Correlation of plasma complement split product levels with allergic respiratory disease activity and relation to allergen immunotherapy.
BACKGROUND
Allergens, including dust mite and grass pollen, and mast cell tryptase are known to generate the complement split products (CSPs) C5a and C3a, which can then trigger allergic inflammation. The relation of these anaphylatoxin levels to clinical allergic disease responses is not known.


OBJECTIVE
To evaluate the relationship of plasma CSP levels to allergic respiratory disease variables in an adult cohort.


METHODS
A cross-sectional survey was used to assess the association of plasma C5a desArg and C3a desArg levels with clinical allergic respiratory disease variables. Furthermore, a time course of the effect of routine allergen immunotherapy on plasma CSP levels and cutaneous and pulmonary responses was determined.


RESULTS
Adult plasma C5a desArg levels correlate with asthma severity as determined by a physician (P = .01) and by Asthma Quality of Life Questionnaire scores (P < .01). Change in plasma C5a desArg levels 1 hour after immunotherapy is associated with baseline rhinoconjunctivitis symptom severity (P = .03), change in total mean wheal diameter (P = .05), and total dust mite dosage (P = .04). Change in plasma C3a desArg levels 3 hours after immunotherapy correlates with change in total mean wheal diameter induced by dust mite (P = .01). Change in plasma CSP levels after immunotherapy did not correlate with change in spirometric outcome.


CONCLUSIONS
Plasma C5a desArg levels reflect allergic respiratory disease severity as assessed by physicians and correlate with Asthma Quality of Life Questionnaire scores. Changes in CSP levels after immunotherapy reflect cutaneous allergic responses, especially to dust mite allergen.
Department of Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York 11203, USA.
Corinna
C
Bowser
David P
DP
Erstein
Jonathan I
JI
Silverberg
Maja
M
Nowakowski
Rauno
R
Joks
D000328:Adult; D039741:Antigens, Dermatophagoides / Q000276:immunology; D052179:Antigens, Plant / Q000276:immunology; D001249:Asthma / Q000097:blood* / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D015926:Complement C3a / Q000378:metabolism*; D015937:Complement C5a, des-Arginine / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003888:Desensitization, Immunologic; D018450:Disease Progression; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000097:blood* / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011058:Pollen / Q000276:immunology; D011788:Quality of Life; D012867:Skin / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D012882:Skin Tests; D013147:Spirometry; D053802:Tryptases / Q000378:metabolism
D039741:Antigens, Dermatophagoides; D052179:Antigens, Plant; D015937:Complement C5a, des-Arginine; C044541:complement C3a, des-Arg-(77)-; D015926:Complement C3a; D053802:Tryptases