Clinical Response to Subcutaneous <b><i>Dermatophagoides pteronyssinus</i></b> Immunotherapy in Children with Allergic Rhinitis and Asthma Is Independent of Sensitization to <b><i>Blomia tropicalis</i></b> Allergens

Abstract

Background: Dermatophagoides pteronyssinus (DP) and Blomia tropicalis (BT) are the dominant house dust mites inducing allergic diseases in tropical climates. It is not known whether the efficacy of DP subcutaneous immunotherapy (SCIT) is similar in patients sensitized to DP alone or to both DP and BT. Method: Ninety-five children (5–17 years old) affected by asthma with rhinitis and sensitized to both DP and BT received 3 years of DP-SCIT. Clinical symptom and medication scores, serum-specific IgE and IgG₄ were evaluated during DP-SCIT. Patients were grouped based on DP and BT co-sensitization or cross-reactivity, according to positive or negative IgE to BT major allergen (BTMA). Results: After 3 years of DP-SCIT, all patients had significant reductions in symptoms and medication use. In all, 65% of the patients were free of asthma symptoms and medication use; in addition, 3% was free of rhinitis symptoms. FEV₁ in all patients were greater than 95% of predicted. DP-SCIT induced significant increases in DP- and BT-specific IgG₄. In 50% of patients, DP-specific IgG₄ increased more than 67-fold. BT-specific IgG₄ increased more than 2.5 fold. A moderate correlation (r = 0.48–0.61, p < 0.01) was found between specific IgE against DP and BT in the BTMA– group (n = 34) before and after DP-SCIT, whereas no correlation was found in the BTMA+ group (n = 61). The 2 BTMA groups responded similarly with regard to clinical improvement and increase in specific IgG₄ to both DP and BT. No safety finding of concern were reported in either group. Conclusion: DP-SCIT may be of clinical benefit to patients with IgE sensitizations to both DP and BT. DP-SCIT induces IgG₄ that cross-react with BT allergens.

Multimorbidity of Allergic Conditions in Urban Citizens of Southern China: A Real-World Cross-Sectional Study

“…The EAACI proposed that the increase in serum sIgE and the symptoms after exposure to allergens are the only criteria for diagnosing allergy at present and are also the selection criteria for AIT [ 36 ]. However, the efficacy of AIT based on this standard is only 52–86.9% [ 37 , 38 , 39 ]. Therefore, many studies have been conducted on these biomarkers.…”

Allergen-specific immunotherapy in children. Consensus document of the Association of Pediatric Allergologists and Immunologists of Russia (positional pаper)

“…Изолированная сенсибилизация к недерматоглифным клещам встречается только в 1,5 % случаев, в остальных она сочетается с Dermatophagoides. Показана клиническая эффективность и безопасность АСИТ аллергеном клещей Dermatophagoides у детей с БА и АР, при наличии косенсибилизации к клещам Blomia, Lepidoglyphus независимо от метода терапии [52]. Это связано, по-видимому, с тем, что, несмотря на стандартизацию лечебных аллергенов по Der p(f) 1 и Der p(f) 2, они содержат и другие белки, которые могут служить возможной причиной эффективности при сенсибилизации к другим клещевым аллергенам.…”

Next-Generation Allergic Rhinitis Care in Singapore: 2019 ARIA Care Pathways

“…17 Allergen immunotherapy has been extensively studied and demonstrated to be effective in multiple randomised controlled trials for D. pteronyssinus and D. farinae, 43 whereas only small-scale studies reported clinical response to AIT with Dermatophagoides extracts in patients who are co-sensitised to both Dermatophagoides and B. tropicalis. 44,45 It is uncertain if polysensitised patients with predominantly B. tropicalis reactivity may benefit from AIT, and no recommendation can be made about patients monosensitised to this mite.…”