Allergen-Specific IgE and IgG4 as Biomarkers for Immunologic Changes during Subcutaneous Allergen Immunotherapy

Abstract

(1) Background: Biomarkers of efficacy for subcutaneous immunotherapy (SCIT) on allergic rhinitis have not been evaluated in details. The present study aims to assess the relevance of measuring of sIgE, sIgG4 and IgE/IgG4 ratio during SCIT in patients with allergic rhinitis; (2) Methods: 20 patients, 13 men and 7 women aged 19 to 58 years, with clinically manifested seasonal and perennial allergic rhinitis were studied. At the initiation and in the end of the three-year course of SCIT serum allergen-specific IgE and IgG4 were measured with ImmunoCAP system. The sIgE/sIgG4 ratio was calculated as a biomarker for immunologic effectiveness; (3) Results: There was a significant increase of sIgG4 antibodies (p < 0.05), while at the end of SCIT for the sIgE levels no significant changes were seen (p > 0.05). Moreover, 90% of patients showed a decrease of the IgE/IgG4 ratio; (4) Conclusions: In most of treated patients with AR, SCIT with Bulgarian allergen products leads to clear immunological changes. After a 3-year of SCIT there is a significant increase in allergen specific IgG4 levels and both decrease of sIgE and IgE/IgG4 ratio. sIgE, sIgG4 and IgE/IgG4 ratio can be used as a substantial biomarker for predicting immunological effectiveness of SCIT.

Efficacy of short‐term combination of intralymphatic allergen immunotherapy and lokivetmab treatment in canine atopic dermatitis: A double‐blinded, controlled, randomised study

“…Within the duration of this study, no changes induced by ILIT measured by serum AsIgE could be found. Repeated measurements over a year or more are likely to be required to better assess changes in AsIgE 11,39 However, in a six-month trial of SLIT a decrease in median serum IgE of D. farinae and increase of median serum IgG concentrations was seen. 13 Use of LVM over a sixmonth period (in the LVM group) may have resulted in a decrease in AsIgE concentrations.…”

Mechanisms and biomarkers of successful allergen-specific immunotherapy

“…The immunosuppressive role of Tregs is crucial in maintaining the homeostatic balance during dysregulated immune responses of asthma inflammation, and AIT enhances the local functional role of Treg cells. IL-10 produced by Treg cells mediates the changes in sIgE to sIgG4 seen in AIT [ 100 ]. Justicia et al [ 101 ] identified increased levels of sIgG4 and sIgE, and IL-10 involved in mechanisms of immune tolerance was induced by AIT specific for HDM.…”

Exploratory immunogenicity outcomes of peanut oral immunotherapy: Findings from the PALISADE trial

“…Some patients may now complete their treatment strategy with controlled exposure using an approved and regulated peanut oral immunotherapy (OIT) in children to achieve desensitization that could protect them from accidental exposures 9,10 . Following immunotherapy for peanut allergy, allergen‐specific IgG4 levels have been found to increase 11–14 and specific IgE levels to peanut and peanut skin prick test to be reduced, 11,12,14 which is aligned with serology changes observed with the rest of the allergen‐specific immunotherapies 15–19 …”

“…9,10 Following immunotherapy for peanut allergy, allergen-specific IgG4 levels have been found to increase [11][12][13][14] and specific IgE levels to peanut and peanut skin prick test to be reduced, 11,12,14 which is aligned with serology changes observed with the rest of the allergen-specific immunotherapies. [15][16][17][18][19] Peanut (Arachis hypogaea) allergen powder-dnfp (PTAH; PAL-FORZIA ® , previously known as AR101) is a biological product for peanut OIT approved in the United States for the mitigation of allergic reactions, including anaphylaxis, that may occur following accidental exposure to peanut in patients with a confirmed diagnosis of peanut allergy, and in Europe for the treatment of patients with a confirmed diagnosis of peanut allergy. 20,21 Dose escalation with PTAH may be initially administered to patients aged 4-17 years, and treatment can be continued thereafter, including in older (aged ≥18 years) patients.…”

“… 9 , 10 Following immunotherapy for peanut allergy, allergen‐specific IgG4 levels have been found to increase 11 , 12 , 13 , 14 and specific IgE levels to peanut and peanut skin prick test to be reduced, 11 , 12 , 14 which is aligned with serology changes observed with the rest of the allergen‐specific immunotherapies. 15 , 16 , 17 , 18 , 19 …”