Allergen-Specific Immunotherapy Follow-Up by Measuring Allergen-Specific IgG as an Objective Parameter (original) (raw)
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Pre-treatment allergen-specific IgE analysis and outcomes of allergen immunotherapy
European Annals of Allergy and Clinical Immunology, 2021
Background. Patients show varied results to allergen immunotherapy (AIT). The reason for this variability is unclear. Objective. To describe the relationship between AIT efficacy and demographic characteristics, as well as pre-treatment plasma levels of specific IgE-antibodies to grass and birch pollen. Methods. A retrospective study was performed based on medical records of 128 patients who received AIT. The patients completed a questionnaire and pre-AIT plasma levels of allergen-specific IgE to grass and birch pollen were measured using EUROLINE DPA-Dx pollen 1 method. Results. Seventy percent of patients classified their allergic symptoms as less severe after AIT. Twenty-seven percent had received AIT targeting only grass pollen, 19% targeting only birch pollen, and 55% targeting both grass and birch. A total of 35 different IgE profiles were found across our study population. On comparison of the demographic characteristics and concentration of allergen-specific IgE-antibodies, no statistically significant differences could be found. Conclusions. The majority of patients rated their allergic symptoms as less severe after AIT. No clear relationship could be demonstrated between pre-treatment allergen-specific IgE concentration, or demographic characteristics, and effect of AIT. There may be other factors underlying the different responses to AIT. Impact statement No correlation exists between profile of allergen sensitization and effect of alleregn immunotherapy. Pre-treatment allergen-specific IgE analysis and outcomes of allergen immunotherapy More research is needed to gain a better understanding of exactly why AIT does not work for all patients. This knowledge will in turn provide opportunities for establishing the optimal dose and method of administration (2). Diagnostic biomarkers help to select the patients who will be the best responders to a specific treatment (2). Analysis of allergen-specific IgE (sIgE) has been proposed as a biomarker for AIT (1). The use of allergen components is of great diagnostic importance to identify the main sensitizing component. One of the aims of this study is to describe the relationship between AIT efficacy and demographic characteristics. Another aim is to study plasma levels of sIgE to grass and birch pollen prior to AIT, measured using the component-resolved, multiplex immunoblot test system, EUROIMMUNE (EUROIM-MUN AG,
Clinical & Experimental Allergy, 1999
Background Although allergen immunotherapy has been established as a treatment of type I allergy back in 1911, until now the underlying mechanisms have not been fully understood, nor are there any parameters which would allow one to monitor an ongoing treatment or to assess therapeutic success in the meantime. Objective We wanted to define allergen-specific parameters that change due to treatment in correlation with the clinical outcome. Methods We conducted a controlled study with grass pollen-allergic children and compared allergen-specific antibody titres before and 1 year after the onset of immunotherapy in contrast with untreated allergic and healthy children. Two recombinant forms of the major allergen group V of Phleum pratense (Phl p 5) served as model allergens. Results No change in IgE levels and no significant reduction of skin prick test (SPT) reactivity were seen. On the other hand, a significant reduction of symptom scores in the treated group and a significant rise in allergen-specific IgG1, IgG2 and IgG4 due to the treatment could be observed, but in neither case could we establish a correlation between the increasing amounts of the single antibody classes and the reduction of symptom scores. But most interestingly, when comparing the ratio of IgG4 to IgG1 with the symtom scores, we found significant correlations. Nevertheless, treated allergic patients still differ considerably from healthy controls as nonatopics have hardly any measurable allergen-specific IgG antibodies and no IgE antibodies at all. Conclusion The ratio of IgG4 to IgG1 can serve as a valuable parameter that allows us to assess the success of immunotherapy already 1 year after the onset. The increase of specific IgG1 in relation to IgG4 during treatment reflects a possible influence of this subclass on the induction of tolerance towards allergens.
Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases
Allergo Journal International, 2014
e present guideline (S2k) on allergen-speci c immunotherapy (AIT) was established by the German, Austrian and Swiss professional associations for allergy in consensus with the scienti c specialist societies and professional associations in the elds of otolaryngology, dermatology and venereology, pediatric and adolescent medicine, pneumology as well as a German patient organization (German All ergy and Asthma Association; Deutscher Allergie-und Asthmabund, DAAB) according to the criteria of the Association of the Scienti c Medical Societies in Germany (Arbeitsgemeinscha der Wissenscha lichen Medizinischen Fachgesellscha en, AWMF).
In vitro diagnosis of allergy: how to interpret IgE antibody results in clinical practice
Primary care respiratory journal : journal of the General Practice Airways Group, 2006
The basis of any diagnosis of allergy requires a good history and examination, which should then provide a certain degree of confidence as to whether or not allergy is present. However, the diagnosis cannot be confirmed on the basis of symptoms alone, because both allergic and non-allergic conditions can present with similar symptoms. Based on prevalence figures, about half of the patients presenting with allergic symptoms in primary care may be non-allergic. Therefore, allergy testing in the form of specific IgE (sIgE) measurement and/or skin prick testing is an invaluable aid in demonstrating both the presence and severity of such an allergy. The usefulness of such tests extends beyond just the positive or negative result. Often, more information can be gleaned by using the test results in a form of a continuous variable in order to determine the likelihood that allergy can be attributed as an explanation for patients' symptoms and disease. In this review, we describe the rati...
IgE antibody-specific activity in human allergic disease
Immunologic Research, 2010
IgE antibody concentration, affinity, clonality and specific activity (also known as the allergen-specific IgE to total IgE ratio) influence the translation of IgE responses into clinically evident allergic symptoms following allergen exposure. Reported IgE-specific activity levels [3-4% place allergic individuals undergoing anti-IgE (Omalizumab Ò ) therapy at a disadvantage for poor resolution of their allergy symptoms following manufacturer's recommended dosing schemes. We investigated the hypothesis that the specific activity of the IgE antibody response is highly variable with respect to age, allergen specificity and an individual's total serum IgE level. Second, we investigated whether the IgE-specific activity level influences the extent and rate of loss of effector cell mediator release. IgE-specific activity distributions were plotted against age, allergen specificity and total serum IgE using 18,950 paired total IgE and allergen-specific IgE antibody data obtained from the analysis of sera from 3,614 allergic subjects and covering 182 allergen specificities. The fraction of specific IgE antibody of the total serum IgE was dependent on age of the individual, epitope specificity (clonality) and total serum IgE. The youngest group of allergic individuals with the lowest total serum IgE levels tended to have the highest allergen-specific IgE to total IgE ratios. Hymenoptera venom (54%), peanut (33%) and milk (27%) were the three allergen specificities that elicited the highest frequency of IgE-specific activities [4% among sensitized individuals. A prospective double-blind, placebo-controlled clinical study involving anti-IgE treatment of cat-allergic subjects showed IgE-specific activity was remarkably constant over the 16-week course of treatment, despite the up to 8-fold rise in total serum IgE following repetitive Omalizumab Ò administration. Changes in specific and total IgE levels paralleled each other in patients receiving anti-IgE therapy. The fastest rate of reduction in cat allergen-induced basophil histamine release following anti-IgE therapy was observed when the cat-specific IgE to total IgE ratio was \2.5%. This reflected the more rapid loss of surface cat-specific IgE antibody with anti-IgE therapy in allergic individuals who displayed a more diverse IgE antibody repertoire. We conclude that IgE-specific activity is an age-, IgE heterogeneity-and total serum IgE-dependent variable that influences the magnitude of effector cell mediator release, and by inference, ultimate allergic symptom induction.
Journal of Clinical Laboratory Analysis, 1997
A simple technique, checkerboard immunoblotting (CBIB), is described for simultaneous quantitation of specific IgE antibodies against several allergens in human sera. Using as little as 50 µl of each of the 20 sera examined against 20 different allergens, it was possible in a single run to achieve 400 tests. To guarantee high specificity and sensitivity of the assay, this new application of CBIB employs purified allergens, cyanogen bromide-activated nitrocellulose membrane, and Phosphorimager technology. Results are expressed both qualitatively (five classes) and quantitatively in kilo units per liter equilibrated against the World Health Organization (WHO) standard for IgE. There was excellent agreement between the results of CBIB and the results of Pharmacia Cap System, an alternative method widely used for measuring serum-specific IgE. The CBIB method certainly could be useful in any laboratory interested in allergy clinical research for easy screening and relative quantitation of allergen-specific human IgE.