Modulation of the level of natural antibodies to endotoxin in bronchial asthma patients receiving mite allergen immunotherapy

Abstract Rationale Modulation of antibody levels to endotoxin (ET) in asthma patients treated with specific immunotherapy suggests an increase in TH 1 responses. Methods 42 asthma patients receiving dust mite allergen specific immunotherapy (SIT) were divided into two groups: 1) 22 who received dust mite SIT extract; and 2) 19 who received dust mite SIT plus polyoxidonium. Levels of natural antibodies (IgA, IgM, and IgG) to ET from Escherichia coli K 30 were investigated by ELISA before SIT, 70 days after treatment, and in 98 healthy controls. Asthma clinical symptom response to SIT was rated as none, satisfactory or good. Results Responses to SIT in Group 1 versus Group 2 were: 2 versus 8, good; 16 versus 12, satisfactory; 4 versus 0, none. The levels of anti-ET antibodies before SIT in both groups were similar to the levels from normal controls, but at day 70 elevated levels of anti-ET IgA antibodies were significantly greater in both groups than in normal controls. [Group 1: 0.476 O.D. before SIT and 0.615 O.D. after SIT (p Conclusions Immunomodulation by polyoxidonium may enhance the clinical effect of SIT in patients with asthma associated with increased response (IgM antibody) to a TH 1 antigen such as ET.