Improvement of clinical and immunological parameters after allergen‐specific immunotherapy in atopic dermatitis

Abstract

Background Allergen immunotherapy (AIT) is considered a curative treatment in some atopic diseases, but in AD contradictory clinical results exist and the action of AIT has not been elucidated. In the literature, there is no evidence for parallel investigations of permeability barrier, cutaneous and blood immune responses after AIT in AD.Objectives The objective was to investigate immune parameters in the blood and skin and to detect clinical and barrier changes after AIT in AD.Methods Mild-to-moderate AD patients (n = 14) with concomitant allergic rhinitis to house dust mites were selected.All patients received topical treatment, while eight patients were randomly selected for adjuvant AIT also. At baseline and after 6 months, clinical, barrier and immunological investigations (serum and skin tests) were performed. In selected patients, biopsies from atopy patch tests (APTs) were analysed by immunohistochemistry for AD-relevant immune cells and mediators. ResultsIn the adjuvant AIT group, clinical parameters and barrier functions improved significantly. Blood immune parameters displayed no significant changes. Post-AIT APT became negative in all patients in the AIT group, but remained positive in the non-AIT group. Cutaneous dendritic cell and T-cell recruitment decreased significantly after allergen challenge in the AIT group, but no significant changes in skin or serum immunoglobulin E levels or prick test (SPT) reactivity were detected. Conclusions Allergen immunotherapy is a beneficial adjuvant treatment for sensitized AD patients. AIT improves not only clinical symptoms, but also permeability barrier functions. The effect of AIT on sensitization should be detected by APT, not by SPT.

Differences in allergen‐specific basophil activation and T cell proliferation in atopic dermatitis patients with comorbid allergic rhinoconjunctivitis treated with a monoclonal anti‐IL‐4Rα antibody or allergen‐specific immunotherapy

“… 37 , 38 In patients receiving an AIT, their IgE levels did not change significantly during the observational period of 16 weeks, whereas significantly decreased IgE levels were detected at later timepoints in previous studies on AD patients receiving an AIT. 58 , 59 …”

“…In previous studies significant changes in the ARC symptoms as a result of an AIT were detected at later times, taking into account that an AIT can last at least 3 years. 27 , 59 …”

Allergenimmuntherapie bei atopischer Dermatitis

“…Nach 2 Jahren zeigte sich eine Reduktion des SCORADs um 10 Punkte verglichen mit 4 Punkten in der Kontrollgruppe. In einer kürzlich publizierten kontrollierten Studie mit 14 Patienten erhielten 8 Patienten eine SLIT ergänzend zu einer topischen Therapie, und die Kontrollgruppe erhielt lediglich eine topische Therapie [ 39 ]. Nach 6 Monaten zeigte sich in der SLIT-Gruppe eine signifikante Reduktion des SCORAD sowie des transepidermalen Wasserverlustes (TEWL), ein Maß für die Störung der Hautbarriere.…”

“… 24 Ja Pharmakotherapie als Kontrolle 2021 Hajdu et al. [ 39 ] 14 ∅ 19 sIgE im Blut und Pricktest Hausstaubmilbe s.l. 6 Ja Begleitende histologische Untersuchungen von Biopsien aus APT-Reaktionen APT Atopie-Patch-Test, IgE Immunglobulin E, NA keine Informationen verfügbar, s.c. subkutan, s.l.…”

The Effectiveness of Allergen Immunotherapy in Adult Patients with Atopic Dermatitis Allergic to House Dust Mites

“…This therapy reduces symptoms, decreases medication use, and improves the quality of life. It can inhibit the progression of IgE-mediated diseases [ 6 , 7 , 8 ].…”