The early-phase transcriptome and the clinical efficacy analysis in three modes of subcutaneous immunotherapy for allergic rhinitis

Jingyu Huang; Wei Zhang; Rong Xiang; Lu Tan; Peiqiang Liu; Zezhang Tao; Yuqin Deng; Huan Tong; Yu Xu

doi:10.1016/j.waojou.2023.100811

The early-phase transcriptome and the clinical efficacy analysis in three modes of subcutaneous immunotherapy for allergic rhinitis

World Allergy Organ J. 2023 Sep 6;16(8):100811. doi: 10.1016/j.waojou.2023.100811. eCollection 2023 Aug.

Authors

Jingyu Huang¹, Wei Zhang¹, Rong Xiang¹, Lu Tan¹, Peiqiang Liu¹, Zezhang Tao^{1

2}, Yuqin Deng¹, Huan Tong³, Yu Xu^{1

4

2}

Affiliations

¹ Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China.
² Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
³ Wound Repair＆Rehabilitation Center Department, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, China.
⁴ Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, China.

Abstract

Background: Allergen immunotherapy is the only etiological treatment for allergic rhinitis.

Objective: To analyze the efficacy, safety, and mechanism of subcutaneous immunotherapy (SCIT).

Methods: The efficacy, safety, and serum immunological changes of 3 modes of subcutaneous immunotherapy were compared. Peripheral blood mononuclear cells (PBMC) transcriptome changes were obtained on the Illumina sequencing platforms. We confirmed differentially expressed genes (DEGs) by quantitative real-time polymerase chain reaction (PCR). The DEGs were analyzed by gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) networks. The correlation between the common DEGs and clinical indicators was analyzed by Origin 2022.

Results: The 3 SCITs were all effective after 1 year. The Combined Symptom and Medication Score (CSMS) and Visual Analog Score (VAS) in rush immunotherapy (RIT) are lowest after 24 and 48 weeks of treatment among the 3 groups. After treatment, the levels of sIgE, sIgE/tIgE, Th2 cytokines, Th17 cytokines, and percentage of peripheral eosinophils (EOS%) decreased significantly (P＜0.05), while the levels of Th1 type cytokines did not change significantly. Transcriptome analysis identified 24, 24, and 91 DEGs at W3 and 42, 52, 175 DEGs at W7 in conventional immunotherapy (CIT), cluster immunotherapy (CLIT), and RIT groups, respectively. The pathways and functions involved in SCIT include secretion of Th1/2 cytokines, immune cell differentiation. Unlike CIT and CLIT, DEGs are also involved in T cell tolerance induction, T cell anergy, and lymphocyte anergy in RIT. CXCR1, CXCR2, and IER3 had a specific effect on reflecting the improvement of symptoms in allergic rhinitis patients with SCIT.

Conclusion: The clinical efficacy of RIT appeared earlier than CIT and CLIT. Clinicians can use the highly conserved gene expression profile to evaluate responses to immunotherapy.

Keywords: Allergic rhinitis; Gene expression array; Gene expression profiles; Subcutaneous immunotherapy.