1005 Analysis of the mechanism of the allergen immunotherapy in Japanese cedar pollinosis

Friday, 13 December 2013
Michigan Ballroom (Westin - Michigan Avenue)

Takenori Haruna, MD , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head & Neck Surgery, Okayama, Japan

Mitsuhiro Okano, MD , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head & Neck Surgery, Okayama, Japan

Takaya Higaki, MD , Ohio State University, Department of Microbilogy and Immunology, OH

Shin Kariya, MD

Kazunori Nishizaki, MD , Okayama University, Department of ENT, Okayama, Japan

Background: The allergen immunotherapy in Japanese cedar pollinosis is established as an effective and curative cure. On the other hand, in the specific allergen immunotherapy the degree of the effect changes with cases. Since the medical treatment for several years is required for this cure, the prediction of an effective case or an invalid case and the analysis of an effective mechanism are pressing need.

Methods: The Japanene cedar pollen allergen subcutaneous immunotherapy was started in our department and it was targeted at 19 Japanese cedar pollinosis patients who continued the maintenance therapy 18 months or more. The JRQLQ (No.1) questionaire was used for the cedar pollen dispersion term in 2010 and 2011, and the all-inclusive state by symptom, QOL, and a face-scale was monitored.  2011 was an extensive scattering year as compared with 2010 ,which is a scattering year in small quantities. We regarded the group in which no aggravation was seen in face-scale in 2011 as an effective group (n=10) , and the group in which an aggravation was seen as the aggravation group (n=9). Clinical immunological comparison examination between the two groups was performed.

Results: No significant difference in sex and age was found between the effective group and the aggravation group. On the other hand, the tendency for a maintenance therapy period to be a long period of time in the effective group was seen, and the tendency was also seen in the more total medication amount of cedar poolen extracts. In the effective group serum total IgE and Japanese cedar pollen specific IgE in 2011 were significantly low. Moreover, in the effective group cypress specific IgE had the tendency to be lower. Furthermore, in serum total IgE and Japanese cedar pollen specific IgE before immunotherapy no significant difference was seen between the two groups, but after immunotherapy serum total IgE and Japanese cedar pollen specific IgE were significantly better as compared with before immunotherapy.

Conclusions: It was suggested that  the control of the increase in the Japanese cedar specific IgE antibody value in pollen exposure involves as one of the effective mechanisms of Japanese cedar pollinosis specific immunotherapy.