Phase I/II study of oral immunotherapy with Cry j1-galactomannan conjugate for Japanese cedar pollinosis.
OBJECTIVE
Among many immunotherapeutic approaches, oral immunotherapy (OIT) is thought to be an effective route for desensitization against a variety of allergens. However, there is little evidence that OIT is effective for airway allergic diseases such as pollen allergy. Thus, in the present study, we assessed the safety, efficacy and immune response of OIT using the Cry j1-galactomannan conjugate for Japanese cedar pollen allergy.


METHODS
An open trial was conducted over a period of 4 months. The OIT group comprised of 23 subjects. Treatment was initiated 1 month before the estimated pollen season and continued for 1 month. The control group (the pharmacological treatment group without OIT) comprised of 11 subjects. The symptoms and medication score, levels of allergen-specific serum antibodies, cellular components of lymphocytes and cytokine production from peripheral blood mononuclear cells (PBMCs) were evaluated throughout the pollen season.


RESULTS
The participants receiving OIT treatment showed significant improvements in total symptom scores and symptom-medication scores during the pollen season compared with the control group. The levels of allergen-specific serum IgG4 and IL-10 production in PBMCs were significantly increased in the OIT group compared with that in the control group. Importantly, no severe adverse effects were observed in the participants receiving OIT treatment.


CONCLUSIONS
Short-term OIT using the Cry j1-galactomannan conjugate is effective, relatively safe and induces tolerant immune responses such as increased allergen-specific serum IgG4 and IL-10 production in PBMCs. These results suggest that OIT using allergen-galactomannan conjugates may provide a rapid, effective, and safe immunotherapy regimen for cedar pollen allergy.
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Department of Otorhinolaryngology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan. Electronic address: muradai@qent.med.kyushu-u.ac.jp.
Daisuke
D
Murakami
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Department of Otorhinolaryngology, Chidoribashi Hospital, Fukuoka, Japan.
Kazuhiko
K
Kubo
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
Motohiro
M
Sawatsubashi
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
Sayaka
S
Kikkawa
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Department of Otorhinolaryngology, Kitakyushu Municipal Medical Center, Fukuoka, Japan.
Masayoshi
M
Ejima
Biobusiness Propulsion Group, Biobusiness Propulsion Division, Wako Filter Technology Co., Ltd., Ibaraki, Japan.
Akira
A
Saito
Department of Biological Chemistry, Yamaguchi University, Yamaguchi, Japan.
Akio
A
Kato
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
Shizuo
S
Komune
D000284:Administration, Oral; D000328:Adult; D000906:Antibodies / Q000032:analysis; D052179:Antigens, Plant / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D032485:Cryptomeria / Q000276:immunology; D016207:Cytokines / Q000096:biosynthesis; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D008351:Mannans / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D008875:Middle Aged; D010940:Plant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D006255:Rhinitis, Allergic, Seasonal / Q000628:therapy*
D000906:Antibodies; D052179:Antigens, Plant; C065290:Cry j I protein, Cryptomeria japonica; D016207:Cytokines; D008351:Mannans; D010940:Plant Proteins; C012990:galactomannan; D005690:Galactose
Adverse effects; Clinical efficacy; Cry j1–galactomannan conjugate; Japanese cedar pollinosis; Oral immunotherapy