The Editors' choiceGrass pollen immunotherapy: IL-10 induction and suppression of late responses precedes IgG4 inhibitory antibody activity
Section snippets
Patient selection
Patients with seasonal allergic rhinitis were selected on the basis of a history of moderate/severe seasonal allergic rhinitis and poor symptom control in previous years despite pharmacotherapy (see the Methods section in the Online Repository at www.jacionline.org for further details). Participants had a positive skin prick test response (wheal >5 mm) to timothy grass pollen extract (Soluprick SQ; ALK-Abelló, Hørsholm, Denmark). Patients were excluded if they were polysensitized with perennial
Overall clinical and immunologic changes during allergen immunotherapy
Subjects who received grass pollen immunotherapy during 2003 had a significant clinical response to treatment, with reduced symptoms and responsiveness to grass pollen allergen compared with those seen in the placebo group. After 1 year's treatment, patients receiving immunotherapy had significantly better mean (±SE) overall assessment scores (2.42 ± 0.22) compared with patients receiving placebo (1.50 ± 0.34, P < .05; Fig 1, A). Patients receiving immunotherapy also required significantly
Discussion
In this study we have examined in detail the time course of clinical desensitization in relation to cellular and humoral immunologic changes during grass pollen immunotherapy. First, immunotherapy resulted in a striking early induction of peripheral IL-10 responses that accompanied suppression of cutaneous allergen–induced late responses. These events were detected as early as 2 to 4 weeks after the first allergen injection, corresponding to a cumulative allergen dose of only 0.9% to 5.4% of
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Supported by grants from the Immune Tolerance Network, National Institutes of Health; Asthma UK; and GlaxoSmithKline in partnership with Imperial College Trust (academic Drug Discovery Initiative) and ALK-Abelló, Hørsholm, Denmark. S.J.T. is the recipient of a Clinician Scientist Fellowship supported by the Health Foundation.
Disclosure of potential conflict of interest: M. A. Calderon has consulting arrangements with ALK-Abelló, MSD, and Schering-Plough and has received research support from ALK-Abelló. S. R. Durham has consulting arrangements with ALK-Abelló and GlaxoSmithKline, has received research support from ALK-Abelló and GlaxoSmithKline, and has served as a member of the Immune Tolerance Network and the National Institutes of Health. The rest of the authors have declared that they have no conflict of interest.
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These authors contributed equally to this work.