All issues > Volume 33(9); 1990

Original Article

J Korean Pediatr Soc. 1990;33(9):1255-1261. Published online September 30, 1990.

Immunologic Changes in Bronchial Asthma on Immunotherapy.

Joon Sung Lee¹, Kyung Tai Whang¹, Sung Hoon Cho¹

¹Department of Pediatrics, Catholic University Medical College, Seoul, Korea

Received: March 6, 1990;  Accepted: May 30, 1990.

Abstract

The best treatment of allergic disease is to avoid exposure to known allergen. Immunotherapy has been attempted in IgE-mediated allergic patients who didn’t show any responses to pharmacologic therapy or couldn’t avoid allergen. There have been many enthusiastic claims for symptomatic relief of allergic disease by various forms of hyposensitization, first introduced by Noon and Freeman (1911) in the treatment of hay fever. The mechanism of immunotherapy is not fully evaluated, but a number of immunologic changes have been demonstrated. Among these changes are 1) A rise in allergen specific IgG antibody, 2) A decrease in specific IgE antibody, 3) A decrease in basophil sensitivity, 4) Generation of specific suppresor T cells. We selected twenty asthmatic children who showed strong reactivity to Dermatophagoides pter- onyssinus (Dp) on skin test and RAST and showed clinical improvement after 1 year immunotherapy. We measured the levels of serum immunoglobulins and complement components before and after immunotherapy and tried to evaluate the relationship between the immunologic changes and clinical improvements. The results are as follows: 1) Peripheral blood eosinophil count was decreased. 2) Serum IgG and IgA levels were increased slightly, but serum IgM and IgE levels were decreased. 3) C3, C4 levels were increased. 4) Dp-specific IgE level was decreased significantly (p=0.043). 5) Dp-specific IgG level was increased significantly (p=0.046). 6) Dp-specific IgG4 level was increased significantly (p=0.0097). In conclusion, there are some changes of serum immunoglobulins in asthmatic children on im- munotherapy and is close relationship between the efficacy of immunotherapy and the changes of allergen specific immunoglobins.

Keywords :Immunotherapy, Dp-specific Immunoglobulin; IgE, IgG, IgG4