BackgroundLocal allergic rhinitis (LAR) is defined by chronic nasal symptoms, absence of atopy, positive nasal allergen challenge (NAC) and a good response to subcutaneous allergen immunotherapy (SCIT). We sought to investigate SCIT capacity to induce local and systemic blocking antibodies in LAR patients.MethodsA RDBPC study of grass SCIT was performed, with participants receiving either SCIT (Group A; n = 10) or placebo (Group B; n = 14) in the first 6 months. Both groups subsequently received SCIT for 12 months at Year 2. Nasal and serum antibodies (IgG4, IgA1 and IgA2) and their inhibitory capacity were measured at multiple timepoints.ResultsThe allergen concentration tolerated increased significantly at 6 months (Group A; p = .047) and 24 months (Group B; p = .049) compared with baseline and persisted until the end of the study. Induction of serum sIgA1 to Phl p was seen in Groups A and B, albeit the former being induced earlier (1.71‐fold, p = .027). A significant induction in sIgG4 to Phl p 1 and 5 was observed in serum of Group A (p = .047 and p = .0039) and sIgA2 to Phl p in Group B (p = .032 and p = .0098) at 18 and 24 months, respectively. Both local and systemic blocking antibodies can inhibit allergen–IgE complexes binding to CD23 on B cells, and this correlated with level of allergen tolerated intra‐nasally in Group A (serum; 𝜌 = −.47, p = .0006, nasal; 𝜌 = −.38, p = .0294).ConclusionsGrass pollen SCIT induced functional systemic blocking antibodies that correlate with the concentration of allergen tolerated following NAC, highlighting their potential as a biomarker of SCIT in LAR.

中文翻译：

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局部过敏性鼻炎患者接受草花粉皮下免疫治疗后，鼻过敏原中和抗体与耐受鼻内过敏原激发剂量密切相关

背景局部过敏性鼻炎（LAR）的定义是慢性鼻部症状、无过敏性、鼻过敏原激发（NAC）阳性以及对皮下过敏原免疫疗法（SCIT）的良好反应。我们试图研究 SCIT 在 LAR 患者中诱导局部和全身阻断抗体的能力。方法对草 SCIT 进行 RDBPC 研究，参与者接受 SCIT（A 组；A 组；A 组）。n= 10) 或安慰剂（B 组；n= 14) 在前 6 个月内。两组随后在第 2 年均接受了为期 12 个月的 SCIT。鼻腔和血清抗体（IgG4, 免疫球蛋白A1和免疫球蛋白A2）并在多个时间点测量其抑制能力。结果耐受的过敏原浓度在6个月时显着增加（A组；p= .047) 和 24 个月（B 组；p= .049）与基线相比并持续到研究结束。血清sIgA的诱导1在 A 组和 B 组中观察到对 Phl p 的影响，尽管前者诱导较早（1.71 倍，p=.027）。sIgG 显着诱导4在 A 组血清中观察到对 Phl p 1 和 5 的影响（p= .047 和p= .0039) 和 sIgA2B 组的 Phl p（p= .032 和p= .0098) 分别在 18 个月和 24 个月时。局部和全身阻断抗体都可以抑制过敏原-IgE 复合物与 B 细胞上的 CD23 结合，这与 A 组鼻内耐受的过敏原水平相关（血清；𝜌 = -.47，p= .0006，鼻音；𝜌 = −.38，p= .0294).结论草花粉 SCIT 诱导功能性全身阻断抗体，这些抗体与 NAC 后耐受的过敏原浓度相关，突出了它们作为 LAR 中 SCIT 生物标志物的潜力。