Specific immunoglobulin G4 inhibits Th2 cytokine production in allergic
asthmatics with Dermatophagoides pteronyssinus
subcutaneous immunotherapy
Abstract
Background: The modulations of subcutaneous allergen immunotherapy
(SCIT) on lymphocyte subsets and cytokine productions are not fully
clarified. Objective: We investigated the changes of T-lymphocyte
subsets and serum Dermatophagoides pteronyssinus specific
immunoglobulin G4 (Der-p-sIgG4), and cytokine productions in allergic
asthmatics during Der-p SCIT. Methods: This study involved 20 allergic
asthmatics receiving 156-week Der-p SCIT, 20 patients without SCIT
(non-SCIT). Symptom and medication scores (SMS), serum Der-p-sIgG4
levels, CD4+CD25+Foxp3+ T regulatory (Treg), CD4+IL-4-IFN-γ+ T-helper
(Th) 1, CD4+IL-4+IFN-γ- Th2 lymphocyte percentage in peripheral blood
mononuclear cells (PBMCs) with/without Der-p extract stimulation at
weeks 0, 4, 12, 16, 52, 104, and 156 were measured. Serum from SCIT and
non-SCIT patients were incubated with Der-p allergen and Der-p
sensitized PBMCs. Levels of interleukin (IL) -4, IL-5, IL-10, IL-13,
IL-17, interferon (IFN) -γ, tumor necrosis factor (TNF) -α and transfer
growth factor (TGF) -β1 in supernatant were detected. Results: SCIT
patients had significantly lower SMS after week 52. Der-p-sIgG4 levels
in SCIT patients significantly increased at week 16 compared to non-SCIT
subjects. CD4+IL-4+IFN-γ- Th2 percentage in SCIT patients showed a
significant decrease from week 104 to 156 comparing to week 0, while no
change was observed in CD4+CD25+Foxp3+ Treg and CD4+IL-4-IFN-γ+ Th1
percentage. IL-5, IL-13, IL-4, IL-17, and TNF-α levels in supernatant of
Der-p-sensitized PBMCs, cultured with serum of SCIT patients after 16
weeks decreased significantly compared with non-SCIT patients, and
showed significant reverse associations with Der-p-sIgG4 levels.
Conclusion: SCIT down-regulated Th2 cytokine productions associated
reversely with Dep-p-sIgG4 levels in Der-p allergic asthma patients.