AN IN VITRO APPROACH TO PROBLEMS OF CLINICAL ALLERGY

本提案的目的是使用实验室技术，主要是 免疫学，探索人类过敏性疾病的诊断和治疗方法 疾病，目的是改善这些技术，从而提高临床 过敏性疾病的护理。 我们将通过组胺来确定患者的敏感性 释放、皮肤测试和IgE抗体测量以及IgE的保护 抗体测量 研究将包括IgE和IgG的测量 针对一系列孤立的过敏原和RAST抑制抗体;我们将 也试图证明IgE异质性的程度和频率， 相对于分子的Fc和Fab部分。 两种类型的过敏会 研究：胃肠外诱导，典型表现为Hypletera敏感性，和 以哮喘和鼻炎为代表的对花粉或皮屑抗原的吸入性过敏。 关于昆虫过敏，我们将尝试确定哪些患者需要 治疗的成本和效果。 我们会研究 胡蜂毒液之间的交叉反应，假设大多数患者 只对黄色夹克敏感，因此只需要治疗 这个毒液。 我们将使用改良的毒液抗原， 免疫治疗期间局部和全身反应的发生率。 治疗方案 将进一步探索免疫疗法，并寻找可能的终点。 最后，一项关于临床和免疫学发病率的流行病学研究， 对昆虫毒液的敏感性将被执行。 关于吸入剂 过敏，我们将开始研究使用抗原，在动物中， 在IgE产生方面的“耐受性”。 这将主要涉及， 通过引入聚乙二醇基团修饰的豚草过敏原，或 在DGL。 使用标准抗原制剂，我们将评估免疫疗法 哮喘猫皮屑，通过支气管激发和对照评估反应 环境暴露。 在每一项研究中，我们将遵循 通过抗体测量和对照临床 试验以确定疗效。 我们会尝试建立一种关系 免疫学测量和临床结果之间的关系。

The objective of this proposal is to use laboratory techniques, primarily immunologic, to explore diagnostic and therapeutic approaches to human allergic disorders with the aim of improving these techniques and thereby the clinical care of allergic disorders. We will determine patient sensitivity by histamine release, skin testing and the IgE antibody measurements and protection by IgE antibody measurements. Studies will include the measurement of IgE and IgG antibodies against an array of isolated allergens and RAST inhibition; we will also seek to demonstrate the degree and frequency of IgE heterogeneity, both with respect to Fc and Fab portions of the molecule. Two types of allergy will be studied: parenterally induced, typified by Hymenoptera sensitivity, and inhalant allergy, typified by asthma and rhinitis to pollen or dander antigens. With respct to insect allergy, we will try to determine which patients require therapy in the context of the cost and effectiveness. We will study the crossreactivity among the vespid venoms, with the hypothesis that most patients are sensitive only to yellow jacket and, therefore, require therapy only with this venom. We will use modified venom antigens in an attempt to decrease the incidence of local and systemic reactions during immunotherapy. The regimens of immunotherapy will be further explored and a possible endpoint searched for. Finally, an epidemiologic study of the incidence of clinical and immunologic sensitivity to insect venoms will be executed. With respect to inhalant allergy, we will begin studies using antigens which, in animals, are "tolerizing" with respect to IgE production. This will involve, primarily, ragweed allergens modified by the introducton of polyethylene glycol groups or by DGL. Using standard antigen preparations, we will evaluate the immunotherapy of asthma to cat dander, assessing response by bronchoprovocation and controlled environmental exposure. In each of these studies we will follow the immunotherapeutic effects by antibody measurements and controlled clinical trials to determine efficacy. We will attempt to establish a relationship between the immunologic measurements and the clinical result.