title: Specific IgG4 production during house dust mite immunotherapy among age, gender and allergic disease populations.
abstract: BACKGROUND
  Specific IgG4 induced by allergen-specific immunotherapy (SIT) is an immunological marker related to the appearance of clinical tolerance. But specific IgG4 levels in different age, gender and allergic disease populations have not been fully investigated.
  
  
  METHODS
  This study involved 226 children and 109 adults with allergic rhinitis and/or asthma receiving a 156-week course of Dermatophagoides pteronyssinus (Der p) subcutaneous SIT. Symptom and medication scores, forced expiratory volume after 1 s (FEV(1)) and Der p-specific IgG4 levels at weeks 0, 5, 10, 25, 52, 104 and 156 were analyzed.
  
  
  RESULTS
  Rhinitis symptom and medication scores and FEV(1) % predicted in children showed significantly greater improvement than in adults at week 104 and 156 (p < 0.05). Levels of Der p-specific IgG4 showed a significant increase after 10 weeks of subcutaneous SIT (p < 0.0001) and continued to increase during the 156-week SIT period. Before SIT, the initial Der p-specific IgG4 level was higher in children than adults (p = 0.0004). The increase ratio of Der p-specific IgG4 was higher in children than adults at 52 weeks (p < 0.001) and 104 weeks (p = 0.0156) of SIT, and was higher in rhinitis compared to asthma patients at 156 weeks of SIT (p = 0.0244). There was no difference between males and females at any time points.
  
  
  CONCLUSIONS
  Children are more responsive to SIT, demonstrating clinical and FEV(1) improvement and producing higher levels of allergen-specific IgG4 during a shorter SIT period compared to adults. Rhinitis patients show a higher increase in specific IgG4 compared to patients with asthma symptoms. The increase of Der p-specific IgG4 reflects a specific response of the immune system towards the SIT vaccine being administrated.
authors.affiliation: Research Asia Pacific, ALK A/S, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou, China.
authors.forename: Xuxin
authors.initials: X
authors.lastname: Lai
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Xiaoxiong
authors.initials: X
authors.lastname: Xiao
authors.forename: Enmei
authors.initials: E
authors.lastname: Liu
authors.forename: Chunqing
authors.initials: C
authors.lastname: Zhang
authors.forename: Hongyu
authors.initials: H
authors.lastname: Wang
authors.forename: Birgitte
authors.initials: B
authors.lastname: Gjesing
authors.forename: Nanshan
authors.initials: N
authors.lastname: Zhong
authors.forename: Michael D
authors.initials: MD
authors.lastname: Spangfort
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use; D060829:Arthropod Proteins / Q000276:immunology; D001249:Asthma / Q000276:immunology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D040002:Dermatophagoides pteronyssinus / Q000276:immunology; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000276:immunology / Q000628:therapy*; D055815:Young Adult
chemical_list: D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; D007074:Immunoglobulin G