Different Responses in Induction of Allergen Specific Immunoglobulin G4 and IgE-Blocking Factors for Three Mite Subcutaneous Immunotherapy Products.
OBJECTIVE
Specific immunoglobulin G4 (sIgG4) and immunoglobulin E (IgE)-blocking factors produced by subcutaneous immunotherapy (SCIT) play a critical role in the induction of allergen tolerance. However, comparative studies of available SCIT reagents on the induction of sIgG4 are limited. We compared increases in sIgG4 for three different house dust mite (HDM) SCIT reagents.


METHODS
Seventy-two HDM sensitized allergic patients were enrolled and classified into four groups: 1) control (n=27), 2) SCIT with Hollister-Stier® (n=19), 3) Tyrosine S® (n=16), and 4) Novo-Helisen® (n=10). Levels of specific IgE (sIgE), sIgG4, and IgE blocking factor to Dermatophagoides farinae (D. farinae) were measured using ImmunoCAP (sIgE, sIgG4) and enzyme-linked immunosorbent assay (ELISA) (IgE-blocking factors). Levels were measured before and 13.9±6.6 months after the SCIT. The allergen specificity and the induction levels of sIgE and sIgG4 were confirmed by immunoblot analysis.


RESULTS
After SCIT, sIgG4 levels to D. farinae increased significantly; however, the increases differed significantly among the SCIT groups (p<0.001). Specific IgG4 levels to D. farinae were highest in Hollister-Stier® (3.7±4.1 mg/L), followed by Novo-Helisen® (2.2±2.3 mg/L) and Tyrosine S® (0.7±0.5 mg/L). In addition, patients who were administered using Hollister-Stier® showed the most significant decrease in IgE/IgG4 ratio (p<0.001) and increase in blocking factor (p=0.009). Finally, according to IgE immunoblot results, the Hollister-Stier® group showed the most significant attenuation of IgE binding patterns among others.


CONCLUSIONS
Currently available SCIT reagents induce different levels of specific IgG4, IgE/IgG4 ratio, and IgE-blocking factor.
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
Kyung Hee
KH
Park
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Sang Chul
SC
Lee
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Young Woong
YW
Son
Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
Kyoung Yong
KY
Jeong
Department of Allergy and Clinical Immunology, Ajou Medical School of Medicine, Suwon, Korea.
Yoo Seob
YS
Shin
Department of Dermatology & Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Jung U
JU
Shin
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
Da Woon
da W
Sim
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
Hye Jung
HJ
Park
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea.
Jae Hyun
JH
Lee
Department of Dermatology & Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.|Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Kwang Hoon
KH
Lee
Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea. parkjw@yuhs.ac.
Jung Won
JW
Park
D000328:Adult; D000485:Allergens / Q000008:administration & dosage / Q000276:immunology*; D000818:Animals; D000918:Antibody Specificity / Q000276:immunology; D039741:Antigens, Dermatophagoides; D000951:Antigens, Neoplasm; D003876:Dermatitis, Atopic / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D003888:Desensitization, Immunologic / Q000379:methods*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology*; D007279:Injections, Subcutaneous; D008297:Male; D008925:Mites / Q000276:immunology*; D039981:Pyroglyphidae / Q000276:immunology; D016896:Treatment Outcome; D055815:Young Adult
D000485:Allergens; D039741:Antigens, Dermatophagoides; D000951:Antigens, Neoplasm; D007074:Immunoglobulin G; C020163:blocking factor; D007073:Immunoglobulin E
Blocking factor; IgG4; house dust mite; immunotherapy; specific IgE