Effect of anti-immunoglobulin E on nasal inflammation in patients with seasonal allergic rhinoconjunctivitis

• Published in: Clinical and experimental allergy Vol. 34; no. 7; pp. 1079 - 1085
• Main Authors: Bez, C., Schubert, R., Kopp, M., Ersfeld, Y., Rosewich, M., Kuehr, J., Kamin, W., Berg, A. V., Wahu, U., Zielen, S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.07.2004; Blackwell; Wiley Subscription Services, Inc
• Subjects: Adolescent; Allergic diseases; anti-IgE; Antibodies, Anti-Idiotypic; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Betula; Biological and medical sciences; Blood Proteins - analysis; Body Fluids - chemistry; Child; Desensitization, Immunologic - methods; Double-Blind Method; ECP; Eosinophil Granule Proteins; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; IL-6; IL-8; Immunoglobulin E - immunology; Immunopathology; Interleukin-6 - analysis; Interleukin-8 - analysis; Male; Medical sciences; nasal inflammation; Nasal Mucosa - immunology; Nasal Mucosa - secretion; Omalizumab; Poaceae; Pollen; Rhinitis, Allergic, Seasonal - immunology; Rhinitis, Allergic, Seasonal - therapy; Ribonucleases - analysis; seasonal allergic rhinitis; Serine Endopeptidases - analysis; specific immunotherapy; tryptase; Tryptases; Allergy; Nose disease; Rhinitis; IgE; Conjunctiva disease; Conjunctivitis; Interleukin 6; anti-IgE; seasonal allergic rhinitis; Immunology; Immunotherapy; ENT disease; specific immunotherapy; Interleukin 8; Human; Immunopathology; EC 3.4.21.59; Immunoglobulins; Serine endopeptidases; Enzyme; nasal inflammation; Cytokine; Inflammation; IL-8; IL-6; Peptidases; Eye disease; Treatment; ECP; Tryptase; Hydrolases
• ISSN: 0954-7894; 1365-2222
• DOI: 10.1111/j.1365-2222.2004.01998.x

Summary Background Binding of allergens to IgE on mast cells and basophils causes release of inflammatory mediators in nasal secretions. Objective The combined effect of specific immunotherapy (SIT) and omalizumab, a humanized monoclonal anti‐IgE antibody, on release of eosinophilic cationic protein (ECP), tryptase, IL‐6, and IL‐8 in nasal secretion was evaluated. Methods Two hundred and twenty five children (aged 6–17 years) with a history of seasonal allergic rhinoconjunctivitis induced by birch and grass pollen were randomized into four groups: either birch‐ or grass‐pollen SIT in combination with either anti‐IgE or placebo. Complete sets of nasal secretion samples before treatment Visit 1 (V1), during birch‐ (V2) and grass (V3)‐pollen season and after the pollen season (V4) were collected from 53 patients. Results A significant reduction in tryptase only was seen in the anti‐IgE‐treated group at V2 (P<0.05) and V4 (P<0.05) compared with the placebo group. During the pollen season, patients with placebo showed an increase of ECP compared with baseline (V2: +30.3 μg/L; V3: +134.2 μg/L, P< 0.005; V4: +79.0 μg/L, P< 0.05), and stable levels of tryptase, IL‐6 and IL‐8. Treatment with anti‐IgE resulted in stable ECP values and a significant decrease of tryptase compared with V1 (baseline): V2: −80.0 μg/L (P< 0.05); V3: −56.3 μg/L, which persisted after the pollen season with V4: −71.6 μg/L (P< 0.05). After the pollen season, a decrease of IL‐6 was observed in both groups (V4 placebo group: −37.5 ng/L; V4 anti‐IgE group: −42.9 ng/L, P< 0.01). Conclusion The combination of SIT and anti‐IgE is associated with prevention of nasal ECP increase and decreased tryptase levels in nasal secretions.