title: Recombinant allergen-based monitoring of antibody responses during injection grass pollen immunotherapy and after 5 years of discontinuation.
abstract: BACKGROUND
  Subcutaneous injection immunotherapy (SCIT) is considered as antigen-specific and disease-modifying treatment with long-lasting effect.
  
  
  METHODS
  We used a panel of recombinant grass pollen allergens for analyzing allergen-specific IgE, IgG(1) -IgG(4) , IgM, IgA, and light-chain (kappa, lambda) responses in grass pollen-allergic patients who had received one course of injection immunotherapy (SCIT) with an aluminum hydroxide-adsorbed grass pollen extract or only anti-inflammatory treatment. Serum samples were analyzed before and after 5 months of treatment as well as after 5 years.
  
  
  RESULTS
  After 5 months of SCIT but not of anti-inflammatory treatment, IgG(1) > IgG(4) > IgG(2) > IgA antibody responses using both kappa and lambda light chains specific for major grass pollen allergens (Phl p 1, Phl p 5, Phl p 6, Phl p 2) increased significantly, whereas specific IgM or IgG(3) levels were unaltered. Allergen-dependent basophil degranulation was only inhibited with SCIT sera containing therapy-induced allergen-specific IgG antibodies. Likewise, decreases in Phl p 1- and Phl p 5-specific IgE levels and significant (P<0.001) reduction in symptom and medication scores were found only in the SCIT group but not in the group of patients receiving anti-inflammatory treatment. After 5 years, allergen-specific IgG antibody levels in the SCIT group had returned to baseline levels and there was no significant difference regarding symptoms between the SCIT and non-SCIT groups.
  
  
  CONCLUSIONS
  The results from our observational study demonstrate that only SCIT but not anti-inflammatory treatment induces allergen-specific IgG and reduces boosts of allergen-specific IgE production but that one SCIT course was not sufficient to achieve long-term immunological and clinical effects.
authors.affiliation: Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18-20, Vienna, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Gadermaier
authors.forename: J
authors.initials: J
authors.lastname: Staikuniene
authors.forename: S
authors.initials: S
authors.lastname: Scheiblhofer
authors.forename: J
authors.initials: J
authors.lastname: Thalhamer
authors.forename: M
authors.initials: M
authors.lastname: Kundi
authors.forename: K
authors.initials: K
authors.lastname: Westritschnig
authors.forename: I
authors.initials: I
authors.lastname: Swoboda
authors.forename: S
authors.initials: S
authors.lastname: Flicker
authors.forename: R
authors.initials: R
authors.lastname: Valenta
mesh_terms: D000485:Allergens / Q000008:administration & dosage / Q000276:immunology*; D000906:Antibodies / Q000097:blood*; D015549:Basophil Degranulation Test; D003888:Desensitization, Immunologic; D000939:Epitopes / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007145:Immunoglobulin kappa-Chains / Q000276:immunology; D007146:Immunoglobulin lambda-Chains / Q000276:immunology; D007279:Injections, Subcutaneous; D006109:Poaceae / Q000276:immunology*; D011058:Pollen / Q000276:immunology*; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000276:immunology; D006255:Rhinitis, Allergic, Seasonal / Q000276:immunology / Q000628:therapy*
chemical_list: D000485:Allergens; D000906:Antibodies; D000939:Epitopes; D007074:Immunoglobulin G; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; D011994:Recombinant Proteins; D007073:Immunoglobulin E