Predictive Response to Immunotherapy Score: A Useful Tool for Identifying Eligible Patients for Allergen Immunotherapy

Abstract

A specific predictive tool of allergen immunotherapy (AIT) outcome has not been identified yet. This study aims to evaluate the efficacy of a disease score referred to as Predictive Response to Immunotherapy Score (PRIS) to predict the response to AIT and identify eligible patients. A total of 110 patients diagnosed with allergic rhinitis with or without concomitant asthma were enrolled in this study. Before beginning sublingual immunotherapy (SLIT), patients were evaluated by analyzing clinical and laboratory parameters. A specific rating was assigned to each parameter to be combined in a total score named PRIS. At baseline (T0) and follow-up [after 12 (T12) and 24 months (T24) of SLIT], a Visual Analogue Scale (VAS) was used to calculate a mean symptom score (MSS). Finally, the percentage variation between the MSS at T0 and at T12 [ΔMSS-12(%)] and T24 [ΔMSS-24 (%)] was measured. We observed a significant improvement of symptoms at T12 and T24 compared to T0 in all groups undergoing SLIT. PRIS was effective in predicting ΔMSS-24 (%) in patients treated with single-allergen SLIT. In addition, PRIS was effective in predicting ΔMSS-24 (%) in both patients with only rhinitis and with concomitant asthma. PRIS assessment can represent a useful tool to individuate potential responders before SLIT prescription.

Eosinophilic Patterns in Patients with Seasonal Allergy Affected by Bronchial Asthma and Rhinitis/Rhinosinusitis: Efficacy of Benralizumab in Patients with the Persistent Pattern

“…In patients with seasonal allergy, the oscillation of blood eosinophils in season and out of season is well known [45,46]. In some geographical regions, including Southern Italy, seasonal allergens can present very long-lasting periods of pollination and be the major allergens responsible for BA and AR [27,47,48]. Indeed, we previously reported that Parietaria and/or Gramineae grass were the dominant allergens in 75.5% of patients from Southern Italy affected by AR and/or BA, as assessed with a multi-parameter score [27].…”

“…In some geographical regions, including Southern Italy, seasonal allergens can present very long-lasting periods of pollination and be the major allergens responsible for BA and AR [27,47,48]. Indeed, we previously reported that Parietaria and/or Gramineae grass were the dominant allergens in 75.5% of patients from Southern Italy affected by AR and/or BA, as assessed with a multi-parameter score [27]. In our view, a single determination of AEC in these patients provides only a partial characterization of the eosinophilic status [26,49,50].…”

“…Inclusion criteria were age ≥ 18 years; data available on sex, date of birth, and age of onset; and a signature on the written informed consent. In Southern Italy, most seasonal allergy at all ages (children, adults, and elderly) is mainly due to sensitization to parietaria and/or grass pollen [27,28]; therefore, we enrolled only patients sensitized to both allergens. Exclusion criteria were sensitization to perennial allergens (e.g., house dust mites, animal dander, molds), other know pulmonary diseases (e.g., chronic obstructive pulmonary disease, interstitial lung disease), use of certain medications (e.g., β-blockers, angiotensin-converting enzyme inhibitors), and uncontrolled gastroesophageal reflux disease [29][30][31][32].…”

Worldwide Heterogeneity of Food Allergy: Focus on Peach Allergy in Southern Italy

“…In the adult population, hazelnuts, peaches, apples, carrots, walnuts, melons, shellfish, sunflower seeds, and bananas are the foods most frequently associated with FA [ 20 ]. A reasonable explanation for this heterogeneity is found in pollen sensitization and cross-reactivity [ 7 , 87 , 90 ]. In fact, while FA in children occurs more frequently through primary sensitization (class 1 FA), in adults it occurs more frequently through cross-reactivity (class 2 FA) [ 20 , 23 , 91 ].…”

Eosinophilic Airway Diseases: From Pathophysiological Mechanisms to Clinical Practice

“…In recent years, a wide range of mAbs targeting IgE or type 2 cytokines have been proved to be highly effective and safe in reducing symptoms and exacerbation in patients with severe allergic and eosinophilic asthma [ 156 ]. However, these therapies are not suitable for about half of patients with severe asthma who often present with non-allergic, non-eosinophilic type 2-low asthma [ 60 , 157 , 158 ]. For this reason, in the era of precision medicine, investigating the different pathways involved in the different endotypes of asthma can help identify new targeted therapies ( Table 2 ).…”