title: Initial immunological changes as predictors for house dust mite immunotherapy response.
abstract: BACKGROUND
  Although specific immunotherapy is the only aetiological treatment for allergic disorders, the underlying mechanisms are not fully understood. Specific immunotherapy induces changes in lymphocyte Th subsets from Th2 to Th1/Treg. Whether differences in immunological patterns underlie patient response to immunotherapy has not yet been established.
  
  
  OBJECTIVE
  We studied the immunological changes occurring during a 1-year period of Dermatophagoides pteronyssinus (DP) immunotherapy and their relation with clinical outcome.
  
  
  METHODS
  We included 34 patients with DP allergy who received subcutaneous specific immunotherapy (SCIT) for 1 year. Following treatment, patients were classified as responders or non-responders. Fourteen allergic subjects who did not receive SCIT were included as controls. Peripheral blood was obtained at 0, 1, 3, 6 and 12 months and cultured with nDer p 1. Phenotypic changes, cytokine production and basophil response were analysed by flow cytometry; transcription factors were measured by mRNA quantification. Serum immunoglobulin levels were also measured.
  
  
  RESULTS
  After 1 year of SCIT, 82% of cases showed improved symptoms (responders). Although increases in sIgG4 were observed, BAT reactivity was not modified in these patients. Increases in T-BET/FOXP3 as well as nDer p 1-specific Th1/Treg frequencies were also observed, along with a decrease in Th2, Th9 and Th17. These changes corresponded to changes in cytokine levels.
  
  
  CONCLUSIONS
  Patients who respond well to DP-SCIT show immunological differences compared to non-responders. In responders, basal differences include a lower frequency of Th1 and higher frequencies of Th2, Th9 and Th17 cells. After 1 year of treatment, an increased production of sIgG4 was observed in responders, along with a change in Th2 response towards Th1/Treg.
authors.affiliation: Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gómez
authors.affiliation: Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: T D
authors.initials: TD
authors.lastname: Fernández
authors.affiliation: Allergy Service, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Doña
authors.affiliation: Allergy Service, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Rondon
authors.affiliation: Allergy Service, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Campo
authors.affiliation: Allergy Service, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Gomez
authors.affiliation: Allergy Service, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Salas
authors.affiliation: Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gonzalez
authors.affiliation: Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: J R
authors.initials: JR
authors.lastname: Perkins
authors.affiliation: Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Palomares
authors.affiliation: Allergy Service, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Blanca
authors.affiliation: Allergy Service, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Torres
authors.affiliation: Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Malaga, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Mayorga
mesh_terms: D000328:Adult; D000818:Animals; D016207:Cytokines / Q000097:blood / Q000276:immunology*; D040002:Dermatophagoides pteronyssinus / Q000276:immunology*; D003888:Desensitization, Immunologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D065631:Rhinitis, Allergic / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology* / Q000378:metabolism
chemical_list: D016207:Cytokines
keywords: Dermatophagoides pteronyssinus; T cells; allergic rhinitis; basophils; cytokines; immunoglobulins; specific immunotherapy