Journal of asthma and allergy · 2026
A Pilot Study on Early-Phase Efficacy and Biomarker Analysis of Cervical Intralymphatic Immunotherapy for Seasonal Rhinoconjunctivitis.
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Zhang Xu-De, Wang Yu-Lin, Tian Tian, Wang Ting, Han Hao, Sun Wen-Kui, Liu Feng-Xia
Аннотация
BACKGROUND: Seasonal allergic rhinitis (SAR) imposes substantial morbidity, and intralymphatic immunotherapy (ILIT) offers a targeted approach for allergen delivery. However, short-term efficacy and associated biomarkers remain insufficiently characterized.
METHODS: Eight SAR patients received ultrasound-guided ILIT with 100 SQ-U allergen extracts injected into cervical lymph nodes. Assessments were performed at baseline, 1 month, and 2 months post-treatment, alongside eight age- and gender-matched healthy controls. Symptom severity was evaluated using Visual Analog Scale (VAS) and Combined Symptom and Medication Scores (CSMSs). Transcriptomic analysis of peripheral blood mononuclear cells (PBMCs) identified differentially expressed genes (DEGs), followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Serum levels of specific and total IgE, together with 96 inflammatory proteins, were also quantified.
RESULTS: ILIT was associated with significant reductions in VAS and CSMSs at one month, with sustained improvement at two months during peak pollen season. Transcriptomic analysis identified 525 DEGs (p ≤ 0.05), reflecting a shift from Th2-dominant response toward Th1 and regulatory T-cell (Treg) phenotypes. Key genes included transcriptional regulator CREM, cytokine IFNG, signaling component TNFAIP3, and chemotaxis-related molecules (CXCR5, CCR4, CCR6, TNFSF14, CCL20), identifying a candidate multi-gene profile of early ILIT response. Serum proteomic analysis showed downregulated CCL20 and upregulated TNFRSF9, though these protein changes correlated weakly with tissue mRNA expression and showed limited between-group variation, indicating insufficient sensitivity for diagnostic or efficacy assessment.
CONCLUSION: ILIT achieves rapid symptom relief in SAR, with transcriptomic and proteomic evidence of immune tolerance induction and innate immune activation. These biomarkers may support early efficacy monitoring, warranting confirmation in larger trials.
METHODS: Eight SAR patients received ultrasound-guided ILIT with 100 SQ-U allergen extracts injected into cervical lymph nodes. Assessments were performed at baseline, 1 month, and 2 months post-treatment, alongside eight age- and gender-matched healthy controls. Symptom severity was evaluated using Visual Analog Scale (VAS) and Combined Symptom and Medication Scores (CSMSs). Transcriptomic analysis of peripheral blood mononuclear cells (PBMCs) identified differentially expressed genes (DEGs), followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Serum levels of specific and total IgE, together with 96 inflammatory proteins, were also quantified.
RESULTS: ILIT was associated with significant reductions in VAS and CSMSs at one month, with sustained improvement at two months during peak pollen season. Transcriptomic analysis identified 525 DEGs (p ≤ 0.05), reflecting a shift from Th2-dominant response toward Th1 and regulatory T-cell (Treg) phenotypes. Key genes included transcriptional regulator CREM, cytokine IFNG, signaling component TNFAIP3, and chemotaxis-related molecules (CXCR5, CCR4, CCR6, TNFSF14, CCL20), identifying a candidate multi-gene profile of early ILIT response. Serum proteomic analysis showed downregulated CCL20 and upregulated TNFRSF9, though these protein changes correlated weakly with tissue mRNA expression and showed limited between-group variation, indicating insufficient sensitivity for diagnostic or efficacy assessment.
CONCLUSION: ILIT achieves rapid symptom relief in SAR, with transcriptomic and proteomic evidence of immune tolerance induction and innate immune activation. These biomarkers may support early efficacy monitoring, warranting confirmation in larger trials.