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Original Article
December 1998

Serologic Study of the Working Mechanisms of Immunotherapy for Children With Perennial Allergic Rhinitis

Author Affiliations

From the Department of Otolaryngology, Osaka City University Medical School, Osaka, Japan.

Arch Otolaryngol Head Neck Surg. 1998;124(12):1337-1346. doi:10.1001/archotol.124.12.1337

ALLERGEN-SPECIFIC immunotherapy has been widely used to treat allergic diseases for more than 80 years, and recent double-blind placebo-controlled trials for perennial allergic rhinitis have clearly demonstrated its efficacy.1 Allergen-specific IgE and IgG, and especially the blocking antibody of IgG4, have been considered of key importance in allergic rhinitis, and for decades considerable attention has been devoted to the clinical role of specific IgE and IgG4 in serum in relation to clinical outcome. However, there has been no definite conclusion concerning the function of these antibodies because an increase in levels of specific IgG4 has been associated with the clinical efficacy of immunotherapy in some studies2 but not in others.3 Although there is evidence of some measure of clinical benefit as well as immunologic changes from short-term immunotherapy, it generally has to be administered for at least several years to sustain clinical efficacy. A serial follow-up study of specific IgE and IgG4 levels in serum during prolonged immunotherapy would improve our understanding of its working mechanism. The primary aim of this prospective study was therefore to investigate the changes over time in levels of specific IgE and IgG4 in children with perennial allergic rhinitis who received immunotherapy for 10 years, with a focus on clinical eficacy.