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Immunotherapy Update: Mechanisms of Action

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Allergen immunotherapy (IT) results in reduction of symptoms of allergic rhinitis and asthma. There still is not satisfactory evidence as to the best marker that explains clinical responses. IT inhibits the early and late nasal, bronchial, and cutaneous responses to allergen challenge. There are increases in antiallergen immunoglobulin G (IgG; 2- to 10-fold) and IgG4 (10- to 100-fold), a gradual decline in antiallergen IgE antibodies, and reduced numbers of nasal or bronchial mast cells, eosinophils, and CD4+ T-helper 2 (TH2) lymphocytes. Cytokine changes include reductions in serum interleukin (IL)-4 and in vitro lymphocyte-derived IL-4 as compared with a lack of increases in interferon  or IL-2. In a study in which skin biopsy specimens were obtained 24 hours after intradermal grass injection, the IT-treated patients had sharply increased numbers of macrophages which had messenger RNA for IL-12. This cytokine supports development of TH0 into TH1 CD4+ lymphocytes. Allergen immunotherapy results in a profound IgG and IgA antibody response with down-regulation of TH2 and possibly up-regulation of TH1 responses.
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Document Type: Conference Report

Publication date: 2002-11-01

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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