Background: Subcutaneous immunotherapy (SCIT) is used to treat Japanese cedar (JC) pollinosis. The formation of IgE-allergen-CD23 complex after SCIT for JC pollinosis has not yet been fully elucidated. Objective: The objective of this study was to investigate the formation of IgE-allergen-CD23 complex after SCIT for JC pollinosis. Methods: Eleven patients were treated with 3-year SCIT for JC pollinosis at Sa­gamihara National Hospital from 2013 to 2014. Nasal and ocular symptoms (in terms of symptom scores) during the scattering of JC pollen and immunological changes were investigated. Levels of JC pollen-specific antibodies (IgE and IgG₄) were measured by ImmunoCAP assays. To detect the changes in allergen-presenting ability of B cells, the levels of IgE-allergen-CD23 complexes in serum were measured by a cell-free, enzyme-linked immunosorbent-facilitated antigen-binding assay. Results: The median (interquartile range) age of the subjects was 8 (6–10) years. Three patients (27%) had comorbid atopic dermatitis, and 5 patients (45%) had comorbid bronchial asthma. Before starting SCIT, the total IgE level was 373 (75–2,870) kU/L, and the level of JC pollen-specific IgE was 77.2 (15.4–528) kU_A/L. Symptom scores improved significantly from the year after treatment. JC pollen-specific IgE levels did not change after 3 years of treatment. JC pollen-specific IgG₄ levels increased significantly throughout the treatment period. The levels of IgE-allergen-CD23 complexes decreased significantly after 3 years of treatment. Conclusion: The ability of IgE-allergen complexes to bind to CD23 decreased after SCIT, suggesting that increasing levels of IgE-blocking antibodies, including IgG₄, may play an important role in the mechanism of SCIT.
Int Arch Allergy Immunol

中文翻译：

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日本雪松花粉症皮下免疫治疗儿童IgE-Allergen-CD23复合体变化的形成

背景：皮下免疫疗法 (SCIT) 用于治疗日本雪松 (JC) 花粉症。JC 花粉症 SCIT 后 IgE-过敏原-CD23 复合物的形成尚未完全阐明。目的：本研究的目的是研究 JC 花粉症 SCIT 后 IgE-过敏原-CD23 复合物的形成。方法： 2013年至2014年在相模原国立医院接受了为期3年的JC花粉症SCIT治疗的11名患者。研究了JC花粉散布期间的鼻和眼部症状（症状评分）和免疫学变化。JC 花粉特异性抗体（IgE 和 IgG ₄) 是通过 ImmunoCAP 测定法测量的。为了检测 B 细胞过敏原呈递能力的变化，通过无细胞、酶联免疫吸附促进抗原结合测定法测量血清中 IgE-过敏原-CD23 复合物的水平。结果：受试者的中位（四分位距）年龄为 8（6-10）岁。3 名患者 (27%) 合并特应性皮炎，5 名患者 (45%) 合并支气管哮喘。在开始 SCIT 之前，总 IgE 水平为 373 (75-2,870) kU/L，JC 花粉特异性 IgE 水平为 77.2 (15.4-528) kU _A /L。症状评分从治疗后一年显着改善。JC 花粉特异性 IgE 水平在治疗 3 年后没有变化。JC 花粉特异性 IgG ₄水平在整个治疗期间显着增加。治疗 3 年后，IgE-过敏原-CD23 复合物的水平显着下降。结论：在 SCIT 后 IgE-过敏原复合物结合 CD23 的能力降低，表明 IgE 阻断抗体（包括 IgG _{4 ）}水平的增加可能在 SCIT 的机制中起重要作用。
Int Arch 过敏免疫