title: Clinical and immunological effects of immunotherapy with alum-absorbed grass allergoid in grass-pollen-induced hay fever.
abstract: A double-blind, placebo-controlled study of immunotherapy was conducted in 19 patients with grass-pollen hay fever to evaluate the efficacy and safety of a formalinized depot grass allergoid. The patients were assessed before and during IT by clinical (symptom-medication scores during the grass- pollen season, specific nasal and skin reactivity) and immunological (specific IgE, IgG, IgG1 and IgG4 antibodies) parameters. High doses of grass allergoid, corresponding to a cumulative pre-seasonal dosage of 46,050 PNU, were administered, with only one systemic reaction. The actively treated patients had significantly lower symptom-medication scores than placebo (p less than 0.01) during the month of May and showed a significant decrease in specific skin (p less than 0.01) and nasal (p less than 0.05) reactivity, and a significant early increase in specific IgE (p less than 0.01), IgG (p less than 0.0005), IgG1 (p less than 0.001) and IgG4 (p less than 0.05), with a subsequent decrease of IgE and IgG1. No differences were detected in any of these parameters in the placebo group. A correlation was found between high IgG4/IgG1 ratio and the specific skin reactivity decrease (r = 0.691, p less than 0.05), whereas a high IgG4/IgG1 ratio was associated with higher symptom-medication scores (r = 0.654, p less than 0.05). Possible explanations of these apparent discrepancies are proposed.
authors.affiliation: First Department of Internal Medicine, University of Milan, Italy.
authors.forename: E A
authors.initials: EA
authors.lastname: Pastorello
authors.forename: V
authors.initials: V
authors.lastname: Pravettoni
authors.forename: C
authors.initials: C
authors.lastname: Incorvaia
authors.forename: M
authors.initials: M
authors.lastname: Mambretti
authors.forename: E
authors.initials: E
authors.lastname: Franck
authors.forename: R
authors.initials: R
authors.lastname: Wahl
authors.forename: C
authors.initials: C
authors.lastname: Zanussi
mesh_terms: D000293:Adolescent; D000328:Adult; D000534:Alum Compounds / Q000627:therapeutic use*; D003888:Desensitization, Immunologic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011058:Pollen / Q000276:immunology; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy*
chemical_list: D000534:Alum Compounds; D007074:Immunoglobulin G; D007073:Immunoglobulin E