Clinical trial NCT01830673: Regulatory T-cells After Subcutaneous Immunotherapy
Official title: Investigation of T-regulatory Cells After Subcutaneous Immunotherapy
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Grass Pollen Allergy
Specific Immunotherapy
Keywords: T-regulatory cells
TH1, TH2 cells
specific IgE
specific IgG
specific IgG4
IL2
IL5
IL10
IL12/23
Y-IFN
TNF-a
Lead sponsor: Johann Wolfgang Goethe University Hospital
Sponsor class: OTHER
First posted: 2013-04-12
Enrollment: 68
Sex: ALL
Minimum age (years): 7
Maximum age (years): 28
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients aged 7-28 years of age with house grass pollen allergy

Brief summary: The primary endpoint was the induction of T-regulatory cells under s specific subcutaneous immunotherapy (SCIT). Patients suffering from grass pollen allergy (relevant clinical symptomes during the pollen season, Skin Prick test diamter \>4mm or RAST class II or higher) were included. The patients were allocated to three study groups:

Group 1: during and directly after SCIT (after completion the 2nd or 3rd year of treatment) Group 2: completed SCIT more then three years ago Group 3: Patients with clinically relevant grass pollen allergy without SCIT.

The investigators analyzed the lung function parameters, exhaled NO (eNO) and asked the patients to record symptoms during the adjacent pollen season. A blood sample was drawn to analyze the amount of TH1 and TH2 and regulatory T-cells, inflammatory markers(IL-2, IL-5, IL-10, IL-12/23, TNF-alpha, IFN-gamma) and blocking antibodies (IgG, IgG4).


Eligibility criteria: Inclusion Criteria:

* informed consent,
* clinically relevant grass pollen allergy,
* age \> 6 and \< 28

Exclusion Criteria:

* severe unstable asthma,
* regular ingestion of antihistamine,
* systemic steroid therapy,
* lung funtcion VC \< 70%,
* FEV1 \< 65%

Primary outcomes:
measure: Induction of regulatory t-cells
timeFrame: group 1: on average within one week after 4th injection of SCIT, group 2: more than three years (3-4 years) after SCIT completion, group 3: no specific time point because there was no intervention
Secondary outcomes:
measure: TH1-cells by FACS
timeFrame: group 1: on average within one week after 4th injection of SCIT, group 2: more than three years (3-4 years) after SCIT completion, group 3: no specific time point because there was no intervention
measure: Th-2 cells by FACS
timeFrame: group 1: on average within one week after 4th injection of SCIT, group 2: more than three years (3-4 years) after SCIT completion, group 3: no specific time point because there was no intervention
measure: Inflammatory cytokines
timeFrame: group 1: on average within one week after 4th injection of SCIT, group 2: more than three years (3-4 years) after SCIT completion, group 3: no specific time point because there was no intervention
measure: Questionnaire
timeFrame: During the pollen season - for group 1: pollen season directly after completion of SCIT therapy, group 2: same pollen season as group 1, three years after completion of a 3 year SCIT, group 3: same pollen season as group 1 and 2
Other outcomes:
Locations:
city: Frankfurt/M
country: Germany
facility: Johann Wolfgang Goethe-university
state: Hessen
Study officials:
affiliation: Johann Wolfgang Goethe University Hospital
name: Stefan Zielen, Prof.
role: STUDY_DIRECTOR
References:
citation: Zielen S, Kardos P, Madonini E. Steroid-sparing effects with allergen-specific immunotherapy in children with asthma: a randomized controlled trial. J Allergy Clin Immunol. 2010 Nov;126(5):942-9. doi: 10.1016/j.jaci.2010.06.002. Epub 2010 Jul 10.
citation: Martin M, Michalek SM, Katz J. Role of innate immune factors in the adjuvant activity of monophosphoryl lipid A. Infect Immun. 2003 May;71(5):2498-507. doi: 10.1128/IAI.71.5.2498-2507.2003.
citation: Drachenberg KJ, Heinzkill M, Urban E, Woroniecki SR. Efficacy and tolerability of short-term specific immunotherapy with pollen allergoids adjuvanted by monophosphoryl lipid A (MPL) for children and adolescents. Allergol Immunopathol (Madr). 2003 Sep-Oct;31(5):270-7. doi: 10.1016/s0301-0546(03)79195-2.
citation: Rosewich M, Schulze J, Eickmeier O, Telles T, Rose MA, Schubert R, Zielen S. Tolerance induction after specific immunotherapy with pollen allergoids adjuvanted by monophosphoryl lipid A in children. Clin Exp Immunol. 2010 Jun;160(3):403-10. doi: 10.1111/j.1365-2249.2010.04106.x. Epub 2010 Mar 16.
citation: Rosewich M, Schulze J, Fischer von Weikersthal-Drachenberg KJ, Zielen S. Ultra-short course immunotherapy in children and adolescents during a 3-yrs post-marketing surveillance study. Pediatr Allergy Immunol. 2010 Feb;21(1 Pt 2):e185-9. doi: 10.1111/j.1399-3038.2009.00953.x. Epub 2009 Dec 8.