Standard Allergens Research Articles

The Clinical Impact of Bet v 6 in Birch Pollen-Sensitized Patients

Background: Bet v 6, a minor birch pollen allergen, is commercially available for allergen-specific IgE antibody testing. However, there is hardly any literature on the clinical impact of Bet v 6. The aim of the present study was to analyze if testing specific IgE against Bet v 6 can add valuable benefit to the standard diagnostics of birch pollen-sensitized patients, especially in patients with unknown sensitization-eliciting allergens. Methods: Birch pollen-sensitized patients with missing IgE reactivity against Bet v 1, 2, and 4 were tested for specific IgE antibodies against Bet v 6. For comparison, an equal number of randomly selected patients with birch pollen sensitization, regardless of their individual sensitization patterns, were tested for specific anti-Bet v 6. Results: Of 57 cases with missing reactivity against the standard birch pollen allergens, 2 patients were positive for Bet v 6. In the representative sample, 3 patients showed specific IgE against Bet v 6 - resulting in a total prevalence of 5%. None of the Bet v 6-positive patients showed allergic symptoms after exposure to birch pollen or an oral allergy syndrome. An increased prevalence of asthma and a higher degree of sensitization were the only distinctive clinical features in Bet v 6-positive patients. Conclusions: Among birch pollen-sensitized patients, the prevalence of specific IgE against Bet v 6 is low. Further, sensitization to Bet v 6, which shows characteristics of a panallergen, remains clinically silent. Therefore, determination of anti-Bet v 6 is not considered useful in the clinical routine.

Allergen-Specific Immunotherapy for Respiratory Allergy in Children: Unmet Needs and Future Goals

Allergen-specific immunotherapy for the treatment of respiratory allergy is currently supported, at least for selected products, by evidence of efficacy and effectiveness in the pediatric age. However, unmet needs remain in terms of administration regimens, duration of treatment, biomarkers, and preventive effects. These knowledge gaps need to be urgently addressed to provide pediatricians and pediatric allergists with more definite recommendations for the use of this treatment in children. This article critically appraises the most relevant debated issues on allergen-specific immunotherapy in children, focusing on allergen standardization procedures, heterogeneity of clinical studies, and regulatory and pharmacoeconomic aspects.

Fungal raw materials used to produce allergen extracts

ObjectiveTo review the topic of fungal raw materials used for the production of allergen extracts and the associated challenges and highlight candidate areas for development before standardized fungal allergen extracts can be commercially produced. Data SourcesA PubMed search was performed using focused keywords and combined with a review of regulatory documents and industry guidelines. Several books on mycology also were consulted. Study SelectionsThe information obtained through the literature, books, and industry was scrutinized and combined with personal experience and expertise to write this article. ResultsFungi are complex ubiquitous organisms on Earth. They are beneficial and detrimental for humans. Fungi can cause hypersensitivity reactions, including types I, III, and IV. The procurement of fungal raw materials to prepare allergen extracts for diagnosis and possible allergen immunotherapy is complex owing to the intrinsic nature of fungi and their complex genome. Allergen manufacturers produce allergen extracts with variable qualitative and quantitative compositions, which can lead to unpredictable clinical outcomes. ConclusionThe clinician should be aware of the factors responsible for the qualitative and quantitative compositions of fungal allergen extracts and the reasons that currently preclude their standardization. Scientific advances and collaboration and cooperation between allergen manufacturing companies and regulatory agencies are necessary to improve the quality and consistency of fungal extracts. Moreover, clinicians should understand the limitations of currently available fungal extracts.

New Insights into Cockroach Allergens.

This review addresses the most recent developments on cockroach allergen research in relation to allergic diseases, especially asthma. The number of allergens relevant to cockroach allergy has recently expanded considerably up to 12 groups. New X-ray crystal structures of allergens from groups 1, 2, and 5 revealed interesting features with implications for allergen standardization, sensitization, diagnosis, and therapy. Cockroach allergy is strongly associated with asthma particularly among children and young adults living in inner-city environments, posing challenges for disease control. Environmental interventions targeted at reducing cockroach allergen exposure have provided conflicting results. Immunotherapy may be a way to modify the natural history of cockroach allergy and decrease symptoms and asthma severity among sensitized and exposed individuals. The new information on cockroach allergens is important for the assessment of allergen markers of exposure and disease, and for the design of immunotherapy trials.

Multiple Reactions Monitoring (MRM) Mass Spectrometry for Absolute Quantification of Allergens in German Cockroach (GCr) Allergen Extracts

Mass spectrometry (MS) offers a unique approach for rapid compositional characterization and absolute quantification of individual allergens and allergen isoforms in complex allergen extracts, and thus has the potential to transform the ongoing efforts of allergen standardization. We developed an assay to evaluate GCr extracts, based on liquid chromatography (LC) and MRM MS, by systematically optimizing the digestion conditions (buffer, protein denaturation, digestion time, and trypsin quantity), LC gradient, and MS parameters (collision energy, dwell time, precursor-fragment pairs). In silico simulation, followed by recombinant-allergen and extract digestion and high resolution MS analysis allowed us to identify 47 proteotypic and quantotypic reference peptides for use as calibrators and internal standards for quantification of endogenous peptides. The peptide list represents 9 allergens and 8 iso-allergens and variants. Since the initial phase of the project aimed to generate a template-method using selected GCr allergens, twenty-six peptides (13 native and 13 isotopically-labelled) representing Bla g 1, 2, 3, 4 and 5 were chemically synthesized and used in LC-MRM/MS method development. Robustness and suitability of the overall protocol was extensively assessed following the ICH (Q2(R1) and FDA guidelines. The protocol offers excellent precision (CV < 10%), linear response (r > 0.99), dynamic range (>3), detection, and recovery. The applicability of the method was further demonstrated using eight commercial GCr extracts from four different vendors. The LC-MRM/MS method proved to be a useful tool for absolute quantification of allergens in GCr extracts and has promise for the standardization of complex allergen extracts.

Relationship between Total Serum IgE Level and Skin Prick Test in Patients with Symptoms of Respiratory Allergy

Background: skin prick test (SPT) and total serum IgE measurement are common tests used for allergy diagnosis.Objective: the current study aimed to determine the association between elevated Total IgE levels and skin test reactivity in patients with symptoms of respiratory allergy.Methodology : the study include 128 patients with symptoms of allergic asthma and or allergic rhinitis who attended to AAC In Al-Sader Medical City, skin prick test was done by using standard allergens extracts like house dust mites extracts, pollens of trees, grasses and weeds also extract for mold allergens. Also sera of patients analyzed for measurement total serum IgE.Results: skin prick test was positive in 112 (87.5%) of patients to one allergen or more and (57.8%) of patients had high IgE levels (&gt;190 IU/ml), 72(64%) out of 112 skin test positive patients had high IgE levels.Conclusion: there is close association between reported allergic symptoms, skin test reactivity and elevated IgE levels, also skin test results correlate significantly with total IgE levels.Recommendation: Total serum IgE measurement could be used as diagnostic marker to identify respiratory allergy and could be used as single cost effective test in cases when skin test not available or contraindicated, and so Respiratory allergy still could be diagnosed on the bases of clinical examination as there is significant association between symptoms and allergy tests positivity.

Monoclonal Antibodies to Recombinant Fag e 3 Buckwheat Allergen and Development of a Two-site ELISA for Its Quantification.

PurposeBuckwheat is a major cause of anaphylaxis, and Fag e 3 is the key major allergen in buckwheat. However, an immunoassay system for the quantification of Fag e 3 has yet to be developed.MethodsWe developed a 2-site enzyme-linked immunosorbent assay (ELISA) using monoclonal antibodies (mAbs) produced against recombinant Fag e 3. We applied this ELISA to quantify native Fag e 3 in total buckwheat extract.ResultsFour clones of mAbs were produced, and all recognized vicilin allergens not only from buckwheat, but also from peanut and walnut. However, the ELISA using these antibodies was only able to quantify Fag e 3 in the total extract after addition of 1% sodium dodecyl sulphate (SDS) and heating, which facilitated dissociation of the allergen. The detection limit of the developed 2-site ELISA was 0.8 µg/mL. The measurement of Fag e 3 in the total extract of buckwheat showed that approximately 12% of protein in total buckwheat extract was Fag e 3.ConclusionsWe have developed an ELISA system for the quantification of the group 3 buckwheat allergen, Fag e 3, specifically. This assay will be useful for standardization of buckwheat allergens and monitoring of buckwheat contamination in foods.

THE CLINICAL EFFICACY OF SUBLINGUAL ALLERGEN-SPECIFIC IMMUNOTHERAPY IN CHILDREN AGED 3-5 YEARS

The aim of this study was to determine the efficacy of sublingual allergen–specific immunotherapy (SLIT) in Ukrainian children younger than 5 years old with allergic rhinitis and bronchial asthma sensitized to house dust mite allergens. Material and methods: Four hundred and fifty children aged 28 months up to 5 years with rhinitis or asthma were examined. One hundred and twenty five children sensitized to house dust mites Dermatophagoides pteronyssinus and/or Dermatophagoides farina were included. In vivo and in vitro tests were made with a standard inhalant allergens panel. Results: The high information value of molecular diagnostics methods applied prior to prescription of the given therapy in children is analyzed. It has been found that in children under 5 sensitized to allergens of house dust mites Dermatophagoides pteronyssinus and/or Dermatophagoides farinae the application of sublingual allergen–specific immunotherapy therapy allows gaining control over the symptoms of the disease during the first 6 months. Conclusion: The high safety of SLIT in children has been proven. Comparative analysis in the group of patients not receiving SLIT shows a high frequency of symptoms of the disease after “free-of-symptoms interval” against full or partial baseline therapy denial.

Environmental exogenous factors and facial dermatitis: A case control study

Abstract Background/objective Facial dermatitis is common and the roles different exogenous factors play between facial and nonfacial dermatitis is unknown. The study aim was to investigate the etiology and self-reported exogenous aggravation factors in facial dermatitis. Methods There were 89 facial dermatitis patients patch tested in a tertiary hospital during a 1-year period, and 112 patients with nonfacial dermatitis tested in the same period who served as a control. Association of exogenous factors was investigated by multivariate analyses. Results Of the cases of facial dermatitis, 30.3% were confirmed allergic contact dermatitis, which was higher than that (23.2%) in controls. Cosmetic allergy was much more common in facial than nonfacial allergic contact dermatitis (96.3% vs. 19.2%); 51.9% of facial allergic contact dermatitis cases were caused by facial creams; 6.7% of facial dermatitis were irritant contact dermatitis, compared with 2.7% for controls; 9.0% of cases were seasonal facial dermatitis. The positive patch test reactions to at least one standard allergen were 65.2% in facial dermatitis and 58.0% in controls. Self-reported exogenous aggravation factors in facial dermatitis were spicy food ingestion (24.7%), low moisture (22.5%), sunlight (19.1%), alcohol ingestion (15.7%), seafood ingestion (14.6%), beef or lamb ingestion (12.4%), and high humidity (5.6%). Multivariate logistic regression analysis adjusting for sex, age, disease duration, atopic diathesis, and contact allergy showed that more patients reported aggravation by sunlight exposure ( p = 0.008), ingestion of spicy food ( p = 0.025), or alcohol ( p = 0.044). Conclusions Contact factors play an important role in facial dermatitis. Aggravation by sunlight exposure, ingestion of spicy food, or alcohol are more reported in facial dermatitis compared with nonfacial dermatitis.

Analysis of allergens distribution of patients with allergic rhinitis in Nanchong of Sichuan

Objective:To annalyze the allergens distribution of patients with allergic rhinitis in Nanchong of Sichuan, and to provide basic information for the prevention,diagnosis,treatment and epidemiological studies.Method:Skin prick tests with 36 kinds of standard allergens were used to 3 621 patients with allergic rhinitis.All the patients were divided into different group on the basis of gender,age and history of allergic disease.Result:Allergen positive rate prick test was 73.73% in all patients.There were no significant differences in allergen positive rate between different gender (P> 0.05).The top five allergens were all inhaled allergens,such as House dust mites,dust mites,rape pollen,the French phoenix tree pollen,and cat hair.In different age groups,allergen positive rate of group A,was different from group B,group C and group D respectively(P< 0.05). Group B was different from group C and group D respectively(P< 0.05). There were no significant differences between group C and group D(P> 0.05). The groups with family history of allergic rhinitis,bronchial asthma and hypersensitivity pneumonitis respectively were different from its counterpart(P< 0.05). And there were no significant differences between group with urticaria and group with contact dermatitis (P> 0.05).Conclusion:The main allergens were inhaled allergens in Nanchong of Sichuan,such as dust mites,pollen,dust mites,rape French phoenix tree pollen,cat hair.Allergen positive rate has nothing to do with gender.Allergen positive rate was connected with age,history of allergic diseases(family history of allergic rhinitis and bronchial asthma and a history of hypersensitivity pneumonitis).

The Association of Race/Ethnicity and Patch Test Results: North American Contact Dermatitis Group, 1998-2006.

The North American Contact Dermatitis Group patch tests patients with suspected allergic contact dermatitis (ACD) to a broad series of screening allergens and publishes periodic reports. We have previously reported on the association of race and ethnicity with the rates of positive responses to standard patch test allergens. This report extends those observations. The aim of the study was to report the North American Contact Dermatitis Group patch testing results from January 1, 1998, to December 31, 2006, comparing the frequency of positive reactions between white and black subjects. Standardized patch testing with 45 allergens was used at 13 centers in North America. χ analysis of results in black subjects as compared with whites was examined. A total of 19,457 patients were tested; 92.9% (17,803) were white and 7.1% (1,360) were black. The final diagnoses of ACD (whites, 45.9%; blacks, 43.6%) and irritant contact dermatitis (13.0%/13.3%) were similar in the 2 groups. The diagnosis of atopic dermatitis was less common in the white patients (8.9%) as compared with the black patients (13.3%). Positive patch test reactions rates were similar for most allergens. However, statistically, blacks reacted more frequently to p-phenylenediamine (7.0% vs 4.4%, P < 0.001), bacitracin (11.6% vs 8.3%, P = 0.0004), as well as specific rubber accelerators mercaptobenzothiazole (2.7% vs 1.8%), thiuram (6.2% vs 4.3%), and mercapto mix (1.9% vs 0.8%, P < 0.001). Whites had an increase in positive reactions to fragrances (12.12% vs 6.77%, P < 0.0001), formaldehyde (9.25% vs 5.45%, P < 0.0001), and some formaldehyde releaser preservatives used in personal care products and textile resins (9.80% vs 6.18%, P < 0.0001). There were statistically different rates of positive patch test reactions to specific allergens between black and white patients suspected of having ACD. The etiology of these differences is unclear but probably relates to culturally determined exposure patterns rather than genetic differences.

An alternative inhibition method for determining cross-reactive allergens

Inhibition assays are an useful tool to identify the allergen of primary sensitization of cross-reactive allergens. Classical ELISA-based inhibition assays are limited by both the availability of commercial standardized allergen extracts and the experience and knowledge needed for making home-made extracts. Moreover the direct comparison of the inhibition ELISAs outcomes between different laboratories is difficult because of different sources of used allergen extracts and a number of methodological variations. Therefore, we propose a novel ImmunoCap (Phadia, Thermofisher Scientific) based immunoinhibition method with the use of commercially available Caps as the allergen source. The novel ImmunoCap based immunoinhibition method was developed and tested with sera from patients with a well-known cross-reactive sensitization for fig (Ficus carica) and ficus (Ficus benjamina). Results were compared with a classically applied inhibition method, i.e. addition of homemade allergen extract to patient serum. The amount of allergens (fig and ficus extracts) needed to reach a similar degree of inhibition was comparable for both inhibition methods. The ImmunoCap based inhibition assay, in addition to classical inhibition methods, is a valuable tool as the ImmunoCap analyzer and commercial allergens (Caps) are more widely available which makes the outcomes of inhibition tests comparable between different laboratories. Furthermore, in the ImmunoCap inhibition method the same protein source is used for both the inhibition of sIgE and sIgE measurement, which might be even more relevant when multiple cross-reactive allergens are tested.

Prevalence of delayed-type and immediate-type hypersensitivity in healthcare workers with hand eczema.

Occupational contact dermatitis is common in healthcare workers. Although irritant contact dermatitis resulting from wet work is the most frequently reported cause, healthcare workers also constitute high-risk group for the development of allergic contact dermatitis and contact urticaria. To evaluate the prevalence of delayed-type and immediate-type hypersensitivity in 120 healthcare workers with hand eczema. One hundred and twenty healthcare workers from three major hospitals in Denmark with self-reported hand eczema within the last year participated in the study. Patch tests included baseline series plus selected allergens, and prick tests included standard inhalational allergens plus natural rubber latex and chlorhexidine. Levels of IgE specific for latex, chlorhexidine and ethylene oxide were measured. Of the participants, 53% had positive patch test reactions. The most frequent positive patch test reactions were to nickel, thiomersal, fragrances, rubber chemicals, and colophonium. The prevalence of natural rubber latex allergy as diagnosed by prick testing was 2.5%, and chlorhexidine allergy (both contact allergy and IgE-mediated allergy) was found in <1%. Ethylene oxide allergy was not identified in any of the participants. Our results confirm previous reports on contact allergy patterns in healthcare workers. Testing for natural rubber latex allergy is still important, but increased risks of chlorhexidine and ethylene oxide allergy could not be confirmed.

Specific allergen immunotherapy for the treatment of atopic eczema: a Cochrane systematic review.

Specific allergen immunotherapy (SIT) is an effective allergy treatment, but it is unclear whether SIT is effective for atopic eczema (AE). We undertook a systematic review to assess SIT efficacy and safety for treating AE. We searched databases, ongoing clinical trials registers, and conference proceedings up to July 2015. Randomized controlled trials (RCTs) of SIT using standardized allergen extracts, compared with placebo/control, for treating AE in patients with allergic sensitization were eligible. We identified 12 eligible trials with 733 participants. Interventions included subcutaneous (six trials), sublingual (four trials), oral or intradermal SIT in children/adults allergic to house dust mite (10 trials), grass pollen or other inhalants. Risk of bias was moderate, with high loss to follow-up and nonblinding as the main concerns. For our primary outcomes, three studies (208 participants) reported no significant difference - patient-reported global disease severity improvement RR 0.75 (95% CI 0.45, 1.26); and eczema symptoms mean difference -0.74 on a 20-point scale (95% CI -1.98, 0.50). Two studies (85 participants) reported a significant difference - SIT improved global disease severity RR 2.85 (95% CI 1.02, 7.96); and itch mean difference -4.20 on a 10-point scale (95% CI -3.69, -4.71). Meta-analysis was limited due to extreme statistical heterogeneity. For some secondary outcomes, meta-analyses showed benefits for SIT, for example investigator-rated improvement in eczema severity RR 1.48 (95% CI 1.16, 1.88; six trials, 262 participants). We found no evidence of adverse effects. The overall quality of evidence was low. We found no consistent evidence that SIT is effective for treating AE, but due to the low quality of evidence further research is needed to establish whether SIT has a role in AE treatment.

ジャパニーズスタンダードアレルゲン（JSA）を接触皮膚炎診療に役立てる

ジャパニーズスタンダードアレルゲン（JSA）を接触皮膚炎診療に役立てる

Contact Allergy to Polymyxin B Among Patients Referred for Patch Testing

Polymyxin B is not included in most standard contact allergen series. The aim of this study was to determine the prevalence of contact sensitization to polymyxin B in a population of patients referred for patch testing. A retrospective cohort study design was used to collect data on 795 patients referred to the contact dermatitis clinic of the McGill University Health Centre, as well as to the office of one of the authors (L.M.), between March 2014 and November 2015. Patients were patch tested to the North American Contact Dermatitis Group baseline series and polymyxin B sulfate 3% in petrolatum. Out of 795 tested individuals, 18 were allergic to polymyxin B, for a prevalence of 2.3%. The eruptions affected almost all body parts, but mostly the face. The degree of reaction ranged from 1+ to 2+. Isolated reactions to polymyxin B occurred in 9 (50%) patients, whereas reactions to bacitracin and polymyxin B were seen in the other 9. Only 1 patient reacted to bacitracin, polymyxin B, and neomycin (11.1%). Most reactions (12/18) were from past exposure to polymyxin B. Allergic reactions to polymyxin B are not rare, and this antibiotic warrants inclusion in the standard patch testing series.

Molecular Reference Materials for Standardization of Allergen Measurements

Allergen measurements are widely used for determination of the potency of allergy vaccines, for environmental exposure assessments, and for validation of IgE molecular diagnostics. With the exception of Bet v 1 and Phl p 5a, few purified allergen standards have been developed. The aim of this study was to produce purified allergen standards, with defined specifications, that could serve as Molecular Reference Materials (MRM) for use in allergy diagnostics, enzyme- or fluorescent immunoassays, and multiplex arrays. Natural and recombinant food, dust mite, pollen and animal allergens (n = 11) were purified by affinity and/or gel-filtration chromatography and analyzed by SDS-PAGE, LC-MS/MS, ELISA, and FEIA or chimeric IgE ELISA. Natural allergens from peanut, dust mite and animal were lyophilized using different buffer conditions. Real time stability data are collected from frozen liquid allergens and lyophilized allergens. Allergen purity, assessed by LC-MS/MS after Trypsin digest and /or silver-stained SDS-PAGE, was >95%. Real time stability tests of frozen liquid allergens (up to 24 months) and frozen lyophilized allergens, showed comparable potency in allergen-specific ELISA and no signs of degradation on SDS-PAGE. Monoclonal antibody ELISA and IgE reactivity of recombinant allergens showed excellent correlations with natural allergens. Optimized, ISO 9001 compliant, bioprocessing pathways have been established to yield pure, immune-reactive natural and recombinant allergens. These MRM are stable and will improve the standardization of allergy diagnostics and vaccines used for immunotherapy.

К вопросу о разработке стандартных образцов биологической активности аллергенов и методах оценки их активности

Описаны принципы изготовления и утверждения международных стандартов и референс-реагентов биологических субстанций, согласно которым аллергены, как и все иммунобиологические лекарственные препараты, должны быть стандартизированы. Единицы биологической (аллергенной) активности для первой серии стандартного образца (СО) устанавливаются по in vivo методике (провокационные тесты, внутрикожные пробы, прик-тест и т.п.) на сенсибилизированных лицах. Активность первой серии стандарта также параллельно оценивается методами иммуноанализа с этапом ингибиции IgE-содержащих специфических сывороток к исследуемому аллергену. Помимо оценки биологической активности, СО должен быть охарактеризован по содержанию главных (мажорных) аллергенов: белку, белковому профилю и структуре белка. Современные требования, предъявляемые к препаратам аллергенов, впервые введены в XIII редакцию Государственной фармакопеи Российской Федерации.

Functional Gastrointestinal Symptoms Are Associated with Higher Serum Total IgE Levels, but Less Atopic Sensitization.

The relation of gastrointestinal (GI) complaints to IgE-mediated allergy is not well understood. Increased numbers of "IgE-armed" mast cells have been observed in duodenal mucosa of patients with functional GI complaints. To explore whether total IgE and atopic sensitization were associated with functional GI complaints. Levels of serum total and specific IgE and GI complaints were measured in 161 patients and in a general population sample of 478 persons. Standard inhalant allergens were measured in the patient group, and selected inhalant allergens in the general population. GI complaints were assessed by two standardized questionnaires. The associations between GI complaints and total IgE were analyzed in multiple regression models. GI complaints were positively associated with higher total IgE levels (all: b = 0.028, p = 0.012; patient group: b = 0.038, p = 0.072; general population: b = 0.038, p = 0.005), but negatively associated with atopic sensitization (all: b = -11.256, p = 0.181; patient group: b = -85.667, p < 0.001; general population: b = -14.394, p = 0.083). The relationship between total IgE and GI complaints was consistent among sensitized and non-sensitized persons, among men and women, and across age groups. Serum total IgE was positively associated with GI complaints, while atopic sensitization was inversely associated with GI complaints. This suggests that IgE-mediated immunology plays a role in the pathophysiology of functional GI complaints. The biological mechanisms reflected in higher total IgE levels, but less atopic sensitization, warrant further studies.

Research on the efficacy and mechanism of standardized house dust mite allergen vaccine to allergic rhinitis

The study was designed to analyze the efficacy of standardized house dust mite allergen vaccine to allergic rhinitis by subcutaneous injection and investigate the possible mechanism of specific immunotherapy (SIT). From January 2011 to December 2011 a prospective study was performed in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Nantong University, involving 90 patients with perennial AR, of whom 60 patients received Der p - SIT + pharmacotherapy after their approval and 30 received only pharmacotherapy. All patients were allergic to house dust mites. Symptom and medication scores were recorded three times: before the treatment, at the middle of treatment and at the end of treatment. Over a period of 1 yr. prior to and at the end of treatment, CD4⁺ CD25⁺ Foxp3⁺ Treg cells and Th17 cells were measured by flow cytometry. SPSS 21.0 software was used to analyze the data. The symptom scores using VAS and medication scores in AR patients treated with SIT and medication were reduced, the differences were significant (14.25 ± 6.40, 1.00 ± 0.84 vs. 32.18 ± 7.78, 3.12 ± 1.54, t value was 19.65, 10.71, both P < 0.05). The symptom of VAS score in medication group was reduced after treatment (30.30 ± 5.97 vs. 20.30 ± 5.79, t = 10.09, P < 0.05), but the medication score had not significant difference (P > 0.05). The frequency of Th17 cells in peripheral blood mononuclear cells were decreased in patients treated with SIT, whereas the frequency of Treg cells were increased (χ² value was 2.81, 2.80, both P < 0.05), but not in medication group. Both SIT and pharmacotherapy can improve symptoms of allergic rhinitis, but SIT can also reduce medication use. The effect of immunotherapy is better than drug treatment alone. The frequency of blood Th17 cells in peripheral blood mononuclear cells were decreased in patients treated with SIT, whereas the frequency of Treg cells were increased.