Soluble cytokines
With immunotherapy, there is redirection of Th2 phenotype towards a Th1 and Treg phenotype with decreases in Th2 cytokines (eg, IL-4, IL-19 13, IL-9) and upregulation of Th1 (eg, IFNγ), and regulatory cytokines (eg, TGFβ and IL-10).181,249 However, serum cytokine measurements are challenging due to low levels, which are often below the detection limit of current methods.230 Changes in cytokine production by CD4 T cells following AIT are assessable throughin vitro stimulation of PBMC from patients using allergen extracts, both at the protein and the transcript level. In T-cell of patients with HDM allergy, high levels of IL10 transcripts predicted immunotherapy success.250