Mechanisms of immunotherapy to aeroallergens
- 15 July 2011
- journal article
- review article
- Published by Wiley in Clinical and Experimental Allergy
- Vol. 41 (9), 1235-1246
- https://doi.org/10.1111/j.1365-2222.2011.03804.x
Abstract
Allergen immunotherapy is allergen‐specific, allergen dose‐ and time‐dependent and is associated with long‐term clinical and immunological tolerance that persists for years after discontinuation. Successful immunotherapy is accompanied by the suppression of numbers of T‐helper 2 (Th2) effector cells, eosinophils, basophils, c‐kit+mast cells and neutrophils infiltration in target organs, induction of IL‐10 and/or TGF‐β+Treg cells and increases in ‘protective’ non‐inflammatory blocking antibodies, particularly IgG4 and IgA2 subclasses with inhibitory activity. These events are accompanied by a reduction and/or a redirection of underlying antigen‐specific Th2‐type T cell‐driven hypersensitivity to the allergen(s) used for therapy. This suppression occurs within weeks or months as a consequence of the appearance of a population of regulatory T cells that exert their effects by mechanisms involving cell–cell contact, but also by the release of cytokines such as IL‐10 (increases IgG4) and TGF‐β (increases specific IgA). The more delayed‐in‐time appearance of antigen‐specific T‐helper 1 responses and alternative mechanisms such as Th2 cell anergy and/or apoptosis may also be involved. The mechanisms of sublingual immunotherapy are similar to those following a subcutaneous administration of allergen, whereas it is likely that additional events following antigen presentation in the sublingual mucosa and regional lymph nodes are involved. These insights have resulted in novel approaches and portend future biomarkers that may be surrogate or predictive of the clinical response to treatment. Cite this as: M. H. Shamji and S. R. Durham, Clinical & Experimental Allergy, 2011 (41) 1235–1246.Keywords
This publication has 106 references indexed in Scilit:
- Birch Pollen Immunotherapy Leads to Differential Induction of Regulatory T Cells and Delayed Helper T Cell Immune DeviationPublished by The American Association of Immunologists ,2010
- Subcutaneous allergen immunotherapy restores human dendritic cell innate immune functionClinical and Experimental Allergy, 2009
- Three-Year Follow-Up Study of Allergen-Induced in vitro Cytokine and Signalling Lymphocytic Activation Molecule mRNA Responses in Peripheral Blood Mononuclear Cells of Allergic Rhinitis Patients Undergoing Specific ImmunotherapyInternational Archives of Allergy and Immunology, 2009
- Peptide immunotherapy in allergic asthma generates IL-10–dependent immunological tolerance associated with linked epitope suppressionThe Journal of Experimental Medicine, 2009
- Induction of interleukin 10 by sublingual immunotherapy for house dust mites: a preliminary reportAnnals of Allergy, Asthma & Immunology, 2005
- T Cell Epitope Immunotherapy Induces a CD4+ T Cell Population with Regulatory ActivityPLoS Medicine, 2005
- IL‐10 and TGF‐β cooperate in the regulatory T cell response to mucosal allergens in normal immunity and specific immunotherapyEuropean Journal of Immunology, 2003
- Pollen-specific rush immunotherapy: clinical efficacy and effects on antibody concentrationsAnnals of Allergy, Asthma & Immunology, 2001
- Clinical and immunologic effects of a rush sublingual immunotherapy to Parietaria species: A double-blind, placebo-controlled trial☆☆☆★Journal of Allergy and Clinical Immunology, 1999
- Effect of immunotherapy on immunoglobulin E and immunoglobulin G antibodies to ragweed antigens: A six-year prospective studyJournal of Allergy and Clinical Immunology, 1982