title: Analysis of the antibody responses induced by subcutaneous injection immunotherapy with birch and Fagales pollen extracts adsorbed onto aluminum hydroxide.
abstract: BACKGROUND
  Allergen-specific subcutaneous immunotherapy (SCIT) is an antigen-specific therapy of IgE-mediated allergies. In the present study, we analyze the epitope specificities of antibody responses induced by SCIT with allergen extracts from pollen of trees belonging to the order Fagales (birch, alder, hazel) adsorbed onto aluminum hydroxide.
  
  
  METHODS
  The IgE, IgG1-4 and IgA responses to defined recombinant allergens (birch pollen: Bet v 1; alder pollen: Aln g 1; hazel pollen: Cor a 1; apple: Mal d 1) as well as to Bet v 1-derived recombinant fragments and synthetic peptides were analyzed in sera from patients who had undergone SCIT for different periods of time.
  
  
  RESULTS
  Long-term SCIT (>1 year; cumulative dose >1,000,000 SQ units) induced more pronounced IgG1, IgG2 and IgG4 responses to Bet v 1 and Bet v 1-related allergens according to the degree of sequence homology (Bet v 1>Aln g 1>Cor a 1>Mal d 1) than short-term SCIT (<1 year; cumulative dose <1,000,000 SQ units). In contrast to patients treated for <1 year, patients treated for >1 year mounted distinct IgG1, IgG2 and IgG4 responses against sequential Bet v 1 epitopes. No relevant allergen-specific IgA or IgG3 responses were induced by short- or long-term SCIT. Using a competitive ELISA assay, it could be shown that serum IgG from patients undergoing long-term SCIT inhibited IgE reactivity to Bet v 1 better than IgG from patients undergoing short-term SCIT.
  
  
  CONCLUSIONS
  SCIT with allergen extracts adsorbed onto aluminum hydroxide induces IgG responses against new epitopes that block IgE binding and cross-react with structurally related allergens depending, among other factors, on duration of treatment and cumulative injected dose.
authors: Division of Immunopathology, Department of Pathophysiology, Center for Physiology and Pathophysiology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
authors: E
authors: E
authors: Gadermaier
authors: S
authors: S
authors: Flicker
authors: W
authors: W
authors: Aberer
authors: C
authors: C
authors: Egger
authors: N
authors: N
authors: Reider
authors: M
authors: M
authors: Focke
authors: S
authors: S
authors: Vrtala
authors: M
authors: M
authors: Kundi
authors: R
authors: R
authors: Valenta
mesh_terms: D000276:Adjuvants, Immunologic / Q000494:pharmacology; D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000008:administration & dosage* / Q000276:immunology; D000536:Aluminum Hydroxide / Q000494:pharmacology; D003888:Desensitization, Immunologic; D018604:Epitope Mapping; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011058:Pollen / Q000276:immunology; D011994:Recombinant Proteins / Q000008:administration & dosage* / Q000276:immunology; D006255:Rhinitis, Allergic, Seasonal / Q000097:blood / Q000276:immunology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000276:Adjuvants, Immunologic; D000485:Allergens; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D011994:Recombinant Proteins; D007073:Immunoglobulin E; D000536:Aluminum Hydroxide