Suppression of the late cutaneous response by immunotherapy

John A. Fling, Michael E. Ruff, William A. Parker, Bonnie A. Whisman, Michael E. Martin, Richard B. Moss, Michael J. Reid

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


In a prospective, double-blind, placebo-controlled study, we examined the effect of mountain cedar (MC) immunotherapy on the MC-induced late cutaneous response (LCR). Fourteen MC-sensitive patients were intradermally skin tested before and after immunotherapy with MC extract. We measured the size of the wheal at 15 minutes and the area of tissue swelling at 6 hours. Patients were matched by the size of the LCR and started receiving either MC immunotherapy or placebo immunotherapy. MC-specific immunoglobulins (MC sIgG, MC sIgG1, MC sIgG4, and MC sIgE) were measured by ELISA. Symptom-medication scores (SMSs) were recorded on a daily basis during the MC season and tabulated at the end of the study. Comparison of the 14 paired patients revealed no significant differences beween MC-treated and placebo-treated groups in preimmunotherapy MC sIgG1 and SIgG4. However, when MC immunotherapy was compared to placebo immunotherapy, patients receiving MC immunotherapy developed significantly higher MC sIgG1 (p < 0.04) and MC sIgG4 (p < 0.01) after immunotherapy. Patients receiving MC immunotherapy also demonstrated significantly greater suppression of the LCR after immunotherapy (p < 0.005) with the postimmunotherapy LCR correlating significantly with both MC sIgG4 (rs = 0.715; p = 0.008) and cumulative dose of MC received (rs = 0.808; p = 0.004). MC sIgE was similar in both groups after immunotherapy. The reduction in SMSs in the MC-treated group did not reach significance, nor was there a correlation of SMSs with MC sIgE, sIgG, sIgG1, or sIgG4. In conclusion, this prospective study demonstrated that the LCR in MC-sensitive patients was suppressed by MC immunotherapy and that this suppression was strongly correlated with both MC sIgG4 and cumulative dose of MC administered.

Original languageEnglish
Pages (from-to)101-109
Number of pages9
JournalThe Journal of Allergy and Clinical Immunology
Issue number1
StatePublished - Jan 1989


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