Monitoring of mite Dermatophagoides farinae allergen‐specific IgG and IgG subclass distribution in patients on immunotherapy

Abstract

House dust mite D. farinae and Der f II‐specific IgG and IgG subclass responses were evaluated in 32 adults with perennial rhinitis undergoing immunotherapy for 1 year by means of IgG‐RAST and ELISA. The ELISA method, which is based on subclass‐specific monoclonal antibodies, could detect 0.5–1.5 ng/ml of specific antibodies. D. farinae and Der f II‐specific IgG4 antibodies increased continuously as immunotherapy proceeded, while total IgG and IgG1 antibodies reached a plateau value 6 months after the start of immunotherapy, followed by a slow decrease during maintenance therapy. During the early phase of treatment the concentration of IgG, and IgG4 antibodies rose, even though the increase of IgG4 antibodies dominated. The positive clinical outcome as measured by the decrease in conjunctival sensitivity was associated with an increased ratio of specific IgG4/IgG, antibodies as well as the magnitude of the IgG4 subclass response. Quantitation of IgG subclass antibodies in patients undergoing immunotherapy may be of some clinical value, but the clinical usefulness needs to be demonstrated for each type of allergen and possibly also for each assay system.

Immunotherapy with standardized extract of Dermatophagoides pteronyssinus in bronchial asthma: a dose‐titration study

“…The change in most of these in vitro parameters was 15-100-fold for patients of the HDI group, in contrast to other studies of SIT with mites, in which the change observed was 3-10-fold (42)(43)(44). We observed a great difference between both groups of patients, according to the maintenance doses reached.…”

Use of peptides to selectively modulate CD4+ T-cell responses

“…After allergen desensitization therapy, clinical improvements and a decrease in immediate and late phase skin reactivity sometimes correlate with a long-term (over 12 months) rise in specific IgG, particularly IgG4, and a decrease in specific IgE. In the short term (over 3 months), specific IgE and IgGl may rise [2]. However, there are numerous studies in which humoral changes do not correlate with clinical outcome, and the role of immunoglobulin isotypes in the protective or pathological immune response to allergens is poorly understood.…”

Inmunoterapia con alérgenos: mecanismos de acción, impacto terapéutico y socioeconómico. Consenso de la Asociación Colombiana de Alergias Asma e Inmunología

“…En las últimas dos décadas, se han llevado a cabo varios estudios aleatorios controlados en los cuales se ha demostrado que un porcentaje importante de los pacientes con dermatitis atópica se puede beneficiar con esta terapia, aunque su impacto varía de acuerdo con la gravedad de la enfermedad (57)(58)(59)(60)(61). En un estudio en Medellín, Colombia, se observó que los pacientes con dermatitis moderada según la puntuación en el Scoring Atopic Dermatitis (SCORAD), tuvieron una mayor y más significativa reducción de los síntomas en comparación con el grupo placebo, así como un aumento significativo de la IgG4 (62) y una disminución en la capacidad de activación de los basófilos (25), lo que indicaría una disminución sostenida de la reacción inflamatoria.…”