Fifteen grass pollen-sensitive asthmatic patients were selected from 200 patients with grass pollenosis on the basis of positive SPTs and RASTs that were restricted to grass pollens (except Bermuda grass), no previous IT, and residence and occupation in an area monitored by serial pollen counts. They underwent a double-blind trial of specific IT with a mixture of three grass pollen-aqueous extracts (velvet, sweet vernal, and timothy) or placebo. After 10 mo, the mean maintenance dose of pollen extract (assayed by RAST inhibition) in eight actively treated patients was 6000 RAST units (range 3000 to 8000) and the mean total dose was 18,700 RAST units (range 10,200 to 30,000). Results were assessment done by the following clinical and immunological data: (1) during the pollen season, daily symptom scores; (2) PD 20% FEV1, IgE antibody to timothy by RAST in serum and in nasal secretions, serum IgG antibody to purified timothy allergen D by solid-phase radioimmunoassay, and the four IgG subclass antibodies by enzyme immunoassay were all measured before treatment and before and after the pollen season. Symptom scores of both treated patients and controls correlated with pollen counts (R=0.88, p<0.05 and R=0.71, p<0.05, respectively). There was a significant difference between the mean symptom score values of treated patients versus controls (Kruskal-Wallis test, p<0.001). No significant differences or changes either in the PD 20% FEV1 or IgE antibody to timothy in serum and nasal secretions were found in the two groups before or after IT. Total IgG and all four IgG subclass antibodies to timothy antigen D increased significantly in actively treated patients (p<0.005 for each). The increase in IgG4 subclass antibodies was greater than in that of the other three IgG subclasses (p<0.05). We conclude that a single year of aqueous grass pollen IT is clinically effective in properly selected patients without demonstrable decreases in serum or secretory IgE antibody and is associated with significant rises in all IgG subclass antibodies, especially IgG4.

Grass-pollen immunotherapy: a single year double blind placebo controlled study in patients with grass pollen-induced asthma and rhinitis / C. Ortolani, E.A. Pastorello, R.B. Moss, Y.P. Hsu, M. Restuccia, G. Joppolo, A. Miadonna, U. Cornelli, G. Halpern, C. Zanussi. - In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. - ISSN 0091-6749. - 73:2(1984), pp. 283-290.

Grass-pollen immunotherapy: a single year double blind placebo controlled study in patients with grass pollen-induced asthma and rhinitis

E.A. Pastorello
Secondo
;
1984

Abstract

Fifteen grass pollen-sensitive asthmatic patients were selected from 200 patients with grass pollenosis on the basis of positive SPTs and RASTs that were restricted to grass pollens (except Bermuda grass), no previous IT, and residence and occupation in an area monitored by serial pollen counts. They underwent a double-blind trial of specific IT with a mixture of three grass pollen-aqueous extracts (velvet, sweet vernal, and timothy) or placebo. After 10 mo, the mean maintenance dose of pollen extract (assayed by RAST inhibition) in eight actively treated patients was 6000 RAST units (range 3000 to 8000) and the mean total dose was 18,700 RAST units (range 10,200 to 30,000). Results were assessment done by the following clinical and immunological data: (1) during the pollen season, daily symptom scores; (2) PD 20% FEV1, IgE antibody to timothy by RAST in serum and in nasal secretions, serum IgG antibody to purified timothy allergen D by solid-phase radioimmunoassay, and the four IgG subclass antibodies by enzyme immunoassay were all measured before treatment and before and after the pollen season. Symptom scores of both treated patients and controls correlated with pollen counts (R=0.88, p<0.05 and R=0.71, p<0.05, respectively). There was a significant difference between the mean symptom score values of treated patients versus controls (Kruskal-Wallis test, p<0.001). No significant differences or changes either in the PD 20% FEV1 or IgE antibody to timothy in serum and nasal secretions were found in the two groups before or after IT. Total IgG and all four IgG subclass antibodies to timothy antigen D increased significantly in actively treated patients (p<0.005 for each). The increase in IgG4 subclass antibodies was greater than in that of the other three IgG subclasses (p<0.05). We conclude that a single year of aqueous grass pollen IT is clinically effective in properly selected patients without demonstrable decreases in serum or secretory IgE antibody and is associated with significant rises in all IgG subclass antibodies, especially IgG4.
Settore MED/09 - Medicina Interna
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/208718
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