Basophil sensitivity reflects long-term clinical outcome of subcutaneous immunotherapy in grass pollen-allergic patients
- 1 May 2021
- Vol. 76 (5), 1528-1538
- https://doi.org/10.1111/all.14264
Abstract
Background Allergic rhinoconjunctivitis is a public health problem. Allergen Immunotherapy is an effective and safe treatment, that modifies the natural course of allergic disease and induces long-term tolerance. Objective To correlate basophil and antibody biomarkers of subcutaneous immunotherapy to clinical outcomes and cellular changes in target tissue. Methods Adults suffering from allergic rhinoconjunctivitis due to grass pollen allergy were randomized to receive subcutaneous immunotherapy (n = 18) or to an open control group (n = 6). Patients reported daily symptom and medication scores and weekly rhinitis related quality of life scores during four pollen seasons. Biomarkers were measured every 3 months for three years treatment and every 6 months in the follow-up year. Nasal and cutaneous allergen challenge tests were performed annually. Leukocyte subsets were assessed in nasal mucosa biopsies at baseline and after treatment. Results Subcutaneous immunotherapy led to a 447-fold decrease in basophil sensitivity during the first treatment year. This remained 100-fold lower than baseline during the 3 year-treatment period and 10-fold lower during the follow-up year (n = 18, P = .03). Decrease in basophil sensitivity after three weeks of treatment predicted long-term improvement in seasonal combined symptom and medication scores (rho=-0.69, P = .0027) during three years of treatment. AUC of IgE-blocking factor correlated to nasal allergen challenge (rho = 0.63, P = .0012) and SPT (rho = 0.45, P = .03). Plasma cell numbers in the nasal mucosa increased during treatment (P = .02). Conclusion Decrease in basophil sensitivity after three weeks of subcutaneous allergen immunotherapy predicted the clinical outcome of this treatment.Keywords
Funding Information
- Lundbeckfonden (R32‐A1482)
This publication has 38 references indexed in Scilit:
- Decrease in antigen‐specific CD63 basophil expression is associated with the development of tolerance to egg by SOTI in childrenPediatric Allergy and Immunology, 2013
- Oral Peanut Challenge Identifies an Allergy but the Peanut Allergen Threshold Sensitivity Is Not ReproduciblePLOS ONE, 2013
- CD-Sens Can Be a Reliable and Easy-to-Use Complement in the Diagnosis of Allergic RhinitisInternational Archives of Allergy and Immunology, 2012
- Rhinitis symptoms caused by grass pollen are associated with elevated basophile allergen sensitivity and a larger grass‐specific immunoglobulin E fractionClinical and Experimental Allergy, 2011
- Mechanisms of immunotherapy to aeroallergensClinical and Experimental Allergy, 2011
- Cat allergen-induced blood basophil reactivity in vitro predicts acute human nasal allergen challenge responses in vivoClinical and Experimental Allergy, 2011
- Sublingual immunotherapy for peanut allergy: Clinical and immunologic evidence of desensitizationJournal of Allergy and Clinical Immunology, 2011
- GA2LEN/EAACI pocket guide for allergen‐specific immunotherapy for allergic rhinitis and asthmaAllergy, 2010
- CD‐sens: a biological measure of immunological changes stimulated by ASITAllergy, 2009
- IL-9 and c-Kit+ mast cells in allergic rhinitis during seasonal allergen exposure: Effect of immunotherapyJournal of Allergy and Clinical Immunology, 2005