Can Serum-Specific IgE/Total IgE Ratio Predict Clinical Response to Allergen-Specific Immunotherapy in Children Monosensitized to House Dust Mite?

Abstract

Background. Allergen-specific immunotherapy (SIT) is one of the important regimens for the treatment of allergic diseases. Predictive tests for the clinical response to SIT are limited. In this study we aimed to evaluate whether specific IgE/total IgE levels can predict clinical improvement in monosensitized patients to house dust mite treated with immunotherapy. Patients and Methods. We analyzed 32 patients who had undergone 2 years of SIT. Serum t-IgE and s-IgE levels, and serum s-IgE/t-IgE ratios were calculated and tested for correlation with clinical response to SIT. Asthma symptom score (ASS), rhinitis symptom score (RSS), pulmonary functions and visual analogue scales (VAS) were evaluated at the beginning and after 2 years. Results. There were 17 boys and 15 girls with the mean age of 10.78 ± 3.03 years. The mean serum house dust mite s-IgE level was 128.62 ± 142.61 kU/L, t-IgE 608.90 ± 529.98 IU/mL, and s-IgE/t-IgE ratio 33.83 ± 53.18. Before immunotherapy, ASS was 6.23 ± 1.63, RSS; 8.20 ± 1.88, VAS; 7.38 ± 2.01, FEV1 (%); 89.14 ± 8.48, PEF (%); 88.93 ± 13.57, and after 2 years, these values were determined as 1.90 ± 1.10, 3.05 ± 1.39, 1.35 ± 1.24, 97.6 ± 11.26, and 97.0 ± 11.55, respectively. s-IgE/t-IgE ratio was correlated with change in RSS (r = −0.392, P = 0.08) and VAS (r = −0.367, P = 0.05). Conclusion. Although SIT is very effective treatment, all patients do not benefit from treatment. We assumed that s-IgE/t-IgE ratio would be useful to predict the clinical response to SIT.

Objective assessment of persistent rhinitis in Chinese and its relationship with serum indicators

“…However, the serum total IgE was not correlated with the objective examinations in our study. Some authors have suggested that the serum sIgE/total IgE ratio might predict allergic diseases [29,30]; however, we found no differences in the serum sIgE/total IgE ratio between AR patients with and without nasal obstruction. This parameter was also not related to objective nasal assessments.…”

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

“…In a retrospective study in adult patients that underwent AIT as part of the therapy for allergic rhinitis, a significant correlation was found between the serum sIgE/tIgE ratio and the clinical response to AIT, with high ratios (>16.2) associated with an effective response [47]. In a prospective study in children monosensitized to HDM treated with AIT during 2 years, sIgE/tIgE ratio correlated with the clinical response [48]. Another study included 185 children who had undergone 3 years of standardized-quality HDM SCIT.…”

“…-Serum allergen-specific IgE is a predictive biomarker for adequate response to AIT (LE 3, grade C) [44][45][46][47][48][49]. -Functional assays of inhibitory IgG4 and IgE-blocking factor may be useful surrogates of clinical response (LE 1b, grade B) [18,50].…”

Factors influencing the response to specific immunotherapy for asthma in children aged 5–16 years

“…Factors predicting the outcome of ASIT would be of great help in clinical practice, but such data are scarce. In a previous report, the serum specific IgE/t‐IgE ratio was reported to be predictive for the clinical response to ASIT in monosensitized patients for HDM …”

“…In a previous report, the serum specific IgE/t-IgE ratio was reported to be predictive for the clinical response to ASIT in monosensitized patients for HDM. 15 The clinical phenotypes of asthma, allergic asthma and nonallergic asthma affect therapeutic outcome. 16 Many studies estimated the risk of atopy for asthma, but the populationattributable risk was surprisingly low (33-56.3%).…”