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The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1990 Apr;85(4):1024–1035. doi: 10.1172/JCI114532

Allergic bronchial asthma due to Dermatophagoides pteronyssinus hypersensitivity can be efficiently treated by inoculation of allergen-antibody complexes.

J J Machiels 1, M A Somville 1, P M Lebrun 1, S J Lebecque 1, M G Jacquemin 1, J M Saint-Remy 1
PMCID: PMC296531  PMID: 2318962

Abstract

Antigen-antibody complexes were made from allergens of the common house dust mite, Dermatophagoides pteronyssinus (Dpt) and an excess of purified autologous specific antibodies. These complexes have been used to treat Dpt-hypersensitive patients who suffered from chronic bronchial asthma. Clinical symptoms and medication intake were followed by filling in diary cards. Peak expiratory flow, measured four times a day, was also followed. Intradermal skin tests and bronchial challenge tests were performed with allergen together with an evaluation of nonspecific bronchial reactivity. Specific IgE and IgG antibodies were assayed after separation from the bulk of serum immunoglobulins by immunoadsorption. The study was carried out over two years according to a double-blind protocol. Intradermal inoculation of antigen-antibody complexes resulted in a marked reduction of both clinical and medication scores. No systemic side-effects were observed and only mild wheal and flare reactions were noted at the injection site. The treatment showed a drastic reduction of specific skin and bronchial reactivities with only marginal effects on nonspecific bronchial reactivity. Concentrations of specific IgE antibodies decreased significantly during the first weeks of treatment and remained at these lower values throughout the study. Specific IgG antibodies actually decreased in the majority of treated patients. The total amount of allergen used in this study was less than 1% of the amount currently used for conventional hyposensitization with the same allergen. These findings show that antigen-antibody complex inoculation is an efficient and safe means of treating allergic bronchial asthma and that the mechanism of action is likely to differ from conventional hyposensitization.

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Selected References

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  1. Bose R., Marsh D. G., Duchateau J., Sehon A. H., Delespesse G. Demonstration of auto-anti-idiotypic antibody cross-reacting with public idiotypic determinants in the serum of rye-sensitive allergic patients. J Immunol. 1984 Nov;133(5):2474–2478. [PubMed] [Google Scholar]
  2. Burrows B., Martinez F. D., Halonen M., Barbee R. A., Cline M. G. Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med. 1989 Feb 2;320(5):271–277. doi: 10.1056/NEJM198902023200502. [DOI] [PubMed] [Google Scholar]
  3. Caulfield M. J., Shaffer D. Immunoregulation by antigen/antibody complexes. I. Specific immunosuppression induced in vivo with immune complexes formed in antibody excess. J Immunol. 1987 Jun 1;138(11):3680–3683. [PubMed] [Google Scholar]
  4. Cockcroft D. W., Ruffin R. E., Frith P. A., Cartier A., Juniper E. F., Dolovich J., Hargreave F. E. Determinants of allergen-induced asthma: dose of allergen, circulating IgE antibody concentration, and bronchial responsiveness to inhaled histamine. Am Rev Respir Dis. 1979 Nov;120(5):1053–1058. doi: 10.1164/arrd.1979.120.5.1053. [DOI] [PubMed] [Google Scholar]
  5. Creticos P. S., Norman P. S. Immunotherapy with allergens. JAMA. 1987 Nov 27;258(20):2874–2880. [PubMed] [Google Scholar]
  6. Dolovich J., Hargreave F. E. Strategies in the control of asthma. Med Clin North Am. 1981 Sep;65(5):1033–1043. doi: 10.1016/s0025-7125(16)31487-0. [DOI] [PubMed] [Google Scholar]
  7. Fish J. E., Kelly J. F. Measurements of responsiveness in bronchoprovocation testing. J Allergy Clin Immunol. 1979 Dec;64(6 Pt 2):592–596. doi: 10.1016/0091-6749(79)90019-8. [DOI] [PubMed] [Google Scholar]
  8. Geha R. S., Comunale M. Regulation of immunoglobulin E antibody synthesis in man by antiidiotypic antibodies. J Clin Invest. 1983 Jan;71(1):46–54. doi: 10.1172/JCI110750. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gilles J. G., Mareschal J. C., Saint-Remy J. M. Latex allergosorbent test (LAST): a new immunoassay for specific IgE with latex particles. J Allergy Clin Immunol. 1988 Jul;82(1):35–39. doi: 10.1016/0091-6749(88)90048-6. [DOI] [PubMed] [Google Scholar]
  10. Hamilton R. G., Sobotka A. K., Adkinson N. F., Jr Solid phase radioimmunoassay for quantitation of antigen-specific IgG in human sera with 125I-protein A from Staphylococcus aureus. J Immunol. 1979 Mar;122(3):1073–1079. [PubMed] [Google Scholar]
  11. Heyman B., Wigzell H. Immunoregulation by monoclonal sheep erythrocyte-specific IgG antibodies: suppression is correlated to level of antigen binding and not to isotype. J Immunol. 1984 Mar;132(3):1136–1143. [PubMed] [Google Scholar]
  12. Ishizaka K., Ishizaka T. Identification of gamma-E-antibodies as a carrier of reaginic activity. J Immunol. 1967 Dec;99(6):1187–1198. [PubMed] [Google Scholar]
  13. Kalinen M. Hypotheses on the contribution of late-phase allergic responses to the understanding and treatment of allergic diseases. J Allergy Clin Immunol. 1984 Mar;73(3):311–315. doi: 10.1016/0091-6749(84)90401-9. [DOI] [PubMed] [Google Scholar]
  14. Klaus G. G. Antigen-antibody complexes elicit anti-idiotypic antibodies to self-idiotopes. Nature. 1978 Mar 16;272(5650):265–266. doi: 10.1038/272265a0. [DOI] [PubMed] [Google Scholar]
  15. Klaus G. G. The role of antigen-antibody complexes in generating immunological memory and auto-antiidiotypic immunity. Adv Exp Med Biol. 1979;114:289–294. doi: 10.1007/978-1-4615-9101-6_46. [DOI] [PubMed] [Google Scholar]
  16. Lee W. Y., Sehon A. H. Suppression of reaging antibody formation. IV. Suppression of reaginic antibodies to penicillin in the mouse. J Immunol. 1976 Sep;117(3):927–934. [PMC free article] [PubMed] [Google Scholar]
  17. Lichtenstein L. M., Ishizaka K., Norman P. S., Sobotka A. K., Hill B. M. IgE antibody measurements in ragweed hay fever. Relationship to clinical severity and the results of immunotherapy. J Clin Invest. 1973 Feb;52(2):472–482. doi: 10.1172/JCI107204. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Lichtenstein L. M., Norman P. S., Winkenwerder W. L. A single year of immunotherapy for ragweed hay fever. Immunologic and clinical studies. Ann Intern Med. 1971 Nov;75(5):663–671. doi: 10.7326/0003-4819-75-5-663. [DOI] [PubMed] [Google Scholar]
  19. Machiels J., Ferrière A. Réponse bronchique a l'acétylcholine et au Dermatophagoides pteronissimus chez les asthmatiques asymptomatiques. Bull Eur Physiopathol Respir. 1983 Sep-Oct;19(5):483–488. [PubMed] [Google Scholar]
  20. Magnusson C. G., Collet-Cassart D., Merrett T. G., Masson P. L. An automated particle-counting immunoassay (PACIA) for serum IgE. Clin Allergy. 1981 Sep;11(5):453–461. doi: 10.1111/j.1365-2222.1981.tb01619.x. [DOI] [PubMed] [Google Scholar]
  21. Marsh D. G., Lichtenstein L. M., Campbell D. H. Studies on "allergoids" prepared from naturally occurring allergens. I. Assay of allergenicity and antigenicity of formalinized rye group I component. Immunology. 1970 May;18(5):705–722. [PMC free article] [PubMed] [Google Scholar]
  22. Platts-Mills T. A., Chapman M. D. Dust mites: immunology, allergic disease, and environmental control. J Allergy Clin Immunol. 1987 Dec;80(6):755–775. doi: 10.1016/s0091-6749(87)80261-0. [DOI] [PubMed] [Google Scholar]
  23. Rousset F., Malefijt R. W., Slierendregt B., Aubry J. P., Bonnefoy J. Y., Defrance T., Banchereau J., de Vries J. E. Regulation of Fc receptor for IgE (CD23) and class II MHC antigen expression on Burkitt's lymphoma cell lines by human IL-4 and IFN-gamma. J Immunol. 1988 Apr 15;140(8):2625–2632. [PubMed] [Google Scholar]
  24. Saint-Remy J. M., Lebecque S. J., Lebrun P. M., Jacquemin M. G. Human immune response to allergens of house dust mite, Dermatophagoides pteronyssinus. IV. Occurrence of natural autologous anti-idiotypic antibodies. Eur J Immunol. 1988 Jan;18(1):83–87. doi: 10.1002/eji.1830180113. [DOI] [PubMed] [Google Scholar]
  25. Saint-Remy J. M., Lebecque S. J., Lebrun P. M., Jacquemin M. G. Human immune response to allergens of house dust mite, Dermatophagoides pteronyssinus. V. Auto-anti-idiotypic antibody characterization and cross-reactivity. Eur J Immunol. 1988 Jul;18(7):1009–1014. doi: 10.1002/eji.1830180706. [DOI] [PubMed] [Google Scholar]
  26. Saint-Remy J. M., Lebrun P. M., Lebecque S. J., Masson P. L. Human immune response to allergens of house dust mite, Dermatophagoides pteronyssinus. Isotypic analysis of antibodies in atopic and non-atopic subjects. Allergy. 1988 Jul;43(5):338–347. doi: 10.1111/j.1398-9995.1988.tb00427.x. [DOI] [PubMed] [Google Scholar]
  27. Tite J. P., Morrison C. A., Taylor R. B. Immunoregulatory effects of covalent antigen-antibody complexes. IV. Priming and tolerance in T-dependent responses. Immunology. 1982 Aug;46(4):809–817. [PMC free article] [PubMed] [Google Scholar]

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