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Original Article


Immunotherapy Reduces CD40L Expression and Modifies Cytokine Production in the CD4 Cells of Pollen Allergy Patients


JM Urra,1 P Carrasco,1 F Feo-Brito,2 F De La Roca,2 F Guerra,3 CM Cabrera1

1Immunology Section, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
2Allergy Section, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
3Department of Allergy and Pathology, Medical School Unit, Reina Sofia University Hospital, Cordoba, Spain

J Investig Allergol Clin Immunol 2014; Vol. 24(2): 98-105



Background: Allergen-specific immunotherapy (SIT) is the only intervention for IgE-mediated respiratory disorders.

Objective: The aim of the study was to investigate the immunological modifications induced by SIT in patients allergic to olive and/or grass pollen by attempting to establish an association between these modifications and clinical improvements.

Methods: We studied 29 patients who were allergic to olive and/or grass pollen. Patients were randomized to 2 groups: an active treatment group, comprising 19 allergic patients who received SIT, and a control group, formed by 10 allergic patients who received pharmacological treatment for their allergic symptoms but not immunotherapy. We used flow cytometry to analyze intracellular expression of the cytokines IL-4, IFN-γ, IL-10, and TGF-β1 in CD4+ T cells, as well as expression of Foxp3, the costimulatory CTLA-4 molecule, and the non–costimulatory CD40L molecule. To assess clinical changes, patients recorded their medication consumption, symptoms, and the limitation of daily activities using diary cards and quality of life questionnaires.

Results: Six months after initiation of SIT, we recorded a reduction in cell surface CD40L expression in the CD4+ T-cell population and a shift in the cytokine production profile (decrease in IL-4–producing CD4+ T cells and increase in IFN-γ, IL-10, and TGF-β1). These changes persisted after 12 months. Simultaneously, a clinical improvement was observed.

Conclusions: SIT-induced clinical improvement is the result of immunological modifications such as a reduction in CD40L expression on CD4 cells and alteration in the cytokine production profile.

Key words: Pollen allergy. Immunotherapy. Cytokines. CD40-L. Foxp3.