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Immunologische Verlaufsparameter unter spezifischer Immuntherapie

Immunologic control parameters during specific immunotherapy

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Zusammenfassung

In-vivo-Untersuchungen zur klinischen Verlaufskontrolle unter spezifischer Immuntherapie (SIT) sind mit dem Risiko potenziell schwerwiegender Reaktionen assoziiert. Als sichere diagnostische Alternative bieten sich In-vitro-Testmethoden an, die eine Evaluation immunmodulatorischer SIT-Effekte erlauben. Hierzu wurden bisher insbesondere der Basophilenaktivierungstest, der Lymphozytentransformationstest sowie Fluoreszenzimmunoassays zur Bestimmung allergenspezifischer IgG- und IgG4-Antikörper eingesetzt. Eine zuverlässige Korrelation einzelner immunologischer Verlaufsparameter mit dem klinischen SIT-Therapieerfolg ist bisher jedoch nicht gelungen. Daher sollte die klinische Wertigkeit der beschriebenen In-vitro-Techniken zunächst in weiteren, mittels Expositionstestung kontrollierten Studien evaluiert werden. In Zukunft könnte es jedoch durch Kombination der dargestellten Untersuchungsmethoden gelingen, sequenzielle immunologische Veränderungen unter SIT zu erfassen und somit charakteristische In-vitro-Profile einer effektiven SIT zu identifizieren.

Abstract

In vivo-methods used for clinical follow-up control during specific immunotherapy (SIT) are associated with the risk of potentially severe reactions. As a safe diagnostic alternative, several in vitro-methods are currently available permitting the evaluation of immunomodulatory SIT effects. The basophil activation test, the lymphocyte transformation test and fluorescence immunoassays detecting allergen-specific IgG- and IgG4-antibodies have been utilized for this purpose. However, a reliable correlation of an immunological follow-up parameter with clinical efficacy of SIT has not been established. Therefore, further controlled studies are needed to evaluate the clinical usefulness of the described in vitro-techniques. In the future, a combination of different diagnostic methods defining sequential immunological modifications could lead to the identification of an in vitro profile characteristic of a successful SIT.

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  1. Klinik für Dermatologie und Allergologie, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland

    H. Ott, M. Wosnitza & H.F. Merk

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  1. H. Ott
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  2. M. Wosnitza
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Ott, H., Wosnitza, M. & Merk, H. Immunologische Verlaufsparameter unter spezifischer Immuntherapie. Hautarzt 59, 551–556 (2008). https://doi.org/10.1007/s00105-008-1492-4

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