Quality of selected immunologic parameters during the subcutaneous and sublingual specific immunotherapy
Anna Grad1*, Anna Jung1, Wanda Stankiewicz2, Marek P. Dąbrowski2, Bolesław Kalicki1, Ludmiła Bartoszewicz1, Andrzej M. Fal1,3
1Klinika Pediatrii, Nefrologii i Alergologii Dziecięcej Wojskowego Instytutu Medycznego w Warszawie
2Pracownia Immunologii Zakładu Ochrony Mikrofalowej Wojskowego Instytutu Higieny i Epidemiologii w Warszawie
3Zakład Alergologii Katedry Zdrowia Publicznego Akademii Medycznej we Wrocławiu
Introduction: The specific immunotherapy (SIT) administered in treatment of allergic diseases modulates functions of T lymphocytes diminishing the activity of Th2 cells and increasing activity of Th 1 lymphocytes. Consequently, the production of proinflammatory cytokines of Th2 pathway (IL-4, IL-5, IL-13) decreases and increase of the production of Th1 pathway cytokines (IL-2, IFNγ) is observed. There are two ways of SIT administration, subcutaneous (SCIT) and sublingual (SLIT) and although their clinical effects are comparable, the mechanisms of the former are better documented. The aim of investigations was to estimate the values of chosen immunological parameters in allergic patients treated with SCIT or with SLIT.
Material and methods: The group of 35 children was tested (11 girls and 24 boys, age 7 – 17 years) representing allergic rhinitis (7 cases), asthma (5 cases) or both illnesses (23 cases). 21 of them received subcutaneous vaccination (Purethal, Novo-Helisen Depot, Allerggovit) and 14 children were treated sublingually (Staloral 300). They all were tested before and at the end of the third month of treatment. The concentrations of IL-10, IL-13 and TGFβ in supernatants of PBMC microcultures were estimated in which the T lymphocyte suppressive activity (SAT index) was also tested.
Results: At the third month of treatment the concentration of IL-10 and TGFβ and the value of SAT index (representing the T cell immunoregulatory activity) significantly increased in the both treated groups of children. At the same time, the concentration of IL-13 decreased in the both groups.
Conclusions: The results suggest that the both methods of immunotherapy (SCIT and SLIT) lead to the increase of T lymphocyte immunoregulatory activity and to the connected to it increase of the production of immunoregulatory cytokines (IL-10, TGFβ). The decrease of IL-13 production observed in the both groups is suggestive for suppression of the activity of Th2 pathway. In the light of presented observations the mechanisms by which the both methods of immunotherapy yield in clinical improvement, are similar.
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