Efficacy and safety of birch pollen immunotherapy for local allergic rhinitis

Bożek, Andrzej; Kołodziejczyk, Krzysztof; Jarząb, Jerzy

doi:10.1016/j.anai.2017.10.009

Cited by 37 publications

(70 citation statements)

References 19 publications

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“…In the first grass pollen season, after about six months of SCIT, combined symptom medication scores were reduced 54%. The efficacy of SCIT in pollen-induced LAR was also demonstrated in a two-year study in 28 subjects with birch sensitivity 79 . The efficacy of SLIT in patients with LAR has not been reported.…”

Section: Efficacy Of Subcutaneous and Sublingual Immunotherapy In Allmentioning

confidence: 76%

Recent advances in allergic rhinitis

2018

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Allergic rhinitis affects 20 to 30% of adults in both the United States and Europe and perhaps a somewhat higher percentage of children. In addition to nasal and ocular symptoms directly related to the allergic process, interference of these symptoms with sleep leads to daytime sleepiness and impaired quality of life. Patients miss work because of symptoms but an even greater problem is interference with work productivity, or presenteeism, which has been reported to be the biggest contributor to the total economic cost of allergic rhinitis. There has been increasing awareness that many patients with either seasonal or perennial symptoms but negative skin and in vitro tests for allergen sensitivity have local nasal allergy, diagnosable by the presence of allergen-specific IgE in their nasal secretions or a positive nasal allergen challenge or both. The pharmaceutical management of allergic rhinitis rests on symptomatic treatment with antihistamines that perhaps are more effectively administered intranasally than orally and intranasal corticosteroids. Allergen immunotherapy is very effective, even for local allergic rhinitis, and the shortcomings of subcutaneous immunotherapy of inconvenience and safety are reduced by the introduction of sublingual immunotherapy (SLIT). Use of the latter is currently somewhat limited by the lack of appropriate dosing information for SLIT liquids and the limited number of allergens for which SLIT tablets are available.

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Section: Efficacy Of Subcutaneous and Sublingual Immunotherapy In Allmentioning

confidence: 76%

Recent advances in allergic rhinitis

2018

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“…17 The promising results obtained have been recently confirmed by a 2-years randomised double-blind, placebocontrolled clinical trial (RDBPCT) with SCIT with D. Pteronyssinus (DP-SCIT), 18 a 2-years RDBPCT with Phleum pratense (Phl-SCIT), 73 and a 2-years RDBPCT with Betula verrucosa pollen (Bet-SCIT). 74 These studies provided evidence for the short-term and sustained clinical effect of SCIT in LAR patients. 7,17,18,75 The beneficial clinical effect of SCIT resulted in a significant improvement of symptoms and medication scores ( Figure 6A), severity of rhinitis and an increase in the number of medication free days ( Figure 6B).…”

Section: Allergic Rh Initismentioning

confidence: 88%

“…The first approach was an observational study to compare the safety and efficacy of 6 months of preseasonal grass‐SCIT vs symptomatic medication in patients with moderate‐severe seasonal LAR due to grass pollen a 2‐years RDBPCT with Phleum pratense (Phl‐SCIT), and a 2‐years RDBPCT with Betula verrucosa pollen (Bet‐SCIT) . These studies provided evidence for the short‐term and sustained clinical effect of SCIT in LAR patients .…”

Section: Therapeutic Management: Present and Futurementioning

confidence: 99%

“…17,18,75 These results have been reproduced in recent RDBPCT with Phl-SCIT 73 and Bet-SCIT. 74 The RDBPCT with Phleum-SCIT has also demonstrated the beneficial effect of SCIT on ocular symptoms, asthma control and quality of life compared to placebo. 75 The effect of SCIT on allergen tolerance and levels of specific IgG in serum in LAR patients was also investigated.…”

Section: Allergic Rh Initismentioning

confidence: 99%

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Local allergic rhinitis: Implications for management

Campo

Eguiluz‐Gracia

Bogas

et al. 2018

Clin Experimental Allergy

104

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A significant proportion of rhinitis patients without systemic IgE-sensitisation tested by skin prick test and serum allergen-specific IgE (sIgE) display nasal reactivity upon nasal allergen provocation test (NAPT). This disease phenotype has been termed local allergic rhinitis (LAR). LAR is an underdiagnosed entity affecting children and adults from different parts of the world, with moderate-to-severe symptoms, impairment of quality of life and rapid progression to symptom worsening. LAR is a stable phenotype and not merely an initial state of AR. Allergic rhinitis and LAR share many clinical features including a positive NAPT response, markers of type 2 nasal inflammation including sIgE in nasal secretions and a significant rate of asthma development. LAR should be considered as a differential diagnosis in those subjects of any age with symptoms suggestive of AR but no evidence of systemic atopy. Although LAR pathophysiology is partially unknown, in some patients sIgE can be demonstrated directly in the nasal secretions and/or indirectly via positive responses in basophil activation test (BAT). LAR can coexist with other rhinitis phenotypes, especially AR. The diagnosis currently relies on the positivity of NAPT to a single or multiple allergens. NAPT has high sensitivity, specificity and reproducibility, and it is considered the gold standard. BAT and the measurement of nasal sIgE can also contribute to LAR diagnosis. LAR patients benefit from the same therapeutic strategies than AR individuals, including the avoidance of allergen exposure and the pharmacotherapy. Moreover, several recent studies support the effectiveness and safety of allergen immunotherapy for LAR, which opens a window of treatment opportunity in these patients.

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“…15,16 Moreover, nasal specific IgE (N-sIgE) has been proposed as a control parameter for the efficacy of allergen-specific immunotherapy (AIT). [17][18][19] IgE testing in NS has been also suggested as a potentially beneficial non-invasive tool to identify the local onset of IgE production in small children. 20,21 Many efforts have been made to standardize the methodology of NS collection.…”

Section: Introductionmentioning

confidence: 99%

IgE antibody repertoire in nasal secretions of children and adults with seasonal allergic rhinitis: A molecular analysis

Arasi

Tripodi

et al. 2020

Pediatric Allergy Immunology

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Background: There is growing interest both in testing IgE in nasal secretions (NS) and in molecular diagnosis of seasonal allergic rhinitis (SAR). Yet, the reliability of nasal IgE detection with the newest molecular assays has never been assessed in a large cohort of pollen allergic patients.Objective: To investigate with microarray technology and compare the repertoires of specific IgE (sIgE) antibodies in NS and sera of a large population of children and adults with SAR.Methods: Nasal secretions were collected with an absorbent device (Merocel 2000 ® , Medtronic) and a minimal dilution procedure from 90 children and 71 adults with SAR. Total IgE (tIgE) (ImmunoCAP, Thermo Fisher Scientific (TFS)) and sIgE antibodies against 112 allergen molecules (ISAC-112, TFS) were measured in NS and serum.Results: Nasal sIgE was detectable in 68.3% of the patients. The detected nasal sIgE antibodies recognized airborne (88%), vegetable (10%), and animal food or other (<1%) allergen molecules. The prevalence and average levels of sIgE in NS and serum were highly interrelated at population level. A positive nasal sIgE antibody to a given molecule predicted the detection of the same antibody in the patient's serum with a specificity of 99.7% and a sensitivity of 40%. Conclusions:The concentration of sIgE is much lower in nasal secretions than in the serum. sIgE assays with very high analytical sensitivity and sampling methods with minimal dilution will be therefore needed to validate nasal secretions as alternative to serum in testing the sIgE repertoire.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Efficacy and safety of birch pollen immunotherapy for local allergic rhinitis

Cited by 37 publications

References 19 publications

Recent advances in allergic rhinitis

Recent advances in allergic rhinitis

Local allergic rhinitis: Implications for management

IgE antibody repertoire in nasal secretions of children and adults with seasonal allergic rhinitis: A molecular analysis

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