A controlled study of the effectiveness of the Rinkel method of immunotherapy for ragweed pollen hay fever

Metre, Thomas E. Van; Adkinson, N. Franklin; Lichtenstein, Lawrence M.; Mardiney, Michael R.; Norman, Philip S.; Rosenberg, Gary L.; Sobotka, Anne K.; Valentine, Martin D.

doi:10.1016/0091-6749(80)90158-x

Cited by 87 publications

(27 citation statements)

References 38 publications

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“…Furthermore, this seldom reported technique employing a # 31 G needle disposable syringe seemed no more painful that the reported standard # 27 needle SCIT administration. AIT has been part of allergist's armamentarium 1,2,3,4,5 for over a hundred years; well controlled studies have confi rmed the eff ectiveness of high dose injection therapy (High Dose Aqueous SCIT) in both seasonal and perennial allergic rhinitis 12,13,14 Notwithstanding, it seems well-established that low dose SCIT is clinically ineff ective 15,16 .In our tropical humid environments respiratory allergies tend to be perennial, with HDM/Blomia tropicalis standing out as major allergens, as in many other developing and tropical areas of the world; 10 pollens, as evidenced in our patients´ sensitization pattern, are of no major concern. In many Latin American countries 34 and likely in other nations, 35 cost remains a key issue impinging on the AIT access/adherence for patients with respiratory allergies.…”

Section: Discussionmentioning

confidence: 99%

“…12,13,14 For HDM, 7 μg of major allergens per maintenance subcutaneous injection of 0.5 mL is considered an eff ective high dose; 12 general agreement exists, however, around the clinical ineffectiveness of very low allergen dosing. 15,16 Injection allergen treatments (SCIT) require a build-up phase, a demand for frequent injections and risk of systemic reactions/anaphylaxis. Other routes of administration have been developed, 17 like the sublingual route (SLIT), to circumvent some of above inconveniences, particularly in children; however, when the issue of compliance has been addressed, it appears that SLIT is not favored over injected SCIT.…”

Section: Introductionmentioning

confidence: 99%

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Intradermal immunotherapy with low-dose house dust mite allergens in patients with allergic rhinitis: A proof-of-concept study

Vieira-Hernández¹,

Capriles‐Hulett²,

Sánchez‐Borges³

et al. 2018

RAM

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Antecedentes: La inmunoterapia subcutánea acuosa a altas dosis es una ruta validada y efectiva de administración de alérgenos para el ácaro del polvo doméstico y alergias al polen.Objetivos: Estudio de definición conceptual empleando inmunoterapia intradérmica (ITID) con alérgenos de ácaros (Dermatophagoides pteronyssinus/Dermatophagoides farinae [Dp/Df] y Blomia tropicalis [Bt]) a bajas dosis; se llevó a cabo en niños con rinitis alérgica sintomáticos a la exposición de polvo de casa. Métodos: A ocho pacientes sin uso previo de inmunoterapia, con pruebas de punción cutánea positivas e IgE sérica específica a una mezcla de Dp/Df y Bt, se les administraron por tres meses 0.05 mL de ITID semanalmente, provenientes de una preparación fenolizada albúmino-salina y contentiva de bajas dosis de ácaros (8.3 AU= 5 ng de Dp/Df y 2.5 DBU de Bt). Los síntomas nasales (Total Nasal Symptom Score) y los faciales (Escala Análoga Visual) fueron registrados dos semanas antes del tratamiento y en el transcurso una vez a la semana. Al comienzo y al final se realizaron pruebas cutáneas diluidas y seriadas (1/100-1/1.000.000) y determinaciones de IgG4 en el suero para los alérgenos. Resultados: Los valores de las escalas sugirieron mejoría clínica. Existió disminución significativa de los diámetros de las pápulas de las pruebas diluidas y seriadas, así como aumento de los valores de la IgG4 sérica al final del tratamiento. La ITID fue bien tolerada.Conclusión: Si estudios ulteriores confirman los presentes hallazgos, se podría promover una mayor utilización de la inmunoterapia alérgeno-específica.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intradermal immunotherapy with low-dose house dust mite allergens in patients with allergic rhinitis: A proof-of-concept study

Vieira-Hernández¹,

Capriles‐Hulett²,

Sánchez‐Borges³

et al. 2018

RAM

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“…The magnitude of increase in Der p-specific IgG4 concentrations is dependent on the concentration of the allergenic extract used for immunotherapy [17] and on the duration of treatment [13], which can be linked to the accumulated dose being administrated. It is well established that low dose subcutaneous SIT is clinically ineffective [3].…”

Section: Discussionmentioning

confidence: 99%

Specific IgG4 Production during House Dust Mite Immunotherapy among Age, Gender and Allergic Disease Populations

Lai

Xiao

et al. 2012

Int Arch Allergy Immunol

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Background: Specific IgG4 induced by allergen-specific immunotherapy (SIT) is an immunological marker related to the appearance of clinical tolerance. But specific IgG4 levels in different age, gender and allergic disease populations have not been fully investigated. Methods: This study involved 226 children and 109 adults with allergic rhinitis and/or asthma receiving a 156-week course of Dermatophagoides pteronyssinus (Der p) subcutaneous SIT. Symptom and medication scores, forced expiratory volume after 1 s (FEV₁) and Der p-specific IgG4 levels at weeks 0, 5, 10, 25, 52, 104 and 156 were analyzed. Results: Rhinitis symptom and medication scores and FEV₁ % predicted in children showed significantly greater improvement than in adults at week 104 and 156 (p < 0.05). Levels of Der p-specific IgG4 showed a significant increase after 10 weeks of subcutaneous SIT (p < 0.0001) and continued to increase during the 156-week SIT period. Before SIT, the initial Der p-specific IgG4 level was higher in children than adults (p = 0.0004). The increase ratio of Der p-specific IgG4 was higher in children than adults at 52 weeks (p < 0.001) and 104 weeks (p = 0.0156) of SIT, and was higher in rhinitis compared to asthma patients at 156 weeks of SIT (p = 0.0244). There was no difference between males and females at any time points. Conclusion: Children are more responsive to SIT, demonstrating clinical and FEV₁ improvement and producing higher levels of allergen-specific IgG4 during a shorter SIT period compared to adults. Rhinitis patients show a higher increase in specific IgG4 compared to patients with asthma symptoms. The increase of Der p-specific IgG4 reflects a specific response of the immune system towards the SIT vaccine being administrated.

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“…Antigens.-Mountain cedar (J Sabinoides) adergerne extract 1:10 wt/vol in 50% glycerol-saline with 0.4% phenol, 10,000 protein nitrogen units (PNU)/mL was used. Beginning with 1:100 wt/vol (bottle 1), fivefold serial dilutions in 0.4% phenolated saline were made for end point determinations and for immunotherapy in the SDET group (Table 1).…”

Section: Treatment Materialsmentioning

confidence: 99%

“…(Arch Otolaryngol 1982;108:787-794) Accepted for publication May 10,1982 Between 1975 and 1979, our group has studied 237 adults with "mountain cedar" allergy, comparing the efficacy, safety, and immunologie changes associated with various immunotherapeutic regimens using mountain cedar antigen. The allergic rhinitis, occasionally accompanied by asthma, is seen from late December to late February when Juniperus Sabinoides pollinates.…”

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confidence: 99%

Aggressive Coseasonal Immunotherapy in Mountain Cedar Pollen Allergy

Lee¹,

Kniker²

1982

Archives of Otolaryngology - Head and Neck Surgery

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\s=b\ Ninety adults with "mountain cedar" pollen allergy were started on coseasonal immunotherapy regimens in December 1979. At season's end, there were 20 whose starting antigen dose was based on serial dilution end point titration (SDET), 1:2,500 or 1:12,500 weight by volume (w/v); 28 in a "traditional" group started at 1:62,500 w/v; and 28 who had been double-blind placebo control subjects. Injections twice weekly were pushed aggressively toward maintenance. The SDET group received 11 times more antigen than the traditional group; both showed a trend for fewer symptoms than the placebo group. As compared with the other groups, SDET subjects had substantially blunted total and specific IgE responses in season, lower specific IgE level at season's end and less shift of skin end point toward higher dilutions. The findings demonstrate that substantial immunologic effects are possible in the first months of aggressive coseasonal immunotherapy.

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A controlled study of the effectiveness of the Rinkel method of immunotherapy for ragweed pollen hay fever

Cited by 87 publications

References 38 publications

Intradermal immunotherapy with low-dose house dust mite allergens in patients with allergic rhinitis: A proof-of-concept study

Intradermal immunotherapy with low-dose house dust mite allergens in patients with allergic rhinitis: A proof-of-concept study

Specific IgG4 Production during House Dust Mite Immunotherapy among Age, Gender and Allergic Disease Populations

Aggressive Coseasonal Immunotherapy in Mountain Cedar Pollen Allergy

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