title: Absence of systemic immunologic changes during dose build-up phase and early maintenance period in effective specific sublingual immunotherapy in children.
abstract: BACKGROUND
  Sublingual immunotherapy (SLIT) has been reported to be a safe treatment for inhalant allergies in children. Yet the immunologic mechanisms resulting in clinical improvement are poorly understood.
  
  
  OBJECTIVE
  To identify early systemic immunologic changes during the first 8 weeks of clinically effective SLIT to grass pollen, tree pollen or house dust mite in paediatric patients with allergic rhinoconjunctivitis and/or asthma.
  
  
  METHODS
  Peripheral blood mononuclear cells and plasma samples of 13 children with reduced symptoms after 1 year of SLIT were obtained before therapy and at 2 and 8 weeks after the initiation of SLIT. Allergen-specific lymphocyte proliferation assays were performed, and allergen-induced cytokine production (IL-2, IL-4, IL-10, IFN-gamma, and TGF-beta(1)) was measured by ELISA and flow cytometry. Allergen-specific IgE, IgG1, IgG4, and IgA levels in plasma samples were determined in ELISA.
  
  
  RESULTS
  During the first 8 weeks of successful SLIT, allergen-specific lymphoproliferation (n=13) as well as levels of allergen-specific intracellular (n=8) and secreted cytokines (n=9) did not change significantly. In addition, no alterations in levels of allergen-specific Igs (n=7) were observed.
  
  
  CONCLUSIONS
  We could not find any early systemic immunologic changes during the first 8 weeks of clinically effective SLIT to inhalant allergens in paediatric patients with allergic rhinoconjunctivitis and/or asthma.
authors.affiliation: Department of Pediatrics and Juvenile Medicine and Department of Pathophysiology, Centre for Physiology and Pathophysiology, Medical University of Vienna, Vienna, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Dehlink
authors.forename: T
authors.initials: T
authors.lastname: Eiwegger
authors.forename: M
authors.initials: M
authors.lastname: Gerstmayr
authors.forename: E
authors.initials: E
authors.lastname: Kampl
authors.forename: B
authors.initials: B
authors.lastname: Bohle
authors.forename: K-W
authors.initials: KW
authors.lastname: Chen
authors.forename: S
authors.initials: S
authors.lastname: Vrtala
authors.forename: R
authors.initials: R
authors.lastname: Urbanek
authors.forename: Z
authors.initials: Z
authors.lastname: Szépfalusi
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000485:Allergens / Q000008:administration & dosage; D000918:Antibody Specificity; D039741:Antigens, Dermatophagoides / Q000008:administration & dosage; D052179:Antigens, Plant; D060829:Arthropod Proteins; D029662:Betula; D049109:Cell Proliferation; D002478:Cells, Cultured; D002648:Child; D002675:Child, Preschool; D003546:Cysteine Endopeptidases; D016207:Cytokines / Q000032:analysis / Q000096:biosynthesis; D040002:Dermatophagoides pteronyssinus / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods*; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood / Q000276:immunology; D008213:Lymphocyte Activation; D008297:Male; D010940:Plant Proteins / Q000008:administration & dosage; D006109:Poaceae; D011058:Pollen; D011994:Recombinant Proteins / Q000008:administration & dosage; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology* / Q000628:therapy*; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; D052179:Antigens, Plant; D060829:Arthropod Proteins; D016207:Cytokines; D007136:Immunoglobulins; D010940:Plant Proteins; D011994:Recombinant Proteins; C090396:PHLPI protein, Phleum pratense; D003546:Cysteine Endopeptidases; C451162:Dermatophagoides pteronyssinus antigen p 1