A 1‐year, placebo‐controlled, double‐blind house‐dust‐mite immunotherapy study in asthmatic adults

Abstract

Thirty-one adult patients with asthma caused by house-dust mites (HDM) were included in this placebo-controlled, double-blind study to evaluate the efficacy and safety of specific immunotherapy (SIT) with biologically standardized extracts of HDM. The specific diagnosis was confirmed by skin prick tests, specific IgE, and bronchial provocation tests with HDM allergens. The patients were randomized to receive active treatment with extracts of either Dermatophagoides pteronyssinus (Dpt) or D. farinae (Dfa) (Alutard SQ, ALK, Denmark) or placebo injections. Twenty-three patients completed the study. After 1 year of treatment, we found a clinically important and significant reduction in both asthma medicine consumption (inhaled steroids 38% and beta 2-agonists 46%) and symptom score (57%) in the actively treated group, but not the placebo group. These findings were confirmed by a significant decrease in skin and bronchial sensitivity to HDM in the active group. Additionally, there was a significant difference in the patients' scores for effect in favor of the actively treated group. Total IgE and specific IgE to HDM showed no significant changes before and after treatment for either group. Spirometric lung-function measurements showed a significant increase in forced expiratory volume in 1 s (FEV1) from 85% before to 89% of predicted values after treatment for the actively treated group. Peak-flow measurements at home showed no significant changes during the study. It is concluded that allergen SIT is an effective treatment in adult patients suffering from asthma due to HDM.

Immunotherapy as an effective tool in allergy treatment

“…TTie characteristics of studies evaluating immunotherapy in asthma (37,(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62) by symptom/medication scores are shown in Table 2. The efficacy of grass-pollen immunotherapy has been investigated in six studies (37,48,52,(54)(55)(56) and documented in five.…”

“…The efficacy of grass-pollen immunotherapy has been investigated in six studies (37,48,52,(54)(55)(56) and documented in five. Mite immunotherapy was investigated in four studies (49,57,60,62) with documented efficacy in two of these. Among animal danders, cat allergen is the only one showing efficacy in both studies (58,61), as one dog study did not document efficacy (53).…”

Effects of Immunotherapy on the Distribution and Clonality of TCR Vγ and Vδ Subfamily T Cells in Allergic Rhinitis Patients

“…Studies also reveal TCR gd T cells can be classified into Th1 cells and Th2 cells. In the different stages of respiratory allergic inflammation, different TCR gd T cells exert positive or negative regulatory effects on the immune function, and specific immunotherapy (SIT) can rectify the imbalance between T cell subsets (3)(4)(5)(6)(7)(8). The knowledge on TCR gd T cells is still insufficient as compared to TCR ab T cells, and few studies report the role of TCR gd T cells in allergic rhinitis (AR) and SIT.…”

“…Ten AR patients undergoing SIT with house-dust-mite extract for 1 year were recruited. Quanti tative analysis of immunofluorescence was performed to detect the serum specific IgE (sIgE) level before and after SIT; RT-PCR-genescan analysis was employed to detect the mRNA expressions of TCR Vg (I-III) and Vd (1)(2)(3)(4)(5)(6)(7)(8) in the peripheral mononuclear cells followed by analysis of T cell clonality. Real-time quantitative PCR was applied to detect the expressions of TCR Vg I-III genes.…”

Avaliação do BCG como adjuvante na imunoterapia específica para asmáticos

“…Na avaliação da sensibilização ao Dpt, o teste de puntura titulado revelou uma queda significativa nos valores das medidas das pápulas, sendo que na concentração mais baixa o teste deixou de ser positivo, dados coincidentes com alguns trabalhos publicados na literatura (Olsen, 1997). Esta mudança estaria correlacionada com a diminuição da liberação de histamina e outros mediadores bioativos pelos mastócitos e basófilos, por ocasião do encontro com o alérgeno, fato descrito no curso da ITE (Durhan, 1998 (Creticos, 1984).…”