Immunotherapy with partially purified and standardized tree pollen extracts. IV. Results from long‐term (6‐year) follow‐up

Abstract

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.

Asthma-related comorbidities

“…Previous studies showed a reduction in long-term asthma risk among allergic rhinitic patients treated with SIT [68,69]. Meta-analyses show that this treatment could be beneficial in pollen-induced rhinitis and asthma, but state that more investigations are needed to determine its efficacy in house dust mite allergy [70].…”

Allergy Vaccine Engineering: Epitope Modulation of Recombinant Bet v 1 Reduces IgE Binding but Retains Protein Folding Pattern for Induction of Protective Blocking-Antibody Responses

“…The most pronounced serological marker of successful vaccination is a 30-to 100-fold increase in allergenspecific IgG (11,12), whereas there is no substantial change in IgE comparing pre-and posttreatment (6). Furthermore, as shown for pollen allergy, the treatment gradually attenuates the seasonal rise in IgE (11) and leads to a seasonal rise in IgG, particularly IgG 4 (13).…”

Effects of Allergen Specific Immunotherapy on the Allergens Excluded From the Treatment

“…A link between allergic rhinitis and atopic asthma has been demonstrated in numerous epidemiological studies. It is reported that 25 to 43 % of the patients experiencing rhinitis naturally develop asthma within 10 years (21,22), whereas in the study by Jacobsen et al, (14) none of the patients with allergic rhinitis developed asthma over a sixyear period following the termination of immunotherapy.…”

“…This mechanism of action has been unique, and different from any other pharmacological treatment in many respects. First, SIT can modify the natural history of allergic disease, as confirmed in rigorously conducted trials (13,14). Second, SIT can prevent the onset of new sensitizations, as demonstrated clearly in children in several studies (15,16).…”

“…Jacopsen et al (14) studied the long term effects of tree pollen extract immunotherapy by following up the symptom scores and skin tests in 36 patients in 6 years after a 3 year course of immunotherapy. The data showed that 86 % of the patients with rhinitis and 68 % of the patients with asthma maintained improvement after the termination of the treatment.…”