title: Systemic immunological changes induced by administration of grass pollen allergens via the oral mucosa during sublingual immunotherapy.
abstract: Twenty-four patients suffering from grass pollen allergy underwent sublingual immunotherapy (SLIT) with standardized grass pollen extract for 1 year. In order to investigate immunological changes induced by the administration of allergens via the oral mucosa, the SLIT-spit method was applied. The cumulative dose of approximately 80 microg of major allergen (grass group 5 allergen), was relatively low. During the time of treatment, we could observe a significant increase in the levels of specific IgG and IgG4 antibodies. However, the titers of allergen-specific IgE antibodies showed a significant increase in the course of SLIT as well. Analyzing lymphoproliferative responses, a significant decrease in reactivity in response to stimulation with complete grass pollen extract (p = 0. 001) and to recombinant Phl p 1 (a major allergen of timothy grass, p<0.001) could be observed, indicating the induction of immunological tolerance. Proliferative responses to a control antigen (tetanus toxoid) were not influenced by the treatment. At different time points during SLIT, allergen (Phl p 1)-specific T cell clones (TCC) were established from the peripheral blood of the patients. Cytokine production by allergen-stimulated T cells did not reveal any changes consistent with immune deviation, i.e. the ratio of Th1/Th2 TCC did not change during SLIT. In conclusion, we provide evidence that sublingual treatment leads to systemic changes in immunoreactivity to the administered allergen.
authors.affiliation: Institute of General and Experimental Pathology, University of Vienna, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Fanta
authors.forename: B
authors.initials: B
authors.lastname: Bohle
authors.forename: W
authors.initials: W
authors.lastname: Hirt
authors.forename: U
authors.initials: U
authors.lastname: Siemann
authors.forename: F
authors.initials: F
authors.lastname: Horak
authors.forename: D
authors.initials: D
authors.lastname: Kraft
authors.forename: H
authors.initials: H
authors.lastname: Ebner
authors.forename: C
authors.initials: C
authors.lastname: Ebner
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000008:administration & dosage*; D002999:Clone Cells / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007167:Immunotherapy; D007371:Interferon-gamma / Q000096:biosynthesis; D015847:Interleukin-4 / Q000096:biosynthesis; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000276:immunology*; D010641:Phenotype; D006109:Poaceae / Q000276:immunology; D011058:Pollen / Q000378:metabolism*; D013361:Sublingual Gland / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology; D013997:Time Factors
chemical_list: D000485:Allergens; D015847:Interleukin-4; D007073:Immunoglobulin E; D007371:Interferon-gamma