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Les allergies respiratoires aux pollens de graminées sont très répandues dans la population générale et le traitement est généralement symptomatique qui reste parfois insuffisant. L'immunothérapie allergénique (ITA) aux 5-graminées est le seul traitement étiologique des rhinites allergiques saisonnières. Étudier l'efficacité des comprimés d'ITA sublinguale aux 5-graminées sur la maladie allergique et décrire les effets indésirables après une année de traitement. Étude prospective, descriptive et évaluative incluant 40 patients ayant une rhinite allergique aux 5-graminées ayant bénéficié d'un traitement par ITA sublinguale et ayant été suivis pendant une année avec évaluation de l'efficacité et de la tolérance pendant la deuxième saison pollinique. L'âge moyen était de 30,9 ± 12,25 ans avec un sex-ratio (H/F) à 0,48. Une conjonctivite allergique était associée dans 70 % et un asthme allergique dans 48 %. Les effets indésirables de l'ITA étaient locaux et locorégionaux, d'intensité faible et de résolution rapide. Une amélioration de la maladie allergique a été notée avec diminution des symptômes et de la charge thérapeutique. Une amélioration de la qualité de vie diurne et nocturne a été rapportée par les patients dans 78 % des cas. L'ITA était significativement plus efficace chez les patients âgés de moins de 30 ans ayant une rhinite allergique et une conjonctivite allergique. L'ITA aux 5-graminées permet, en toute sécurité, la diminution des symptômes allergiques et l'amélioration de la charge thérapeutique et de la qualité de vie des patients. Respiratory allergies to grass pollens are very widespread in the general population and the treatment is generally symptomatic which sometimes remains insufficient. Grass pollen allergen immunotherapy is currently the only etiological treatment of seasonal allergic rhinitis apart from allergenic eviction. The aim was to study the effectiveness of sublingual ITA tablets with 5-grasses on allergic disease and describe the adverse effects after one year of treatment. We conducted a prospective, descriptive and evaluative study including 40 patients suffering from grass pollen allergic rhinitis. A grass pollen sublingual allergen immunotherapy was received and patients were followed during a one-year treatment to study the efficacy and the safety profile. The mean age was 30.9 ± 12.25 years. The sex ratio (M/F) was 0.48. Allergic conjunctivitis was associated in 70% and allergic asthma was associated in 48% of cases. Allergen immunotherapy side effects were mild, consisting of local side effects. No severe side effects were observed. A decrease in allergic rhinitis symptoms was observed in 83% with improvement in medication score in 65%. All patients noted a decrease in conjunctivitis symptoms with a total regression in 54% of cases. A better asthma control was noted in 33%. Among the 19 patients suffering from asthma, we could decrease the drug use in 63% of cases during the first year of treatment. An improvement of the quality of life was observed in 78% of cases. Allergen immunotherapy was significantly more efficient in allergic rhinitis and conjunctivitis with patients under 30 years old. Grass pollen allergen immunotherapy leads safely to the regression of allergy symptoms and improves the therapeutic load and the quality of life. [ABSTRACT FROM AUTHOR]

Abstract: Background: Allergen-specific TH cells play an important role in IgE-mediated disorders as allergies. Since this TH cell-population only accounts for a small percentage of TH cells, they are difficult to phenotype without prior selection or expansion. Methods: Grass-pollen-specific TH cell profiles were evaluated in 5 allergic and 4 non-allergic individuals using three different approaches: CD154 expression on ex vivo grass-pollen-activated PBMCs (i); CFSE-dilution in grass-pollen-restimulated PBMCs (ii) and T cell lines enriched for allergen-specific T cells (iii). Results: Relatively low numbers of allergen-specific TH cells were detected using CD154 expression, limiting the power to detect phenotypic differences between allergic and non-allergic individuals. In contrast, higher frequencies of proliferating TH cells were detected by loss-of-CFSE intensity in PBMCs and TCLs after grass-pollen-stimulation, resulting in the detection of significantly more IL-4 producing TH cells in allergic vs non-allergic individuals. In addition, higher numbers of IFNγ producing TH cells were detected in long-term cultures compared to the CD154 expressing TH cells. Conclusion: To detect allergen-specific TH cells for a common allergen as grass-pollen, expansion is not absolutely necessary, although within 8-day grass-pollen cultures, higher numbers of proliferating TH cells resulted in increased statistical power to detect phenotypic differences. However, this approach also detects more bystander activated TH cells. TCLs resulted in comparable percentages of cytokine expressing T cells as 8-day cultures. Therefore enrichment can be necessary for detection of TH cells specific for a single allergen or allergen-derived peptides, but is dispensable for the detection and phenotyping of allergen-specific TH cells using crude extracts. [Copyright &y& Elsevier]