Specific immunotherapy to specific allergens induces allergen-specific anergy in peripheral T lymphocytes and this appears to be due to IL-10 production by Tr1 cells, followed by its production from monocytes.78 Endogenous IL-10 switches off the production of specific IgE and IgG4. IL-10 acts directly T cells by suppressing the CD28 co-stimulation signal transduction via tyrosine phosphorylation of CD28. Immunotherapy results in increased numbers ofTr1 cells that secrete both IL-10 and TGF-P, resulting in suppression of Th2-driven allergic inflammation.80 Grass pollen immunotherapy in seasonal rhinitis results in increased IL-10 production and this is expressed predominantly in CD4+CD25+ T cells that are a variant of regulatory T cells.81
Certain bacterial products stimulate Th1 immunity and may therefore have a therapeutic role in reversing the Th2 immunity found in allergic disease. Lactobacillus added to the diet of children with atopic dermatitis improves symptoms and this is accompanied by an increased secretion of IL-10 from peripheral blood monocytes.82
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