HUMORAL RESPONSE TO SUBCUTANEOUS, ORAL, AND NASAL IMMUNOTHERAPY FOR ALLERGIC RHINITIS DUE TO DERMATOPHAGOIDES-PTERONYSSINUS

We investigated variations in total IgE, and specific IgE, IgG, and Ig G4 for Dermatophagoides pteronyssinus in 5 7 Patients with perennial r hinitis due to house dust mite allergy in an open controlled study: 43 subjects received immunotherapy (17 subcutaneous, 14 sublingual, and 12 local immunotherapy) and 14 were controls. The results were compare d with the clinical course to determine possible associations between serum and clinical changes. Subcutaneous, but not sublingual and nasal , immunotherapy induced a significant clinical benefit (P < .001). Spe cific antibody behavior in patients receiving subcutaneous immunothera py was similar to literature reports. Specific IgE levels fell startin g from the 6th month of therapy, and specific IgG and IgG4 levels rose significantly, but there was no correlation with the clinical course. The other two forms of immunotherapy did not induce significant speci fic antibody modifications. We conclude that the specific IgG4 rise in duced by subcutaneous immunotherapy was the most important variation o bserved. This change, however, was not correlated with the clinical ou tcome.