BACKGROUND The SQ tree SLIT-tablet (containing birch extract) proved clinically significant effects during the pollen season for birch as well as alder/hazel. Immune outcomes of this treatment for allergens from multiple birch homologous trees needs further investigation. We hypothesize that birch pollen extract AIT modulate a highly cross-reactive immune response and that this may be the basis for the observed clinical cross-protection. METHODS Blood samples were collected from 397 birch allergic patients during SQ tree SLIT-tablet or placebo treatment (1:1) for up to 40 weeks. Serum-IgE and IgG4 specific to birch, and birch homologous tree pollens from alder, hazel, hornbeam, beech, and chestnut were measured by ImmunoCAP. IgE-Blocking Factor (IgE-BF) for alder, birch, and hazel during treatment were measured by Advia Centaur and blocking effects for birch and all these birch homologous tree pollens were further investigated by basophil activation (BAT). Antibody readouts were investigated in patient subsets. T-cell responses (proliferation) to allergen extracts and peptide pools (group 1 allergens) were investigated in T-cell lines from 29 untreated birch pollen allergic individuals. RESULTS Significant Pearson correlations between serum-IgE toward birch, alder, hazel, hornbeam, and beech were observed (r-values>0.86). T-cell reactivity was observed throughout the birch homologous group. Almost identical kinetics for changes in IgE towards birch, alder, and hazel were observed during treatment and similar species-specific changes were seen for serum-IgG4 . IgG4 reactivity toward birch and alder, hazel, hornbeam, and beech, correlated significantly at end-of-treatment (r-values>0.72). Treatment resulted in similar IgE-BF kinetics for alder, birch, and hazel and blocking of BAT for multiple trees in most actively treated patients investigated. CONCLUSIONS Systematic analyses of T-cell and antibody cross-reactivities before and during birch pollen extract AIT provides the immunological basis for the observed clinical effect of SQ tree SLIT-tablet treatment of tree pollen allergy induced by multiple trees in the birch homologous group.

中文翻译：

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对几种树花粉过敏的简化 AIT - 使用 SQ 树 SLIT 片剂治疗后免疫结果分析的论据

背景 SQ tree SLIT 片剂（含有桦树提取物）在花粉季节对桦树和桤木/榛树具有显着的临床疗效。这种治疗对来自多种桦树同源树的过敏原的免疫结果需要进一步研究。我们假设桦树花粉提取物 AIT 调节高度交叉反应的免疫反应，这可能是观察到的临床交叉保护的基础。方法 在 SQ 树 SLIT 片剂或安慰剂治疗 (1:1) 长达 40 周期间，从 397 名桦树过敏患者中采集血样。通过 ImmunoCAP 测量桦树特异性血清-IgE 和 IgG4，以及来自桤木、榛树、角树、山毛榉和板栗的桦树同源树花粉。桤木、桦木的 IgE 阻断因子 (IgE-BF) Advia Centaur 测量处理期间的榛子和榛子，并通过嗜碱性粒细胞活化 (BAT) 进一步研究所有这些桦树同源树花粉的阻断作用。在患者亚组中研究抗体读数。在来自 29 个未处理的桦树花粉过敏个体的 T 细胞系中研究了 T 细胞对过敏原提取物和肽库（第 1 组过敏原）的反应（增殖）。结果 观察到血清-IgE 与桦树、桤木、榛树、角树和山毛榉之间存在显着的 Pearson 相关性（r 值>0.86）。在整个桦树同源组中观察到 T 细胞反应性。在治疗过程中观察到 IgE 对桦树、桤木和榛树的变化几乎相同的动力学，血清 IgG4 也观察到类似的物种特异性变化。IgG4 对桦木和桤木、榛树的反应性，角树和山毛榉在治疗结束时显着相关（r 值>0.72）。在研究的大多数积极治疗的患者中，治疗导致桤木、桦树和榛树的相似 IgE-BF 动力学和多棵树的 BAT 阻断。结论对白桦花粉提取物AIT前后T细胞和抗体交叉反应的系统分析为观察到SQ树SLIT片治疗白桦同源组多棵树致花粉过敏的临床效果提供了免疫学依据。