The effect of short-term immunotherapy with molecular standardized grass and rye allergens on eosinophil cationic protein and tryptase in nasal secretions

Background: Activation of mast cells and eosinophils under pollen exposure can be inhibited by specific immunotherapy. Objective: The effect of short- term immunotherapy with 7 preseasonal injections of molecular standardized allergens from grass and rye pollen on eosinophil cationic protein (ECP) an d tryptase levels in nasal secretions has been compared with symptomatic dr ug treatment in an open, randomized study with 48 patients. Methods: Nasal reactivity and mediator levels in nasal secretions were meas ured at baseline, before season, in season, and after season. Results: Symptom scores in the immunotherapy group were 134.5 (95% CI, 65 t o 336) versus 386.0 (95% CI, 185 to 563), significantly lower as in the dru g-treated group. ECP and tryptase levels increased significantly during nat ural allergen exposition. The seasonal levels in the immunotherapy group we re significantly lower than in the drug-treated group with 272.1 ng/mL (252 .0 to 293.9 ng/mL; immunotherapy) versus 470.4 ng/mL (SEM, 435.6 to 508.0 n g/mL; drugs) for ECP and with 8.73 ng/mL (SEM, 8.20 to 9.29 ng/mL) versus 1 7.47 ng/mL (16.42 to 18.60 ng/mL) for tryptase (all, P < .001). The ECP lev el induced by nasal provocation was 105.6 ng/mL (99.0 to 112.6 ng/mL) versu s 180.1 ng/mL (169.2 to 192.4 ng/mL), significantly lower (P < .001) in the immunotherapy group, as was the tryptase level with 12.12 ng/mL (11.53 to 12.75 ng/mL) versus 8.19 ng/mL (7.79 to 8.62 ng/mL; P < .001) at the after- season visit. Conclusion: Short-term immunotherapy is able to reduce tryptase and ECP in nasal secretions more effectively than drug treatment in patients with alle rgic rhinitis.