Abstract

We have studied the influence of wasp venom immunotherapy (VIT) on cellular recruitment and cytokine mRNA expression during allergen-induced cutaneous late-phase responses (LPR). Nine subjects with a history of wasp sting anaphylaxis, and specific IgE in their sera underwent wasp VIT. Skin biopsies were taken 24 h after intradermal diluent and allergen before and after 3 months VIT. Pre-immunotherapy, there were significant allergen-induced increases in EG2(+) eosinophils, elastase(+) neutrophils, CD68(+) macrophages and IL-10 protein(+) cells, and increased expression of mRNA for IL-4, IL-13, IFN-gamma, IL-12, IL-10, TGF-beta, RANTES and eotaxin. When these allergen-induced changes in cytokine mRNA and cellular profiles were compared with those obtained after 3 months VIT there was a significant reduction in IL-4 mRNA (p=0.012) and increase in IL-10 protein(+) cells (p=0.004) with a trend to an increase in IL-10 mRNA (p=0.054). There were also significant reductions in eosinophils (p<0.004) and the size of the cutaneous LPR (p<0.01) but no change in mRNA to IFN-gamma, IL-13 or IL-12. Therefore, VIT is associated with a significant increase in cells positive for IL-10 protein but not IL-12 or IFN-gamma. These results suggest that induction of IL-10 may be important in VIT and occur independently of the switch to a Th1 phenotype. IL-10 generation may down-regulate IL-4 expression and eosinophil recruitment.

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