Immunotherapy in patients allergic to cat and dog dander

Abstract

Twenty-four asthmatics allergic to cat and/or dog dander were included in a study to examine the efficacy and safety of immunotherapy (IT) with partially purified, standardized extracts of cat or dog dander. In the first placebo controlled, double-blind part of the study, 10 patients were treated with extracts of both cat and dog, 12 with cat extracts and 2 with dog extracts. Fifteen patients received active IT and 9 placebo injections. Patients treated with both extracts received active extracts only, or placebo only. Bronchial allergen challenge after 5 months demonstrated a significant fall in sensitivity to cat (P = 0.04) in patients treated with cat extracts. No significant changes were found in sensitivity to dog after treatment with dog dander extract or in the placebo groups. During this period, bronchial sensitivity to histamine did not change significantly in any of the groups. To examine the effect of more prolonged IT, 19 patients allergic to cat (17) and/or dog (9) were treated for 12 months. Bronchial sensitivity to cat decreased further (P = 0.003), while no significant change was found in dog extract-treated patients. In cat extract-treated patients a significant decrease in bronchial histamine sensitivity developed (P = 0.02). Systemic side effects were few, but in some cases, local side effects were a dose-limiting factor. This study demonstrated that IT with cat extract may benefit cat-allergic asthmatics, whereas no influence of IT with dog extract was detected in dog-sensitive asthmatics.

Multiallergen immunotherapy for allergic rhinitis and asthma

“…See Table I for a summary of multiallergen findings in the 13 studies. 11,[19][20][21][22][23][24][25][26][27][28][29][30] Studies using both single-and 2-allergen extracts without separate reporting of outcome This section summarizes the 3 studies in which separate results were not provided for single-versus 2-allergen treatment arms. Study 1.…”

“…In a 2-phase study in 24 patients with asthma caused by allergy to cat dander, dog dander, or both, SCIT was found to be an effective treatment for allergy to cat but not to dog. 19 The first part of the study consisted of a 5-month, double-blind, placebo-controlled phase in which 15 patients were treated with SCITaccording to allergy (cat, dog, or both) and 9 patients were treated with placebo. In phase 2 the patients treated with placebo were switched to active treatment based on their respective allergies, and all patients were actively treated for 12 months.…”

Allergen immunotherapy: A practice parameter third update

“…[74][75][76][77][78][79][80][81] Immunotherapy is effective for the treatment of allergic rhinitis 77 (including ocular symptoms 82 ), allergic asthma, 74,79,81,83,84 and stinging insect hypersensitivity 78,85 and is effective in both adults and children. [86][87][88][89][90][91][92] Its efficacy is confirmed for the treatment of inhalant allergy caused by pollens, 93-101 fungi, 102-107 animal allergens, 18,21,22,47,[108][109][110][111] dust mites, 17,83,84,[112][113][114][115][116][117][118][119][120] and cockroaches. 121 There have been no controlled trials of fire ant whole-body extract, but it does appear to be effective in uncontrolled trials.…”

“…Exposure to both dog and cat allergen has been shown to be ubiquitous and can occur even without an animal in the home, making avoidance even more difficult. 331 Because immunotherapy has been shown to be effective for cat 18,22,47,[108][109][110]332,333 and dog, 21,47 the decision to include dog or cat allergen in an allergen immunotherapy extract should be considered in those circumstances in which there is exposure. However, the major allergen content of cat extracts is relatively low, requiring larger amounts to be given than for pollens or house dust mite.…”

Immunotherapy as an effective tool in allergy treatment

“…In DBPC asthma studies assessing efficacy on bronchial challenge (BPT) or exposure tests (63,71) (Table 3), one grass-pollen study noted a reduction in BPT sensitivity (68), as was also the case for one out of three mite studies (65,70,71). Five studies have investigated the efficacy of cat and/or dog immunotherapy (63,64,66,67,69), and three documented a reduction in challenge test or improvement in exposure tests. A recently published study investigating the effectiveness of immunotherapy in children (72) was excluded from this review because mixtures of allergens were used.…”