Original Paper

Systemic Immunological Changes Induced by Administration of Grass Pollen Allergens via the Oral Mucosa during Sublingual Immunotherapy
C. Fanta^a, B. Bohle^a, W. Hirt^b, U. Siemann^a, F. Horak^c, D. Kraft^a, H. Ebner^b, C. Ebner<sup>a

a</sup>Institute of General and Experimental Pathology, University of Vienna,
^bAllergy Clinic Reumannplatz, Vienna,
^cDepartment of ENT, University of Vienna Medical School, Vienna, Austria

Address of Corresponding Author

Int Arch Allergy Immunol 1999;120:218-224 (DOI: 10.1159/000024270)

  Key Words

• Type I allergy
• IgE
• Sublingual immunotherapy
• T helper cells

  Abstract

Twenty-four patients suffering from grass pollen allergy underwent sublingual immunotherapy (SLIT) with standardized grass pollen extract for 1 year. In order to investigate immunological changes induced by the administration of allergens via the oral mucosa, the SLIT-spit method was applied. The cumulative dose of approximately 80 µg of major allergen (grass group 5 allergen), was relatively low. During the time of treatment, we could observe a significant increase in the levels of specific IgG and IgG4 antibodies. However, the titers of allergen-specific IgE antibodies showed a significant increase in the course of SLIT as well. Analyzing lymphoproliferative responses, a significant decrease in reactivity in response to stimulation with complete grass pollen extract (p = 0.001) and to recombinant Phl p 1 (a major allergen of timothy grass, p<0.001) could be observed, indicating the induction of immunological tolerance. Proliferative responses to a control antigen (tetanus toxoid) were not influenced by the treatment. At different time points during SLIT, allergen (Phl p 1)-specific T cell clones (TCC) were established from the peripheral blood of the patients. Cytokine production by allergen-stimulated T cells did not reveal any changes consistent with immune deviation, i.e. the ratio of Th1/Th2 TCC did not change during SLIT. In conclusion, we provide evidence that sublingual treatment leads to systemic changes in immunoreactivity to the administered allergen.

  Author Contacts

Correspondence to: Dr. Christof Ebner
Institute of General and Experimental Pathology, Department of Immunopathology
Währinger Gürtel 18-20
A-1090 Vienna (Austria)
Tel. +43 1 40400 5101, Fax +43 1 40400 5130, E-Mail christof.ebner@akh-wien.ac.at

  Article Information

Received: Received: February 5, 1999
Accepted after revision: August 9, 1999
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 1, Number of References : 30