TY - JOUR
T1 - Effects of immunotherapy on the early, late, and rechallenge nasal reaction to provocation with allergen
T2 - Changes in inflammatory mediators and cells
AU - Iliopoulos, Othon
AU - Proud, David
AU - Adkinson, N. Franklin
AU - Creticos, Peter S.
AU - Norman, Philip S.
AU - Kagey-Sobotka, Anne
AU - Lichtenstein, Lawrence M.
AU - Naclerio, Robert M.
N1 - Funding Information:
From the Departments of Medicine (Division of Clinical Immu-nology) and Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md. Supported in part by National Institutes of Health Grants DC 00320, AI 08270, HL 32272, and AI 04866. Received for publication Feb. 13, 1990. Revised Oct. 8, 1990. Accepted for publication Oct. 22, 1990. Reprint requests: Robert M. Naclerio, MD, The Johns Hopkins Asthma and Allergy Center, 301 Bayview Blvd., Unit Office 7, Baltimore, MD 21224. Publication No. 033 from The Johns Hopkins Asthma and Allergy Center. *Dr. Lawrence M. Lichtenstein is the recipient of a Pfizer Biomed-ical Research Award. 111126322
PY - 1991/4
Y1 - 1991/4
N2 - We investigated the effects of immunotherapy (IT) on the early (ER), late (LPR), and rechallenge reactions (RCRs) to nasal challenge with antigen as well as on the cutaneous ER and LPR to intradermal skin challenge. Our expectation was that IT would have a preferential effect on the LPR, and our aim was to understand the mechanism. Twenty-one ragweed hay fever-sensitive subjects were treated with a moderate dose of antigen extract (maintenance dose of 1.94 μg of antigen E (Amb a I)) during a period of 8 months (total dose equivalent to 24 (μg of antigen E), and 20 matched subjects received placebo injections in a double-blind manner. Both groups underwent identical nasal challenges and intradermal skin tests with ragweed-antigen extract both before 1985 and during 1986 IT. Symptom and medication diaries, recorded during seasonal exposure, and changes in specific serum IgE and IgG antibodies confirmed the efficacy of the administered IT dose. Between-group analysis revealed that IT significantly reduced the levels of histamine, TAME-esterase activity, and kinins, as well as symptoms of rhinorrhea and congestion generated during the ER to nasal challenge. Within-group paired analysis demonstrated ER, LPR, and RCR mediators and symptoms also to be reduced by IT. Surprisingly, the placebo-treated group demonstrated an increase in the ER. There was no decrease of the LPR without an antecedent decrease of the ER. IT did not clearly change the late cellular inflammatory response. In the case of skin challenge, IT significantly reduced the cutaneous ER. The reduction of the cutaneous LPR was more pronounced. We speculate that moderate-dose IT ameliorates seasonal symptoms of allergic rhinitis by reducing the ER, LPR, and RCR to antigen challenge but does not preferentially reduce the nasal LPR.
AB - We investigated the effects of immunotherapy (IT) on the early (ER), late (LPR), and rechallenge reactions (RCRs) to nasal challenge with antigen as well as on the cutaneous ER and LPR to intradermal skin challenge. Our expectation was that IT would have a preferential effect on the LPR, and our aim was to understand the mechanism. Twenty-one ragweed hay fever-sensitive subjects were treated with a moderate dose of antigen extract (maintenance dose of 1.94 μg of antigen E (Amb a I)) during a period of 8 months (total dose equivalent to 24 (μg of antigen E), and 20 matched subjects received placebo injections in a double-blind manner. Both groups underwent identical nasal challenges and intradermal skin tests with ragweed-antigen extract both before 1985 and during 1986 IT. Symptom and medication diaries, recorded during seasonal exposure, and changes in specific serum IgE and IgG antibodies confirmed the efficacy of the administered IT dose. Between-group analysis revealed that IT significantly reduced the levels of histamine, TAME-esterase activity, and kinins, as well as symptoms of rhinorrhea and congestion generated during the ER to nasal challenge. Within-group paired analysis demonstrated ER, LPR, and RCR mediators and symptoms also to be reduced by IT. Surprisingly, the placebo-treated group demonstrated an increase in the ER. There was no decrease of the LPR without an antecedent decrease of the ER. IT did not clearly change the late cellular inflammatory response. In the case of skin challenge, IT significantly reduced the cutaneous ER. The reduction of the cutaneous LPR was more pronounced. We speculate that moderate-dose IT ameliorates seasonal symptoms of allergic rhinitis by reducing the ER, LPR, and RCR to antigen challenge but does not preferentially reduce the nasal LPR.
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U2 - 10.1016/0091-6749(91)90134-A
DO - 10.1016/0091-6749(91)90134-A
M3 - Article
C2 - 2013680
AN - SCOPUS:0025732717
SN - 0091-6749
VL - 87
SP - 855
EP - 866
JO - The Journal of allergy and clinical immunology
JF - The Journal of allergy and clinical immunology
IS - 4
ER -