Clinico-immunological changes post-immunotherapy with Periplaneta americana
Version of Record online: 17 FEB 2011
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 41, Issue 8, pages 879–888, August 2011
How to Cite
Srivastava, D., Gaur, S. N., Arora, N. and Singh, B. P. (2011), Clinico-immunological changes post-immunotherapy with Periplaneta americana. European Journal of Clinical Investigation, 41: 879–888. doi: 10.1111/j.1365-2362.2011.02480.x
- Issue online: 6 JUL 2011
- Version of Record online: 17 FEB 2011
- Received 28 April 2010; accepted 4 January 2011
- Periplaneta americana;
Eur J Clin Invest 2011; 41 (8): 879–888
Background Cockroach proteins induce allergies including asthma in predisposed individuals. Well-designed controlled studies are required to show the effect of cockroach immunotherapy (IT). This study is aimed to assess changes in clinical and immunological parameters post-IT with Periplaneta americana extract.
Materials and methods A double-blind, placebo-controlled trial of cockroach IT was performed for 1 year in 50 patients of asthma, rhinitis or both. The efficacy of IT was assessed by change in skin reactivity and clinical parameters such as symptom/drug score, airway reactivity and immunological parameters namely IgE, IgG1 and IgG4, IL-4 and IFN-γ by enzyme-linked immunosorbent assay and western blotting using patients’ sera at baseline and after 1 year of treatment.
Results Immunotherapy with cockroach extract demonstrated significant improvement in clinical parameters of active group patients compared with baseline values and placebo group. Specific IgE levels showed a modest reduction, while IgG4 levels increased significantly in active IT group after 1 year. IgE immunoblotting demonstrated reduction in intensity and number of specific bands, whereas IgG4 binding showed more number and distinct bands following IT. Active group patients showed correlation between increase in IgG4/IgG1 ratio and reduction in symptom score post-IT.
Conclusions Immunotherapy with cockroach extract improved clinical and immunological status of asthma and rhinitis patients. Clinical improvement in patients after IT is associated with immunological changes.