Effect of immunotherapy in bronchial asthma: treatment with mite extract adsorbed on tyrosine

Abstract

A trial was carried out in 18 asthmatic patients to assess the effectiveness of a vaccine of house dust mite extract (Dermatophagoides pteronyssinus) absorbed on tyrosine. Patients were initially given 6 graduated doses of the vaccine subcutaneously at 7-day intervals. Maintenance injections were then given at 2-week intervals, the total dose being determined by clinical response. About 60% of the treated patients showed a significantly beneficial response to immunotherapy as assessed by symptomatic improvements. Seventy-two per cent of the patients required less oral anti-asthmatic therapy and 50% of the patients had a demonstrable increase in blocking antibodies. Local reactions were not severe and occurred infrequently. None of the patients developed systemic reactions to immunotherapy. Clinical response was found to depend to some extent on the dosage of antigen administered and rise in blocking antibodies of the patient's serum.

Immunotherapy in asthma: an updated systematic review

“…However, Maunsell et al (50) did find that patients randomized to HDM were significantly less likely to report asthma symptoms than those randomized to house dust (OR=0.2, 95% CI 0.05–0.8). Choovoravech (28) did not find any significant reduction in asthma medications after immunotherapy (OR=0.5, 95% CI 0.15–1.7).…”

“…Because of the small number and disparate outcomes reported by the non‐placebo‐controlled randomized trials, only limited meta‐analysis could be performed. Choovoravech (28) did not find a significant reduction in asthma symptoms comparing house‐dust‐mite (HDM) immunotherapy with house dust (SMD=–0.23, 95% CI–0.77 to 0.30). However, Maunsell et al (50) did find that patients randomized to HDM were significantly less likely to report asthma symptoms than those randomized to house dust (OR=0.2, 95% CI 0.05–0.8).…”

“…A further 125 studies were excluded from this review (77–201). The most common but not mutually exclusive reasons for exclusion were as follows: 37 studies were not randomized (84, 86, 91, 93, 97, 98, 103, 105, 108, 114, 116, 120, 122, 123, 126, 130, 132, 133, 135, 140, 145, 146, 149, 151, 157, 159, 163, 164, 166, 176, 177, 180, 185, 189, 193, 194, 198), 25 studies were not controlled (87–89, 99, 101, 107, 115, 121, 128, 131, 134, 137, 140, 148–150, 155, 169, 172, 181, 184, 189, 195, 199, 201), 29 studies solely or predominantly involved subjects who had allergic rhinitis/conjunctivitis rather than asthma (77, 79, 80, 82, 85, 90, 94, 96, 100, 108–113, 117–…”

“…Fifty‐three studies were placebo‐controlled trials of allergen‐specific immunotherapy, two compared immuno‐therapy with an antigenically inactive control (28, 50), three compared house dust with placebo (10, 16, 75), and three utilized untreated controls (19, 22, 41). Only one study directly compared immunotherapy with inhaled steroids (64), although Torres Costa et al (69) administered inhaled beclomethasone to both the active treatment and control groups for the first 18 months.…”