The long-term effect of tree pollen extract immunotherapy was investigated 6 years after termination of the treatment. Subjective symptom evaluation of 36 patients 6 years after a 3-year period of immunotherapy showed that rhinitis and asthma symptoms remained at the improved level reached just after termination of the treatment. Some 86% of the rhinitis patients and 68% of the asthma patients maintained improvement. None of the rhinitis patients developed asthma in the study period. Skin prick tests reflected the outcome of the subjective symptom assessment. The skin sensitivity of the patients decreased significantly during immunotherapy, and the skin reactions 6 years after specific immunotherapy were still significantly lower than the pretreatment levels. Total IgE and birch-specific IgE levels were constant throughout the study period, and both the affinity and epitope specificity of the IgE antibodies of the patients were the same before, during, and 6 years after treatment. In conclusion, specific immunotherapy reduces symptoms in patients suffering from rhinitis and asthma, and the effect is maintained 6 years after termination of the treatment. Specific immunotherapy seems to prevent long-term development of asthma in rhinitis patients. IgE measurements do not reflect the overall status of the patients.

The specificity pattern of IgE from non-treated tree pollen allergic patients (n = 38) were evaluated by solid phase absorption of serum samples followed by CRIE on alder, birch and hazel CIE precipitation profiles. The majority of the serum samples seemed to contain IgE antibodies with the following characteristics: specific towards Bet v I alone and common between Aln g I, Bet v I and/or Cor a I, 'II'. The IgE specificity profiles observed for 95% of the sera tested are compatible with birch pollen allergens being the only sensitizing allergens, indicating that the patients react to allergens from other tree pollens of the Fagales order due to IgE cross-reaction with the major allergens of birch and alder and/or hazel pollens.

Dialysed extracts of alder (Alnus glutinosa) and hazel (Corylus avellana) pollens were characterized by immunochemical methods. The alder pollen extract contained at least 33 distinct antigens of which one, antigen 5, was classified as a major allergen, three, antigens 4, 10, and 17, were classified as intermediate allergens and two, antigens 19 and 23, were classified as minor allergens. The molecular weight and pI of the major allergen were determined to be 19,000 D and 5.2, respectively. The hazel pollen extract contained at least 40 distinct antigens, two of which were classified as major allergens, antigens 8 and 13, three as intermediate allergens, antigens 12, 17, and 26, and seven as minor allergens, antigens 6, 11, 16, 18, 29, 39, and 40. The molecular weights and pI's of the major allergens of hazel pollen were determined to be: antigen 8; Mw = 12,000 D, pI = 5.1 and less than 3.5, antigen 13; Mw = 26,000 D, pI = 5.1. Further, crossed line immunoelectrophoresis and tandem crossed immunoelectrophoresis of alder, birch and hazel strongly indicate that there exists an immunochemical partial identity between the major allergens (antigens 5 (alder), 23 (birch), and 13 (hazel)) from these tree pollens.

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