Effects of immunotherapy with a purified standardized allergen preparation of Dermatophagoides farinae in adults with perennial allergic rhinoconjunctivitis

Abstract

Immunotherapy (IT) was performed for 12 months with a purified and standardized preparation of Dermatophagoides farinae. Twenty adults with rhinoconjunctivitis sensitive to house-dust mite were given IT, and a similar group of 11 patients served as open controls. A total of 512 injections were given. Twenty-eight episodes of allergic side-effects occurred, 13 general and 15 local, most of them during the initial incremental dose period. No severe reactions started later than 30 min after the injection. One patient suffered anaphylactic shock. In this patient, specific antibodies fell immediately, followed by an increase within 1 week. The therapy group improved significantly in relation to the open controls in patients' subjective evaluation of symptoms (P < 0.028) and skin (P < 0.0001) and conjunctival (P < 0.001) sensitivity. Specific IgE increased in controls (P < 0.0001) but not in IT-treated patients during the "mite season"; that is, there was a significant difference in change during the observation period (P < 0.0001). There was also a difference in change of specific IgG between the groups during the first 4-5 months and the whole year (P < 0.0001), but not from 4-5 months to 12 months. In contrast to changes in antibody titers (IgG, P = 0.04), changes in conjunctival (P < 0.01) and especially skin sensitivity (P < 0.005) correlated well with subjective improvement. This implies that the skin prick test and the conjunctival test can be recommended for follow-up of IT.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of Conjunctival and Nasal Provocation Test in Allergic Rhinitis to House Dust Mite

“…Because CPTs are easy to perform, are cost-effective [19]and rarely complicated by systemic reactions [20], they would be an attractive alternative to NPTs and BPTs. In several studies, CPTs have actually been used as a surrogate for NPTs in patients with allergic rhinitis [7, 8, 9, 10]. …”

“…As a consequence, conjunctival provocation tests (CPTs) have been employed as an alternative to NPTs in patients with allergic rhinitis in various studies. CPTs have been employed to confirm the clinical diagnosis of nasal allergy as an inclusion criterion in clinical studies and as a measure of outcome [7, 8, 9, 10]. …”

Mechanisms of specific immunotherapy of allergic diseases

“…However, in most studies, general correlation of specific IgG with the clinical benefit of immunotherapy is poor or cannot be demonstrated, especially for immunotherapy with aeroallergens (18)(19)(20). In the case of venom allergy, the rise of antivenom IgG correlates, at least at the onset of desensitization, with protection achieved by the treatment (21 -23).…”

Fish and Shellfish Allergens

“…A major allergen denotes a substance originating from an appropriate source material that will induce an IgE response in more than 50% of a sample of patients exposed to the allergen source material and who have clinical symptoms on contact with that source material [22,40] . Parvalbumin, Gad c 1, a 12 -kDa molecular mass protein, is reported as a major allergen in codfi sh ( Gadus callarias ) [41] .…”