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We have prepared antigen-antibody complexes from grass pollen allergens and autologous specific antibodies isolated by immunoadsorption from the serum of allergic patients. These complexes were inoculated into patients in a double-blind trial to evaluate their effect on grass pollen-related rhinitis and bronchial asthma. Thirty-eight grass pollen-hypersensitive patients were allocated to three groups; patients in the first two groups were treated with antigen-antibody complexes at different ratios and dosages and were compared with the third group who received the placebo carrier buffer alone. In addition, we treated a fourth group who had already received antigen-antibody complex inoculation during the previous pollen season. Injections were given every 2 weeks during the pollen season, starting 5 weeks prior to it. Tolerance was excellent with no signs of local or systemic side effects. The treatment prevented nasal symptoms while enabling the patients to reduce antihistamine intake. Bronchial asthma was virtually absent in the treated groups even though no bronchodilators or corticosteroids had to be taken. Specific IgE antibodies did not increase during the pollen season nor did IgG "blocking" antibodies. Inoculation of allergen-antibody complexes could provide a valuable alternative for the treatment of immediate hypersensitivity to airborne allergens as it appears to be safe and rapidly efficacious. This treatment offers several advantages compared to conventional hyposensitization and is characterized by the absence of an increase in specific IgG antibodies.

Specific antibodies isolated by immunoabsorption on four main insolubilized allergens from Dermatophagoides pteronyssinus (DPT) had the following isotypic distribution: in 16 atopic patients, 52% IgG, 40% IgM, 8% IgA, 0.1% IgE and, in 12 non-atopic individuals, 48% IgG, 46% IgM, 6% IgA, 0.03% IgE. The ratios between geometric means of antibody values in each class (atopic vs non-atopics) were 2.4 for IgG, 2.0 for IgM, 2.8 for IgA and 66.7 for IgE. The amount of anti-DPT antibodies in IgG subclasses did not follow the usual distribution of total IgG subclasses, i.e., IgG1 greater than IgG2 greater than IgG3 greater than IgG4. In atopics the order was IgG2 greater than IgG1 greater than IgG4 greater than IgG3 and in non-atopics, IgG4 greater than IgG1 = IgG2 greater than IgG3 although 6/12 of the latter had no detectable (less than 0.5 micrograms/ml plasma) IgG4.