may play a role in contact sensitization against various allergens.

B-Lymphocytes↗
PubMed2004

[Sublingual hyposensitization].

Specific hyposensitization remains the only way to alter profoundly the progress of the allergic disease. The last discoveries in immunology allow better to understand the mechanisms of action. Now, we can use more purified and standardised solutions to improve the results. Subcutaneous way remains the gold method. But, since 10 years, European screws publishes the results of their works about alternative ways like sublingual way. Less dangerous and less compelling, it allows to begin the treatment earlier in the live and to give more important doses. The results are equivalent to the subcutaneous method. Recently, W.H.O. decided to consider sublingual immunotherapy as un full treatment of some allergic diseases.

Administration, Sublingual↗
PubMed1999

[Specific immunotherapy (hyposensitization) in allergic rhinoconjunctivitis. Meta-analysis of effectiveness and side effects].

BACKGROUND: Specific immunotherapy (SIT) of allergic disorders as introduced by Freeman and Noon involves the application of gradually increasing doses of extracts of the material to which the individual is sensitive. SIT represents the only specific treatment that can be offered to allergic patients besides allergen avoidance. SIT has been widely used in patients with pollen allergic rhinitis and its clinical efficacy has been demonstrated in several controlled clinical trials. The underlying mechanism of this treatment is still not understood. Previous studies have focused on changes in serum antibodies, including blunting of seasonal rises in specific IgE and increases in specific IgG antibodies, especially of the IgG4 isotype. Recent studies have suggested an effect on T-lymphocytes, leading to a switch from a predominant Th2 response--that is, interleukin (IL)-4 and IL-5--to a Th1 response involving interferon (IFN)-gamma. The switch of a cytokine profile to a predominant IFN-gamma response results in inhibition of IL-4 dependent IgE production, which is reinforced by a decrease in the production of IL-4 by Th2 cells. METHODS: In the present study a meta-analysis was performed to evaluate all double-blind placebo-controlled studies investigating the effect of SIT on clinical and immunological treatment used in patients with allergic rhinoconjunctivitis. RESULTS: SIT was shown to be an effective treatment modality in allergic rhinoconjunctivitis, decreasing symptoms, the need for medication and reactivity in specific nasal and conjunctival provocation tests, as well as inflammatory markers. Histologically, a switch might be induced from a predominant Th2 cell profile to that of a Th1. CONCLUSIONS: In general, the efficacy of SIT is dependent on the allergen the individual patient is sensitive to, the quality and total amount of the allergen applied and the SIT schedule.

Conjunctivitis, Allergic↗
PubMed2006

Does allergen-specific immunotherapy represent a therapeutic option for patients with atopic dermatitis?

House dust mite (HDM) allergens are perennial indoor allergens, which may play a role as allergic trigger factors in atopic dermatitis (AD). Facilitated by their high enzymatic activity, HDM allergens are capable of penetrating the impaired epidermal skin barrier in patients with AD, gaining access to immune cells. In this way, HDM allergens induce both allergic reactions of the immediate type and allergic reactions of the delayed type, which contribute to impairment of AD. Because allergen reduction achieved by encasing strategies does not always lead to significant improvement of clinical symptoms, specific immunotherapy (SIT) might represent an attractive therapeutic option for long-time treatment of this subgroup of patients with AD. However, systematic studies on the effectiveness of SIT in patients with AD are rare. Furthermore, data on the immunologic changes induced by SIT in patients with AD are not well studied. In this review, we provide an overview of the pathogenic impact of HDM allergens as an example for aeroallergens on the course of AD. In addition, we discuss prophylactic and therapeutic options for the treatment of HDM allergy in patients with AD, including a summary of the current data available on SIT as a potential therapeutic option for patients with AD.

Adolescent↗
PubMed1981

Adverse reactions to venom immunotherapy.

The authors treated 22 adults patients with histories of systemic hypersensitivity to hymenoptera with venom extracts using a traditional approach to immunotherapy. Patients had an immunological response consisting of an increase in venom specific IgE and IgG. Twelve patients underwent an uneventful in-hospital insect sting challenge. Injections of venom extract elicited large reactions in 50% of the patients for which subsequent venom dosages were adjusted proportionately to the local reaction. Using this approach, the investigators observed no systemic reactions to venom therapy. They conclude that systemic reactions to venom immunotherapy may be lessened by the adjustment of venom dose after local reactions to therapy without a loss of efficacy.

Antibodies↗
PubMed1999

Long-term treatment with allergoid immunotherapy with Parietaria. Clinical and immunologic effects in a randomized, controlled trial.

BACKGROUND: Specific immunotherapy (SIT) is a valuable treatment for respiratory allergy, and the use of chemically modified allergens (allergoids) has improved its safety, as testified by several studies. We evaluated the effects of a SIT course with an allergoid extract of Parietaria pollen in a double-blind, placebo-controlled trial. METHODS: The study was double-blind in the first year; then it was prolonged up to 3 years with all patients on active treatment. Clinical effectiveness, safety, skin reactivity, systemic immunologic parameters, and subjective assessment were evaluated. We also had available a self-evaluation recorded in a follow-up visit 4 years after the discontinuation of SIT. RESULTS: A significant reduction of the symptoms plus drug intake scores during the pollen seasons was observed in the patients receiving active SIT. The placebo patients, after switching to active SIT, also showed significant clinical improvement. The clinical efficacy persisted during years 2 and 3 of treatment. After year 1, the actively treated patients reported a significant subjective improvement (frequency of symptoms, P = 0.001; duration of symptoms, P = 0.024; physical performance, P = 0.043) compared with the placebo group. The self-evaluation by visual analog scale showed that all patients maintained a significant clinical improvement up to 4 years after discontinuing SIT (year 1: active=+31.6%, placebo=-15.7%; year 7: active=+35.8%, placebo=+31.3%). The systemic immunologic changes after active SIT paralleled those described elsewhere (IgE decreased from 22 to 9 and from 21 to 8 IU/ml; IgG4 increased from 43 to 87 and from 18 to 60 IU/ml). A significant decrease in skin reactivity to three different allergen concentrations was observed at year 3 compared with pretreatment values (P<0.05). CONCLUSIONS: The investigational SIT with Parietaria appeared to be effective and safe; a 3-year course of treatment achieved a long-lasting efficacy.

Adolescent↗
PubMed1994

A three-year double-blind placebo-controlled study with specific oral immunotherapy to Dermatophagoides: evidence of safety and efficacy in paediatric patients.

Very few double-blind trials of oral immunotherapy have been reported. The majority of these have been performed with pollen extracts and the results have often been equivocal. The major weaknesses of these studies have been the short periods of the trials, the low doses of allergen employed and inadequate evaluation of efficacy. The present study has involved a placebo-controlled double-blind trial of oral immunotherapy for three years with Dermatophagoides pteronyssinus at relatively high doses in 18 paediatric patients. Throughout the trial clinical parameters (symptom and medication scores) and immunological parameters (specific IgE, IgG1 and IgG4 levels) were monitored in order to assess the safety and efficacy of the treatment. The treatment was well tolerated by all patients and no side-effects were experienced. Clinical improvement was evident after the second year of therapy and this was confirmed by a significant reduction in conjunctival reactivity assessed by a specific conjunctival provocation test. In addition, there were significant changes in the immunological parameters with a reduction in specific IgE and increased levels of IgG4 and IgG1, results in keeping with previous studies of oral and subcutaneous immunotherapy. Although the results do not provide an explanation of the basis of successful oral immunotherapy, they clearly demonstrate the efficacy and safety of the treatment and suggest that it may be a useful and more acceptable alternative for patients than the traditional subcutaneous immunotherapy.

Administration, Oral↗