The early changes of humoral immune response after rush immunotherapy with Dermatophagoides farinae (D.f) and Dermatophagoides pteronyssinus (D.p) in house dust mite sensitive asthmatic children / 천식및알레르기

ABSTRACT

PURPOSE: Rush immunotherapy (RIT) with house dust mite may be effective to treat house dust mite allergic disease, but the mechanisms are not clear. Considerable attention has been devoted to the IgG subclass in relation to clinical outcome. Usually, conventional immunotherapy with D.f and D.p is followed early on by a rise in allergen-specific IgG1 with a gradual decline over time and slow rise in allergen-specific IgG4. Some investigators have implicated that IgG4 is a more important blocking antibody than IgG1 in RIT. But there is no consistent data on the early changes of allergen-specific IgG1 or IgG4. To inves- tigate the alteration of humoral immunity in the mechanism of early phase of RIT, the D.f -specific IgE, IgG1, and IgG4 levels of the RIT group were compared with that of the con- trol group with asthma. METHOD: The RIT group included 17 D.f and D.p-sensitized asthmatic children, who had received RIT with D.f and D.p, and the control group included 15 D.f and D.p-sensitized asthmatic children who had not received RIT. They received RIT to mite for just over 8 weeks until maintenance was achieved. The symptom scores of asthma, skin reactivity to D.f (allergen/histamine ratio), RIT changes of D.f-specific IgE, IgG1, and IgG4 levels were compared before and 8 weeks after for the two groups. D.f-specific IgE, IgG1, and IgG4 levels were measured by ELISA. RESULTS: The symptom scores and the skin reactivity to D.f decreased significantly 8 weeks after RIT. D.f-specific IgG1 levels increased significantly 8 weeks after RIT in the RIT group but not in the control group. But D.f-specific IgE and D.f- specific IgG4 levels did not change 8 weeks after RIT in either of the two groups. CONCLUSION: D.f-specific IgG1 production was increased in the early phase of RIT. These findings suggest that the early clinical changes after RIT may be linked to the early increase of IgG1 blocking antibody.