Modulation of immune mediators with MQT-based immunotherapy

Objective: Assess immune and clinical changes with immunotherapy based on modified quantitative testing (MQT). Background: Immunotherapy promotes immunomodulation that occurs over several years. Quantitative testing offers the advantage of initiating immunotherapy with robust antigen concentrations. This study assessed whether changes in immune mediators and allergy symptoms occur rapidly using quantitative techniques. Methods: Sixteen allergic adults were tested using MQT. Subjects had serum drawn for immunoglobulins E and G4 (IgE, IgG4) to 3 antigens, Der p1, Der f1, and Fel d1, and for interleukins IL-1 beta, IL-2, IL-4, IL-5, IL-10, IL-12, and IL-13, and IL-1 receptor antagonist (IL-1RA). Subjects also completed the Sino-Nasal Outcome Test-20 (SNOT-20), the Allergy Outcome Scale (AOS), and the Rhinosinusitis Disability Index (RSDI). They underwent MQT-based immunotherapy and completed outcome measures again at 6 and 12 weeks. Results: Nine subjects completed the study. Analysis demonstrated significant increases in IgG4 levels to all antigens, significant decreases in serum levels of IL-1 beta and IL-5, and significant increases in levels of IL-1RA. Improvement was also noted in AOS and RSDI subscales. Conclusion: Immunotherapy based on MQT demonstrates significant changes in immunoglobulin and cytokine levels by 12 weeks following initiation. In addition, improvement in symptom and quality-of-life measures Occurs by 12 weeks. These findings support the rapid onset of clinical effects with MQT-based treatment of inhalant allergy.