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The changes in different symptom scores during subcutaneous immunotherapy in Chinese house dust mite allergic patients: a two-year, observational study

Published online by Cambridge University Press:  24 January 2019

Y Tu
Affiliation:
School of Medicine, Shandong University, Jinan, People's Republic of China
H Zhang
Affiliation:
Department of Otolaryngology, Second Affiliated Hospital of Shandong University, Jinan, People's Republic of China
L Zhao
Affiliation:
Department of Otolaryngology, Second Affiliated Hospital of Shandong University, Jinan, People's Republic of China
P Jin
Affiliation:
Department of Otolaryngology, Second Affiliated Hospital of Shandong University, Jinan, People's Republic of China
X Zi
Affiliation:
School of Medicine, Shandong University, Jinan, People's Republic of China
T Li
Affiliation:
School of Medicine, Shandong University, Jinan, People's Republic of China
L Shi
Affiliation:
Department of Otolaryngology, Second Affiliated Hospital of Shandong University, Jinan, People's Republic of China
L Zhi*
Affiliation:
Department of Otolaryngology, Central Hospital of Zibo, People's Republic of China
*
Author for correspondence: Dr Lili Zhi, Department of Otolaryngology, Central Hospital of Zibo, 55 Liuquan Road, Zibo 255031, Shandong Province, People's Republic of China E-mail: 8wy3390410@163.com

Abstract

Background

Subcutaneous immunotherapy is an effective and safe treatment for allergic rhinitis and allergic asthma. Different symptom scores are used to evaluate the efficacy of subcutaneous immunotherapy in clinical trials.

Method

A total of 58 allergic rhinitis patients sensitised to house dust mites, with or without mild asthma, were included. Symptom score, medication score, visual analogue scale score and quality of life were assessed before and after 6, 12 and 24 months of subcutaneous immunotherapy.

Results

After two years of subcutaneous immunotherapy, asthma symptom scores nearly reached zero, whereas the scores remained higher for nasal symptoms. The changes in asthma symptom scores were markedly different (p < 0.05) and occurred faster than the changes in nasal symptom scores when compared between monosensitised and polysensitised groups. Significant reductions in visual analogue scale score and medication score were demonstrated after subcutaneous immunotherapy.

Conclusion

Two-year subcutaneous immunotherapy with house dust mite vaccine is an effective treatment for both monosensitised and polysensitised allergic patients. The changes in asthma symptom scores were markedly different and occurred quicker than the changes in nasal symptom scores in Chinese house dust mite allergic patients.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr L Zhi takes responsibility for the integrity of the content of the paper

References

1Asher, MI, Montefort, S, Björkstén, B, Lai, CK, Strachan, DP, Weiland, SK et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet 2006;368:733–43Google Scholar
2Han, DM, Zhang, L, Huang, D, Wu, YF, Dong, Z, Xu, G et al. Self-reported prevalence of allergic rhinitis in eleven cities in China [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2007;42:378–84Google Scholar
3Law, M, Morris, JK, Wald, N, Luczynska, C, Burney, P. Changes in atopy over a quarter of a century, based on cross sectional data at three time periods. BMJ 2005;330:1187–8Google Scholar
4Bousquet, J, Khaltaev, N, Cruz, AA, Denburg, J, Fokkens, WJ, Togias, A et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63(suppl 86):8160Google Scholar
5Pichler, CE, Marquardsen, A, Sparholt, S, Lowenstein, H, Bircher, A, Bischof, M et al. Specific immunotherapy with Dermatophagoides pteronyssinus and D. farinae results in decreased bronchial hyperreactivity. Allergy 1997;52:274–83Google Scholar
6Qi, S, Chen, H, Huang, N, Li, W, Liu, G, Wang, Y et al. Early intervention improves clinical responses to house dust mite immunotherapy in allergic rhinitis patients. Int Arch Allergy Immunol 2016;171:234–40Google Scholar
7Zuberbier, T, Bachert, C, Bousquet, PJ, Passalacqua, G, Walter Canonica, G, Merk, H et al. GA(2) LEN/EAACI pocket guide for allergen-specific immunotherapy for allergic rhinitis and asthma. Allergy 2010;65:1525–30Google Scholar
8Pawankar, R, Canonica, GW, Holgate, ST, Lockey, RF, Blaiss, MS, eds. WAO White Book on Allergy: Update 2013. Milwaukee: World Allergy Organization, 2013Google Scholar
9Adjers, K, Luukkainen, A, Pekkanen, J, Hurme, M, Huhtala, H, Renkonen, R et al. Self-reported allergic rhinitis and/or allergic conjunctivitis associate with IL13 rs20541 polymorphism in Finnish adult asthma patients. Int Arch Allergy Immunol 2017;172:123–8Google Scholar
10Möller, C, Dreborg, S, Ferdousi, HA, Halken, S, Høst, A, Jacobsen, L et al. Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol 2002;109:251–6Google Scholar
11Jacobsen, L, Niggemann, B, Dreborg, S, Ferdousi, HA, Halken, S, Host, A et al. Specific immunotherapy has long-term preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy 2007;62:943–8Google Scholar
12Mailing, H-J, Weeke, B. Position paper: immunotherapy. Allergy 1993;48:935Google Scholar
13Canonica, GW, Baena-Cagnani, CE, Bousquet, J, Bousquet, PJ, Lockey, RF, Malling, HJ et al. Recommendations for standardization of clinical trials with allergen specific immunotherapy for respiratory allergy. A statement of a World Allergy Organization (WAO) taskforce. Allergy 2007;62:317–24Google Scholar
14Juniper, EF. Measuring health-related quality of life in rhinitis. J Allergy Clin Immunol 1997;99:S7429Google Scholar
15Juniper, EF, Guyatt, GH, Ferrie, PJ, Griffith, LE. Measuring quality of life in asthma. Am Rev Respir Dis 1993;147:832–8Google Scholar
16Cox, L, Wallace, D. Specific allergy immunotherapy for allergic rhinitis: subcutaneous and sublingual. Immunol Allergy Clin North Am 2011;31:561–99Google Scholar
17Pinart, M, Keller, T, Reich, A, Fröhlich, M, Cabieses, B, Hohmann, C et al. Sex-related allergic rhinitis prevalence switch from childhood to adulthood: a systematic review and meta-analysis. Int Arch Allergy Immunol 2017;172:224–35Google Scholar
18Sporik, R, Holgate, ST, Platts-Mills, TA, Cogswell, JJ. Exposure to house-dust mite allergen (Der p I) and the development of asthma in childhood. A prospective study. N Engl J Med 1990;323:502–7Google Scholar
19International rhinitis management working group. International consensus report on the diagnosis and management of rhinitis. Allergy 1994;49:134Google Scholar
20Rak, S, Lowhagen, O, Venge, P. The effect of immunotherapy on bronchial hyperresponsiveness and eosinophil cationic protein in pollen-allergic patients. J Allergy Clin Immunol 1988;82:470–80Google Scholar
21Hamid, QA, Schotman, E, Jacobson, MR, Walker, SM, Durham, SR. Increases in IL-12 messenger RNA+ cells accompany inhibition of allergen-induced late skin responses after successful grass pollen immunotherapy. J Allergy Clin Immunol 1997;99:254–60Google Scholar
22Ebner, C, Siemann, U, Bohle, B, Willheim, M, Wiedermann, U, Schenk, S et al. Immunological changes during specific immunotherapy of grass pollen allergy: reduced lymphoproliferative responses to allergen and shift from TH2 to TH1 in T-cell clones specific for Phl p 1, a major grass pollen allergen. Clin Exp Allergy 1997;27:1007–15Google Scholar
23Durham, SR, Walker, SM, Varga, EM, Jacobson, MR, O'Brien, F, Noble, W et al. Long-term clinical efficacy of grass-pollen immunotherapy. N Engl J Med 1999;341:468–75Google Scholar
24Maestrelli, P, Zanolla, L, Pozzan, M, Fabbri, LM; Regione Veneto Study Group on the “Effect of immunotherapy in allergic asthma”. Effect of specific immunotherapy added to pharmacologic treatment and allergen avoidance in asthmatic patients allergic to house dust mite. J Allergy Clin Immunol 2004;113:643–9Google Scholar
25Chen, J, Li, B, Zhao, Y, Zhang, Q, Wan, L, Liu, J et al. A prospective multicenter study of systemic reactions in standardized specific immunotherapy for allergic rhinitis in China. Am J Rhinol Allergy 2014;28:e404Google Scholar
26Bousquet, J, Braquemond, P, Feinberg, J, Guerin, B, Maasch, H, Michel, FB. Specific IgE response before and after rush immunotherapy with a standardized allergen or allergoid in grass pollen allergy. Ann Allergy 1986;56:456–9Google Scholar
27Ciprandi, G, Gallo, F, Ricciardolo, FL, Cirillo, I. Fractional exhaled nitric oxide: a potential biomarker in allergic rhinitis? Int Arch Allergy Immunol 2017;172:99105Google Scholar