Diminished response to grass pollen allergen challenge in subjects with concurrent house dust mite allergy.
BACKGROUND
The clinical manifestation of allergic rhinitis is influenced by many factors; while different subpopulations are not well defined. Different combinations of allergic sensitization may lead to different clinical manifestations of allergic disease.


METHODS
In a nasal allergen challenge model we compared allergic rhinitis symptoms between subjects mono-sensitized to grass pollen or house dust mite, poly-sensitized subjects, and healthy controls. We measured visual analogue scales of symptoms and peak nasal inspiratory flow. We also compared serum total IgE, allergen-specific IgE and IgG4, and basophil histamine release.


RESULTS
Nasal challenge with grass pollen extract led to a significantly larger increase in subjective (p = 0.031) and objective (p = 0.001) nasal symptoms in grass pollen mono-sensitized subjects than in poly-sensitized subjects. No differences were found in serum levels of allergen-specific IgE and IgG4 or in biological activity of IgE (basophil histamine release) between mono-sensitized and poly-sensitized subjects. We found a strong inverse correlation between serum allergen-specific IgE and basophil histamine release (-0.789, p = 0.001).


CONCLUSIONS
Grass pollen mono-sensitized subjects have a more severe clinical response to nasal challenge than poly-sensitized subjects. This cannot be explained by serum levels of IgE or its biological activity. The continuous allergen exposure in poly-sensitized subjects may alter local immuno-regulatory processes, leading to a reduced clinical response to allergen challenge.
Reinartz
Susanne M
SM
Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands. s.m.reinartz@amc.uva.nl
van Ree
Ronald
R
Versteeg
Serge A
SA
Zuidmeer
Laurian
L
van Drunen
Cornelis M
CM
Fokkens
Wytske J
WJ
D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology*; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D009299:Nasal Provocation Tests; D006109:Poaceae / Q000276:immunology; D011058:Pollen / Q000276:immunology*; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology*; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology*; D018709:Statistics, Nonparametric
D000485:Allergens; D039741:Antigens, Dermatophagoides; D007074:Immunoglobulin G; D007073:Immunoglobulin E