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原标题：用300 IR舌下尘螨片免疫治疗后的分子反应谱显示主要过敏原的显著体液变化
背景：目前尚未有对舌下尘螨（HDM）片剂免疫疗法治疗患者的分子抗体反应谱进行深入研究。本研究旨在使用300IR HDM舌下片进行过敏原特异性免疫治疗（AIT）的双盲安慰剂对照试验中，通过过敏原微阵列技术对临床定义的高应答和低应答患者进行体液免疫应答研究。
方法：在100名表现出高或低临床收益的受试者中，于基线和1年AIT后使用过敏原微阵列测量了血清中13种尘螨组分IgE、IgG和IgG4抗体水平。
结果：Der p 1、Der p 2和Der p 23是研究人群中最常见的过敏原组分。HDM相关哮喘患者Der p 1和Der p 23特异性IgE水平明显高于其他组分。高应答者和低应答者之间的过敏原组分致敏分布没有显著差异。AIT时血清过敏原特异性IgG和IgG4增加，尤其是过敏原Der p1、Der p2和Der p 23（p<0.0001）。
结论：我们的研究人群确认Der p1和Der p23特异性IgE水平与哮喘相关。IgE反应谱并不预示着舌下AIT的结果，300IR舌下片对单独和多重致敏的受试者均有效。我们的研究首次证明了舌下AIT对HDM过敏原Der p1、Der p2和Der p2 3特异性IgG和IgG4的诱导作用。


原始出处
Allergy                                                  
Molecular reactivity profiling upon immunotherapy with a 300 IR sublingual house dust mite tablet reveals marked humoral changes towards major allergens
DOI: 10.1111/all.15327
Abstract:
Background: Molecular antibody reactivity profiles have not yet been studied in depth in patients treated by sublingual house dust mite (HDM) tablet immunotherapy. Humoral immune responses to a large panel of HDM mite allergens were studied using allergen microarray technology in a subset of clinically defined high and low responder patients from a double-blind placebo-controlled allergen-specific immunotherapy (AIT) trial using sublingual 300 IR HDM tablets.
Methods: : Serum levels of IgE, IgG and IgG4 to 13 Dermatophagoides pteronyssinus molecules were measured at baseline and after 1-year AIT, using allergen microarrays in 100 subjects exhibiting high or low clinical benefit.
Results: Der p 1, Der p 2 and Der p 23 were the most frequently recognized allergens in the study population. Patients with HDM-related asthma had significantly higher allergen-specific IgE levels to Der p 1 and Der p 23. No significant difference in the distribution of allergen sensitization pattern was observed between high and low responders. An increase in serum allergen-specific IgG and IgG4 occurred upon AIT, in particular to allergens Der p 1, Der p 2 and Der p 23 (p < 0.0001).
Conclusion: We confirm for our study population that Der p 1-and Der p 23-specific IgE levels are associated with asthma. IgE reactivity profiles were not predicitive of sublingual AIT outcomes, with 300 IR tablets as efficacious in pauci-and multi-sensitized subjects. Our study is the first to demonstrate the induction of IgG and IgG4 specific for the HDM allergens Der p 1, Der p 2 and Der p 23 by sublingual AIT.
First Author:
Ekaterina Potapova
Correspondence:
Laurent Mascarell, Innovation & Science Department, Stallergenes SAS, Antony, France.
2023-02-01 Article