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Intralymphatic immunotherapy with 2 concomitant allergens, birch and grass: A randomized, double-blind, placebo-controlled trial  Laila Hellkvist, MD,

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Presentation on theme: "Intralymphatic immunotherapy with 2 concomitant allergens, birch and grass: A randomized, double-blind, placebo-controlled trial  Laila Hellkvist, MD,"— Presentation transcript:

1 Intralymphatic immunotherapy with 2 concomitant allergens, birch and grass: A randomized, double-blind, placebo-controlled trial  Laila Hellkvist, MD, Eric Hjalmarsson, MSc, Susanna Kumlien Georén, MSc, PhD, Agneta Karlsson, RN, Karin Lundkvist, MD, PhD, Ola Winqvist, MD, Ulla Westin, MD, Lars Olaf Cardell, MD  Journal of Allergy and Clinical Immunology  Volume 142, Issue 4, Pages e9 (October 2018) DOI: /j.jaci Copyright © 2018 American Academy of Allergy, Asthma & Immunology Terms and Conditions

2 Fig 1 A, Local adverse reactions in the active group were reduced in size and frequency during treatment. B, Grass-specific IgG4 levels increased in the active group. C, Total rhinoconjunctivitis score at NPTs decreased after ILIT. D, Nasal score at NPTs decreased after ILIT. E-H, Changes in T-cell populations from fine-needle aspirations from lymph nodes. I, Numbers of TH1-type central memory (CM) T cells were increased after active ILIT. J, Numbers of regulatory T cells increased after active ILIT. *P ≤ .05, ***P ≤ .001, and ****P < n.s., Not significant. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2018 American Academy of Allergy, Asthma & Immunology Terms and Conditions

3 Fig E1 Patient flow. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2018 American Academy of Allergy, Asthma & Immunology Terms and Conditions

4 Fig E2 A, Safety. Mild systemic reactions (grade 1), most frequently from the upper airways, were reported to the same extent in both groups. No grade 1 cutaneous systemic reactions and no moderate or severe adverse events (grade 3-5) were recorded. B, IgE. Birch- and grass-specific IgE levels decreased 2 to 4 weeks after treatment in the winter in the placebo group. In the active group birch-specific IgE levels remained unchanged, and grass-specific IgE levels were increased. C-E, Medication use. There was an increased use of either intranasal steroid tablets, antihistamine tablets, or both during the birch and grass pollen season. There was a trend toward reduced use of intranasal steroids during the birch season. Use of β2-agonist inhalation was reduced in the active group during the birch pollen season. F, SPTs. Reactivity at birch and grass SPTs was reduced in the active group 2 to 4 weeks after treatment. *P < .05 and ***P < .001. n.s., Not significant. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2018 American Academy of Allergy, Asthma & Immunology Terms and Conditions

5 Fig E3 Gating strategy. Forward scatter height (FSC-H) and forward scatter area (FSC-A) were used to identify single cells. In fine-needle aspirates (FNA) dead cells and debris were removed from the analysis based on low FSC. Memory T cells constitutes the summary of central memory (CM) T cells, EM T cells RA−, and EM T cells RA+ (EMRA) EM T cells constitutes the summary of EM and EMRA. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2018 American Academy of Allergy, Asthma & Immunology Terms and Conditions

6 Fig E4 Overall improvement in VAS and Juniper RQLQ scores. A, No substantial difference between the groups could be measured on VAS recalled after the pollen season. B-E, Overall QoL (Fig E4, B) had a trend toward improvement during the birch season in the active group, which was statistically significant when looking at the separate domains nasal symptoms, nonnose/eye symptoms, and emotional function (Fig E4, C-E). F, Differences did not reach statistical significance at the sleep domain or for eye symptoms, practical symptoms, and activities (data not shown). During the grass season, RQLQ scores did not differ between the groups (Fig E4, B-F). *P < .05. n.s., Not significant. Journal of Allergy and Clinical Immunology  , e9DOI: ( /j.jaci ) Copyright © 2018 American Academy of Allergy, Asthma & Immunology Terms and Conditions

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