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Results for “Desensitization, Immunologic”

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PubMed1997

[Atopic dermatitis].

Atopic dermatitis is a type of eczema determined by polygenic inheritance which is often associated with further phenotypes of the atopic syndrome such as extrinsic asthma and allergic rhinoconjunctivitis. Discussion of pathogenesis includes complex immunological and biochemical disorders as well as various triggering environmental factors. Characteristic patterns of distribution and morphology of the lesions vary with the patient's age. In addition, there is a broad spectrum of clinical variants. Diagnosis is based on stage-dependent eczematous morphology, if necessary validated by histology, family and personal history and clinical features of atopy, as well as on the results of allergologic assessment primarily comprising intra- and epicutaneous testing. Topical corticosteroids still are the main therapeutic approach.

Administration, Topical↗

PubMedDate not supplied

Donor bone marrow transplantation: chimerism and tolerance.

Infusion of donor bone marrow (DBM)-derived cells continue to be tested in clinical protocols intended to induce specific immunologic tolerance. Central clonal deletion of donor-specific alloreactive cells associated with mixed chimerism reliably produced long-term graft tolerance. In this setting, depletion of recipient T cells by antilymphocyte antibodies and subsequent repopulation by donor hematopoietic cells after donor bone marrow infusion (DBMI) are prerequisites for tolerance induction. Major advances have been made in animal models and in pilot clinical trials and the key questions with the future perspectives are presented in this article.

Animals↗

PubMedDate not supplied

[Latex allergy].

Latex allergy has become an increasing cause of morbility in the last few years and is now recognized as an international health problem. The prevalence of latex sensitization among the general population is less than 1 %. The groups at highest risk include healthcare workers, rubber industry workers, patients with a history of multiple surgical procedures, particularly children with spina bifida and urogenital abnormalities, atopic individuals, and patients with certain fruit allergies (especially kiwi, avocado, chestnut and banana). The molecular and immunological characteristics of several natural latex allergens have been identified. Symptoms range from contact urticaria to anaphylaxis. Diagnosis is based on clinical history and is confirmed by skin prick tests. Measurement of serum specific IgE to latex can also be useful. The best treatment is latex avoidance and substitution by other materials. However, because latex products are ubiquitous in medical and nonmedical devices of daily use, a latex-free environment is not easy to achieve. In some patients, immunotherapy could be an alternative.

Allergens↗

PubMed2002

Novel approaches for the treatment of food allergy.

At present there is no effective therapy for IgE-mediated food allergy, and patients must rely upon food-allergen avoidance. Unfortunately, the accidental ingestion of allergen-containing foods leading to potentially severe reactions is common. Definitive therapies for food allergy are desperately needed. Although rush immunotherapy has been reported to induce tolerance in some patients, the rate of maintenance of tolerance was low, and there was an undesirably high incidence of adverse reactions. New knowledge of the immunological mechanisms underlying allergic disease has expanded the potential therapeutic options for food allergy. The establishment of animal models of food hypersensitivity, which include sensitization by the oral route and anaphylaxis upon oral challenge, have facilitated the investigation of therapies for food allergy. Novel approaches under investigation include the reduction of IgE by the infusion of anti-IgE antibodies, vaccination with plasmid DNA, the use of anti-allergy immunostimulatory sequences, cytokines and bacterial agents, immunotherapy with mutated proteins and peptides, and complementary medicine such as Chinese herbs.

Antibody Specificity↗

PubMed2001

The role of interleukin 10 in the regulation of allergic immune responses.

Several clinical studies and animal models have shown that Th2 lymphocytes play a key role in the pathophysiology of IgE-mediated allergic immune responses like allergic rhinitis and asthma or venom anaphylaxis. Classical specific immunotherapy (SIT) that has been proven to be clinically effective can serve as a role model for immunological changes that are associated with amelioration of allergic diseases. During SIT, the Th2-dominated immune response is modified towards a Th1 response leading to a decline in allergen-specific IgE and an increase in allergen-specific IgG production. Most importantly, however, production of the immunosuppressive/-regulatory cytokine interleukin 10 (IL-10) is also induced leading to T cell tolerance and prevention of tissue inflammation. In this article the role of IL-10-producing T cells in the regulation of allergic immune responses will be discussed.

Clonal Anergy↗

PubMed2001

Safety and efficacy of specific immunotherapy with standardized allergenic extracts adsorbed on aluminium hydroxide.

Specific immunotherapy (SIT) with standardized allergenic extracts is the only specific treatment of allergic patients. In order to evaluate the safety, side effects, and efficacy of SIT with standardized extracts adsorbed to aluminium hydroxide manufactured by Stallergènes S.A., a prospective multicenter open study was performed in Switzerland. Fifteen patients suffering from seasonal or perennial rhinoconjunctivitis with or without asthma were included in the trial and received a total of 442 injections with standardized mix of grass pollens (n = 8) or house dust mites (n = 7) over one year. Low incidence of local reactions was noted (7%). Subcutaneous nodules (granuloma) following injections were not recorded. Only a few systemic reactions (one mild rhinitis, one mild asthma attack, one worsening of eczema) were recorded. No anaphylactic reactions requiring adrenaline were recorded. No admission to the hospital was required. Global appreciation of the physicians and the patients after the first year of treatment showed a good efficacy of SIT: Only two patients (13%) did not improve. A worsening of the symptoms was not observed. In order to assess the efficacy, skin reactivity and conjunctival reactivity to allergen challenge were compared before and after one year of treatment as well as immunologic parameters (such as specific IgE, specific IgG4) in blood samples. A significant decrease in skin reactivity (p = .001) and in conjunctival reactivity (p = .01) was observed. Specific IgE level decreased for both types of allergens but to a significantly greater extent for grass pollen allergen (p = .03). Specific IgG4 level increased significantly for grass (p = 0.01) and for mites (p = 0.04). Specific immunotherapy appears to be a valuable tool in the efficient management of the allergic respiratory diseases.

Adult↗

PubMed1991

Local immunotherapy by inhalation of a powder extract in asthma due to house dust mite Dermatophagoides pteronyssinus: a double-blind comparison with parenteral immunotherapy.

To verify the efficacy and the tolerability of local immunotherapy (LI) by inhalation of a powder extract of house dust mite (HDM), in comparison with parenteral immunotherapy (PI) by injection, 10 patients with asthma due to HDM were studied in a blind fashion. 5 patients (Group A) underwent LI and subcutaneous injections of placebo, 5 patients (Group B) underwent PI and inhalation of lactose for 6 months. In both groups each inhalation was preceded by premedication with disodium cromoglycate (DSCG) (40 mg). In Group A a significant decrease in symptoms score and in peak expiratory flow (PEF)-derived parameters was observed already after 3 months of treatment, and 2 patients lost the late component of the bronchial response to the challenge with HDM. No significant variation was found in bronchial responsiveness to methacholine and ultrasonically nebulized distilled water (UNDW) and in immunologic humoral and cellular parameters in peripheral blood after treatment in either group. No local important adverse reactions were observed in Group A and no systemic side effects were observed in either group. We conclude that LI is as effective as PI, but more rapid in its action, in the treatment of asthma due to HDM. Moreover, LI is locally well tolerated, providing DSCG is inhaled before each therapeutic inhalation, and does not induce systemic side effects.

Administration, Inhalation↗

PubMed1981

[Immunologic studies in allergic children].

IgG-mediated allergic reaction can be provoked by inhalants (pollens, moulds, dust, animal danders), by food allergens, drugs and by hymenoptera venoms. The level of total-IgE is higher in allergic patients than in normal children. The degree of clinical sensitivity can be evaluated by the estimation of allergen specific IgE together with the patient's history and the results of the skin test. The allergy against bee venom is a suitable model for the immediate hypersensitivity. The assessment of the therapeutic efficacy of hyposensitization treatment can be achieved by the course of the allergen specific IgE- and IgG-antibodies and the insect sting challenge.

Antibody Specificity↗

PubMedDate not supplied

Effect of immunotherapy on antigen-specific IgG4 in asthmatics sensitive to D. pteronyssinus.

The aim of this paper is to study the optical density (O.D.) values, correlated with an ELISA system to determine specific IgG4 levels against D. pteronyssinus in the serum of 20 control subjects, 35 asthmatic patients without previous immunotherapy (I.T.) and 77 patients who had variable periods of I.T. The group of non-treated patients showed specific IgG4 levels which were significantly higher than those of the control group (p less than 0.05). In this group of patients, 31.43% of the cases showed levels superior to the control group. All treated patient groups showed specific IgG4 levels which were significantly higher than those of the control group and than those of the non-treated patients, with various levels of significance (see Table IV). Of the asthmatic patients with I.T. as a whole group, 59.74% showed O.D. levels superior to the control group. The highest level of specific IgG4 was found in the patient group with the longest time of I.T. There was no significant correlation between the specific IgG4 levels with the different immunologic parameters (cutaneous reactivity, HRT, total and specific IgE). As for the clinical picture, there were no significant differences in comparing active with inactive patients during the period of study. There were no statistically significant differences in the levels observed between patients with a good clinical course and those who did not respond favourably, although all the groups of patients with a good response had higher specific IgG4 levels. This way, these antibodies may play the role of a blocking agent.

Adolescent↗

PubMed1999

The immunological and clinical effects of immunotherapy in patients suffering from house dust allergy.

A group of 48 patients with asthma and rhinitis, sensitive to house dust allergen, underwent immunotherapy with an extract of crude house dust for a period of 6-12 months. The clinical results of the therapy, as evaluated by symptom medication scores, demonstrated the significant clinical improvement of the patients treated by crude dust extract (CDE) compared to those treated by placebo. A significant (p < 0.001) reduction of specific IgE and elevation (p < 0.001) of specific IgG in the post-therapeutic patient sera was demonstrated by serological tests. A good correlation was observed between the changes in specific IgE and IgG levels.

Adolescent↗

PubMedDate not supplied

Food allergens transformed into tolerogens.

Antigen presentation determines immunologic outcome, and by modifying the presentation of allergen to the host one can prevent an allergic response. Under certain conditions, covalent linkage, of ovalbumin to rat IgG, a molecule already tolerated by the host, can make a protein-IgG conjugate which down-regulates the immune response to this food allergen. The suppression is allergen specific. It affects both T and B cell immune responses. Administration of allergens linked to isologous IgG may provide a novel strategy for allergy prevention.

Allergens↗

PubMed2006

Immunological mechanisms of allergen-specific immunotherapy.

Allergen-specific immunotherapy has been carried out for almost a century and remains one of the few antigen-specific treatments for inflammatory diseases. The mechanisms by which allergen-specific immunotherapy exerts its effects include the modulation of both T-cell and B-cell responses to allergen. There is a strong rationale for improving the efficacy of allergen-specific immunotherapy by reducing the incidence and severity of adverse reactions mediated by IgE. Approaches to address this problem include the use of modified allergens, novel adjuvants and alternative routes of administration. This article reviews the development of allergen-specific immunotherapy, our current understanding of its mechanisms of action and its future prospects.

Allergens↗

PubMed1990

[Hyposensitization: indications and expectations].

Allergy is the most frequent immunologic disorder in childhood. The prevalence of allergic complaints among children is estimated as about 10%. The diagnosis of an allergy takes the following factors into account: The patient's history, skin test, determination of total and specific IgE antibodies and a provocation test to a diseased organ. Hyposensitization is recommended for allergic patients without any significant improvement in spite of avoidance of allergen and in spite of pharmacologic therapy. Modified allergens/allergoids demonstrate a comparable efficacy as a conventional subcutaneous allergen immunotherapy. Measurement of specific IgE- and IgG-antibodies permits an evaluation of degree of sensitization and/or immune response to hyposensitization treatment.

Allergens↗

PubMed1999

[Induction of penicillin tolerance in therapy of neurosyphilis in penicillin allergy].

Pharmacologically or immunologically induced hypersensitivity to penicillin is frequent. Immunological, i.e., allergic, hypersensitivity reactions are among the most important side effects and can lead to severe and life-threatening reactions. All types of allergic reactions have been described secondary to penicillin therapy. Immediate type hypersensitivity reactions, the symptoms of which range from urticaria and angioedema to respiratory and cardiovascular symptoms, and finally to life threatening full anaphylactic shock are particularly dangerous. This case-report demonstrates that in a patient allergic to penicillin, in whom there is a vital indication to administer this compound, the drug can be given safely after tolerance induction.

Aged↗

PubMed1984

IgG, IgA, IgM and IgE serum levels in asthmatic patients sensitive to house dust and mite allergens after two-year specific immunotherapy.

The investigations were carried out on 36 atopic asthma patients treated with a specific allergen vaccine--Allpyral. The serum immunoglobulin levels, specific IgE blocking antibodies were determined by various immunological methods. It was shown that a marked rise in the IgG level appeared after 6 months of therapy and maintained during the whole period of observation. This higher IgG level was often correlated with an increase in blocking antibody titer. IgE serum revealed a higher value after 6 months, but on prolongation of the immunotherapy the total IgE level decreased not statistically significantly. The specific IgE antibody showed a tendency to fall after 2-year hyposensitization. The most marked changes in the behaviour of specific IgE and blocking antibodies were observed in the patients with clinical improvement.

Adult↗

PubMedDate not supplied

Therapeutic targets in allergic eye disease.

The objective of this article is to provide an overview of the present state of treatment of ocular allergy. Immuno-ophthalmology arose in the portion of this past century when investigators uncovered the uniqueness of the lens proteins and that it could induce an immunological response otherwise know as phacoanaphylaxis. Further studies have shown many similarities between the eye and other organ systems, but one of the most profound problems was the spring "catarrh" that involved the eyes and nose, i.e., rhinoconjunctivitis. Treatment over the past 10 years has expanded with the better understanding of the allergic response at the conjunctival surface. Allergen immunotherapy remains a cornerstone of treatment. In fact, the very first report of the use of immunotherapy in 1911 "measured the patient's resistance during experiments ... of pollen extracts to excite a conjunctival reaction" (Noon L, and Cantar BO, Lancet 1572-1573, 1911).

Anti-Allergic Agents↗

PubMed1981

[Immunotherapy (hypo-/desensitization) in allergic diseases (author's transl)].

The aim of hyposensitization therapy is to achieve an allergen tolerance. The solutions for hyposensitization are available as water soluble, semi-depot or depot allergen extracts. The strengths of the solutions are given in the following units: PNU (protein nitrogen units), w/v (weight/volume) and HEP (histamine equivalent in pricktesting). A comparison between the units is of limited value, as no information about the immunological potency is possible. Most experience centres on the parenteral allergen application, but recently oral hyposensitization has gained ground. The hyposensitization treatment can be performed in the conventional manner or in the form of a rapid hyposensitization. The length of treatment is at least 2 years. The assessment of the therapeutic efficacy of the treatment can be achieved by the history of natural allergen exposition, provocation tests on the target organs, the course of the allergen specific IgG and IgE antibodies as well as testing the histamine release from leukocytes. Further improved efficacy, shortening of the course of immunisation and the elimination of side effects should be developed.

Child↗

PubMedDate not supplied

Preseasonal specific immunotherapy with modified phleum pratense allergenic extracts: tolerability and effects.

UNLABELLED: The preparation of chemically modified allergens, with a reduced IgE binding capacity (responsible for side effects with traditional immunotherapy) but with the same or greater immunogenic activity, is one of the paths followed to obtain better results with specific immunotherapy (IT). The aim of the study was to evaluate the tolerability and effects of extracts of Phleum pratense, modified with glutaraldehyde and absorbed on aluminium hydroxide, in controlling the seasonal symptomatology induced by grass pollen in a group of 10 monosensitized patients, compared to a group of 10 similar patients not treated with specific IT but with drugs alone. The monitoring parameters were: 1) Clinical: a) symptomatology after specific conjuctival provocation test (pre and post seasonal) and during the natural exposure to the allergen b) drug consumption. 2) Immunological (peripheral blood eosinophils, total and specific IgE, total specific IgG). 3) Cytological, before, during and after the pollen season. CONCLUSIONS: in subjects treated with specific IT a) both the overall symptomatology and the drug consumption resulted significantly reduced compared to the controls (p = 0.045); b) the phlogistic infiltrate showed a tendency to decrease during the pollen season; c) the peripheral blood eosinophils, total and specific IgE and IgG did not show any significant variation compared to the controls; d) no systemic reactions occurred and there were only two slight local reactions.

Adolescent↗