Abstract
BackgroundBiomarkers of clinical efficacy for subcutaneous immunotherapy (SCIT) on allergic rhinitis (AR) have not been identified yet. This study aims to assess the clinical relevance of serum inhibitory activity for IgE by the method of enzyme-linked immunosorbent facilitated antigen binding (ELIFAB) during SCIT for Artemisia-sensitized AR patients.Methods19 AR patients were studied who had undergone Artemisia-specific SCIT for more than 8 months (19.68 months on average, ranging from 9 to 33 months). Peripheral bloods were collected before and after treatment. The serum inhibitory activity for IgE was tested by ELIFAB and the level of Artemisia-specific IgG4 (Artemisia-sIgG4) was determined by ELISA. Clinical improvement was evaluated based on the symptom scores and rescue medication use (SMS). The 2-tailed Wilcoxon signed-rank test and the Spearman rank test (two-tailed) were used to analyze data by using SPSS 20.0, with P values of less than 0.05 considered as significant.ResultsThe SMS decreased significantly after SCIT (before: 12.79 ± 4.250, after: 6.11 ± 3.828, P = 0.000 < 0.01), the treatment was remarkably effective for 6 patients, effective for 10 and ineffective for 3, along with a total effective rate 84.21%. The serum inhibitory activity for IgE increased significantly after SCIT (P < 0.05) and was correlated with the levels of Artemisia-sIgG4 (r = − 0.501, P = 0.002 < 0.01). The levels of Artemisia-sIgG4 elevated dramatically after treatment (P < 0.01) and were related with the duration of treatment (r = 0.558, P = 0.000 < 0.01). But there was no relationship between clinical improvements and the serum inhibitory activity for IgE.ConclusionsThe serum inhibitory activity for IgE increased significantly after SCIT, however, there was no correlation between it and clinical improvements by statistics analysis. So whether the serum inhibitory activity for IgE can act as biomarker of efficacy for SCIT or not needs to be studied further.
Highlights
Biomarkers of clinical efficacy for subcutaneous immunotherapy (SCIT) on allergic rhinitis (AR) have not been identified yet
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Design and setting In this study, Artemisia-sensitized AR patients were chosen as subjects, and the main purpose was to analyze the clinical relevance of the serum inhibitory activity for IgE tested by enzyme-linked immunosorbent facilitated antigen binding (ELIFAB) assay, by detecting the serum before and after subcutaneous immunotherapy (SCIT), one of the predominant forms of Allergen immunotherapy (AIT)
Summary
Biomarkers of clinical efficacy for subcutaneous immunotherapy (SCIT) on allergic rhinitis (AR) have not been identified yet. It has been demonstrated that the serum inhibitory activity for IgE, determined by the IgE-FAB assay, increased after AIT and had relevance with the clinical improvements [10, 11]. It has been recommended as potential biomarker for efficacy of AIT in 2017 EAACI Position Paper [12]. It seems that the allergen specific IgGs, especially IgG4s, play a key role in the inhibitory activity for IgE, as the depletion of total IgGs lead to the reduction of the inhibition [11, 13] and it has close relationship with serum levels of sIgG4 [11]. There are limited researches focused on the clinical relevance of the inhibition tested by ELIFAB
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