Evidence map›Paper›PMID 40891674›Full record

ArticleClinical and translational allergy2025

Subcutaneous Allergen-Specific Immunotherapy for Allergic Rhinitis: Divergent IgA Responses in Nasal Mucosa and Blood With Validation of B Cell Class-Switching in Lymph Nodes and Blood.

Maryam Jafari, Marianne Petro, Eirini Paziou, Eric Hjalmarsson, Agnetha Karlsson, Monika Ezerskyte, Laila Hellkvist, Susanna Kumlien Georén, Eduardo I Cardenas, Lars-Olaf Cardell

Abstract read
In one paragraph

Article in Clinical and translational allergy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Recent advances in allergen immunotherapy.Chinese medical journal · 2026
    Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Maryam JafariDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Marianne PetroDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Eirini PaziouDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Eric HjalmarssonDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Agnetha KarlssonDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Monika EzerskyteDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Laila HellkvistDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Susanna Kumlien GeorénDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Eduardo I CardenasDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Lars-Olaf CardellDivision of Ear, Nose, and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0003-0538-9580

Funding

Astma- och AllergiförbundetKonsul Berghs StiftelseStockholm countySwedish Research CouncilVetenskapsrådet
6 · The paper itself

Abstract

backgroundSubcutaneous immunotherapy (SCIT) has been a cornerstone treatment for allergic rhinitis (AR) for over 50 years, consistently demonstrating symptom reduction and modulation of immune responses. Despite this, the underlying mechanisms responsible for the efficacy of SCIT remain incompletely understood, especially with regard to local immune responses in lymph nodes and nasal mucosa.

aimTo determine the impact of SCIT treatment on immunoglobulin production in blood and nasal mucosa, as well as B cell class-switching in blood and lymph nodes. METHODOLOGY: Blood, nasal lavage (NAL), and fine-needle aspirates (FNA) of inguinal lymph nodes were collected from 23 patients with birch and/or timothy pollen-induced AR before and after SCIT updosing. General response to SCIT was evaluated with symptom and medication scores, as well as allergen-mediated activation of basophils. Allergen-specific IgE, IgA, IgG, and IgG4 were measured in blood and NAL via ELISA. B-cell class-switching was assessed in blood and FNAs by flow cytometry.

resultsAR symptoms, medication use, and basophil sensitivity to allergens was reduced after SCIT updosing. Interestingly, the plasma levels of allergen-specific IgA, IgG, and IgG4 increased after SCIT updosing, while the levels of allergen-specific IgE and IgA decreased in NAL at this timepoint. Moreover, these results were accompanied by an increase in conventional (IgD

conclusionThis study highlights the differential effects of SCIT on local and systemic immunity and identifies early immunological changes associated with treatment. However, confirmation of long-term tolerance will require extended follow-up, including in-season analyses. The local decrease in allergen-specific IgA in NAL, alongside a systemic increase in allergen-specific IgA and IgG4, underscores the importance of assessing both mucosal and systemic responses when evaluating SCIT efficacy.

Indexed as

allergic rhinitisB cellsIgAIgG4lymph nodeSCIT

Identifiers

PMID40891674
PMCPMC12403106

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.