GRASS Mechanistic Manuscript Highlighted as JACI Editors’ Choice
ITN’s recently published article, reporting the mechanistic results from the GRASS clinical trial, was highlighted in The Journal of Allergy and Clinical Immunology’s Editors’ Choice Feature in its May 2018 issue.
Novel allergen immunotherapy strategies should target both arms of the immune response
In the GRASS trial, 2 years sublingual or subcutaneous immunotherapy was effective in suppressing the clinical response to nasal allergen challenge but was insufficient to sustain inhibition at 3 years. Renand et al explored cellular and humoral responses at annual intervals during the trial.
Reductions in peripheral allergen-specific CD4 Th2 cells and local nasal Th2 cytokines closely paralleled inhibition of the clinical response, with rebound at 3 years.
Ratios of allergen specific IgG4/IgE along with IgE-inhibitory activity increased and persisted, at least in part, for 3 years.
Rebound of allergen-specific T cells in parallel with the clinical response suggests that restoration of Th2 immunity abrogated the potential for durable tolerance whereas persistence of IgE-blocking activity might be an early indicator of a pro-tolerogenic mechanism.
Results suggest that in order to enhance induction of long-term tolerance novel strategies for allergen immunotherapy should target both arms of the immune response.
A PDF of the full JACI Editors’ Choice Feature can be found here.