Serologic study of the working mechanisms of immunotherapy for children with perennial allergic rhinitis.
BACKGROUND
Recent double-blind placebo-controlled trials have clearly shown the efficacy of immunotherapy for perennial allergic rhinitis. However, the exact working mechanisms related to the clinical effect of immunotherapy remain unclear.


OBJECTIVE
To monitor the changes over time in immunologic parameters in children who received immunotherapy for perennial allergic rhinitis, and to elucidate the working mechanisms of immunotherapy related to its clinical efficacy.


METHODS
Nineteen children with perennial allergic rhinitis due to Dermatophagoides farinae enrolled in this prospective open study. Venous blood was collected to determine levels of specific IgE, specific IgG4, soluble interleukin 2 receptor, interleukin 4, soluble intercellular adhesion molecule 1, and soluble vascular cell adhesion molecule 1 at enrollment and 1, 2, 3, 5, and 10 years after enrollment.


RESULTS
Immunotherapy affected serum levels of specific IgE, specific IgG4, soluble interleukin 2 receptor, interleukin 4, and soluble intercellular adhesion molecule 1, but not soluble vascular cell adhesion molecule 1. The rates of increase of levels of specific IgG4 and the rates of decrease of levels of soluble interleukin 2 receptor were correlated with the rates of decrease of symptom scores during the first 3 years of treatment, but not after 5 years. The rates of decrease in levels of soluble intercellular adhesion molecule 1 were correlated with the rates of decrease in symptom scores at 3 and 5 years after the beginning of the course of immunotherapy. The rates of decrease in levels of specific IgE and interleukin 4 were correlated with the rates of decrease in symptom scores after 5 and 10 years of treatment, but not during the first 3 years.


CONCLUSIONS
Each modulation in levels of specific IgE, specific IgG4, soluble interleukin 2 receptor, interleukin 4, and soluble intercellular adhesion molecule 1 contributed to the clinical effect of immunotherapy in particular phases of treatment for children with perennial allergic rhinitis.
Ohashi
Y
Y
Department of Otolaryngology, Osaka City University Medical School, Abeno, Osaka, Japan.
Nakai
Y
Y
Tanaka
A
A
Kakinoki
Y
Y
Washio
Y
Y
Kato
A
A
Masamoto
T
T
Yamada
K
K
Hayashi
M
M
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D002648:Child; D004205:Cromolyn Sodium / Q000627:therapeutic use; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D007074:Immunoglobulin G / Q000097:blood*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000628:therapy*; D013997:Time Factors
D018927:Anti-Asthmatic Agents; D007074:Immunoglobulin G; D018799:Intercellular Adhesion Molecule-1; D007073:Immunoglobulin E; D004205:Cromolyn Sodium