title: Allergen-specific nasal IgG antibodies induced by vaccination with genetically modified allergens are associated with reduced nasal allergen sensitivity.
abstract: BACKGROUND
  We have performed a double-blind, placebo-controlled injection immunotherapy study with genetically modified derivatives of the major birch pollen allergen, Bet v 1 (Bet v 1-trimer, Bet v 1-fragments).
  
  
  OBJECTIVE
  To investigate whether vaccination with genetically modified allergens induces allergen-specific antibodies in nasal secretions and to study whether these antibodies affect nasal allergen sensitivity.
  
  
  METHODS
  A randomly picked subgroup of patients (n = 23; placebo, n = 10; trimer, n = 10; fragments, n = 3) was subjected to an extensive analysis of serum samples and nasal lavage fluids and to nasal provocation testing. Bet v 1-specific IgG(1-4) and IgA antibodies were determined in serum samples obtained before and after vaccination, after the birch pollen season, and 1 year after start of vaccination as well as in nasal lavage fluids obtained after the birch pollen season and 1 year after start of vaccination by ELISA. Nasal sensitivity to natural, birch pollen-derived Bet v 1 was determined by active anterior rhinomanometry after the birch pollen season and 1 year after start of vaccination.
  
  
  RESULTS
  Vaccination with genetically modified Bet v 1 derivatives, but not with placebo, induced Bet v 1-specific IgG1, IgG2, and IgG4, and low IgA antibodies in serum, which also appeared in nasal secretions, but no IgG3 antibodies. The levels of therapy-induced Bet v 1-specific IgG4 antibodies in nasal secretions were significantly (P < .05) associated with reduced nasal sensitivity to natural, birch pollen-derived Bet v 1 as objectively determined by controlled nasal provocation experiments.
  
  
  CONCLUSIONS
  Our data demonstrate that vaccination with genetically modified allergens induces IgG antibody responses against the corresponding natural allergen not only in serum but also in mucosal fluids, where they may protect against allergen-induced inflammation.
authors.affiliation: Department of Otorhinolaryngology, Center for Physiology and Pathophysiology, Vienna General Hospital, Vienna, Austria.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Reisinger
authors.forename: Friedrich
authors.initials: F
authors.lastname: Horak
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Pauli
authors.forename: Marianne
authors.initials: M
authors.lastname: van Hage
authors.forename: Oliver
authors.initials: O
authors.lastname: Cromwell
authors.forename: Franz
authors.initials: F
authors.lastname: König
authors.forename: Rudolf
authors.initials: R
authors.lastname: Valenta
authors.forename: Verena
authors.initials: V
authors.lastname: Niederberger
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant; D003888:Desensitization, Immunologic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis* / Q000145:classification; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000276:immunology*; D010940:Plant Proteins / Q000276:immunology*; D011994:Recombinant Proteins / Q000276:immunology; D014611:Vaccination; D014614:Vaccines, Synthetic / Q000276:immunology*
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D007074:Immunoglobulin G; D010940:Plant Proteins; D011994:Recombinant Proteins; D014614:Vaccines, Synthetic; C061312:Bet v 1 allergen, Betula