Predictors for Short-Term Efficacy of Allergen-Specific Sublingual Immunotherapy in Children with Allergic Rhinitis

Liu, Wenlong; Zeng, Qingxiang; Luo, Renzhong

doi:10.1155/2020/1847061

“…In addition, the Dpt IgE/tIgE ratio seemed to increase in these patients after hookworm treatment. This is in accordance with data observed in allergic diseases, showing that a high allergen-specific IgE/tIgE ratio can predict allergy in sensitized children [41,42]. Taken together, the findings suggest that the intensity of sensitization to HDM is linked to the intensity of the T2 response to helminths and, perhaps, to a predisposition for developing a strong T2 response.…”

Section: Evolution Of the Humoral Response After Treatment Of Infectionsupporting

confidence: 91%

Helminth infection induces non-functional sensitization to house dust mites

Doyen

¹

,

Truyens

²

,

Thi

³

et al. 2021

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Background IgE characterizes the humoral response of allergic sensitization but less is known about what modulates its function and why some patients present clinical symptoms for a given IgE level and others do not. An IgE response also occurs during helminth diseases, independently of allergic symptoms. This response could be a model of non-functional IgE. Objective To study the IgE response against environmental allergens induced during natural helminth infection. Methods In 28 non allergic subjects from the periphery of Ho Chi Minh city with (H+, n = 18) and without helminth infection (H-, n = 10), we measured IgE and IgG4 against several components of Dermatophagoïdes pteronyssinus (Dpt) and Ascaris (a marker of immunization against nematodes), and determined the IgE component sensitization profile using microarray ISAC biochips. The functional ability of IgE to induce degranulation of cultured mast cells was evaluated in the presence of Dpt. Results Non allergic H+ subjects exhibited higher levels of IgE against Dpt compared to H- subjects. Dpt IgE were not functional in vitro and did not recognize usual Dpt major allergens. IgE recognized other component allergens that belong to different protein families, and most were glycosylated. Depletion of IgE recognizing carbohydrate cross-reactive determinant (CCD) did not induce a reduction in Dpt IgE. The Dpt IgG4 were not significantly different. Conclusion Helminth infections induced IgE against allergens such as Dpt and molecular components that belong to different sources as well as against CCD (such as β-1,2-xylose and/or ⍺-1,3-fucose substituted N-glycans). Dpt IgE were not able to induce degranulation of mast cells and were not explained by sensitization to usual major allergens or N-glycans.

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“…Therefore, it is desirable to identify and exclude nonresponder patients before administrating SLIT. Although previous publications have found several potential indicators to objectively reflect the disease severity and predict the clinical response of SLIT, including serum-specific IgE, serum metabolites, and leukotriene A4 hydrolase [10][11][12], these biomarkers were not clinically available because of poor sensitivity and specificity. Thus, exploring biomarkers with high accuracy and reliability for monitoring disease severity and predicting the clinical efficacy of SLIT is extremely important.…”

Section: Introductionmentioning

confidence: 99%

Serum Soluble ST2 Correlated with Symptom Severity and Clinical Response of Sublingual Immunotherapy for House Dust Mite-Induced Allergic Rhinitis Patients

Zhu

¹

,

Cui

²

,

Chen

³

et al. 2021

Mediators of Inflammation

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Background. Suppressor of tumorigenicity 2 (ST2) is a key biomarker in inflammation and cardiovascular diseases, but limited data is available on its role in allergic rhinitis (AR). Objective. The aim of this study is to explore the role of serum soluble ST2 (sST2) in evaluating disease severity and predicting the efficacy of sublingual immunotherapy (SLIT) in house dust mite- (HDM-) induced AR patients. Methods. Eighty healthy controls (HC group) and 160 HDM-induced AR patients, including 40 mild patients (MAR group) and 120 moderate-severe patients (MSAR group), were recruited in this study. Serum was collected from all participants and levels of sST2 were determined by ELISA and the relationship between sST2 levels and disease severity was assessed. In the MSAR group, 109 patients received 3 years of SLIT, and the relationship between serum levels of sST2 and efficacy of SLIT was exampled. Results. Serum sST2 levels were increased in HDM-induced AR patients compared to the HC group ( P < 0.001 ), and the concentrations were higher in the MSAR group than in the MAR group and HC group (all P < 0.05 ). Moreover, sST2 levels positively correlated with the total nasal symptom score (TNSS), visual analogue scale (VAS), and specific IgE levels ( P < 0.05 ). Seventy-eight MSAR patients accomplished SLIT, and they were divided into an effective group ( n = 40 ) and an ineffective group ( n = 38 ). The serum sST2 levels in the effective group were lower than those in the ineffective group ( P < 0.001 ). In addition, patients in the effective group levels exhibited significantly lower sST2 levels post-SLIT than pre-SLIT ( P < 0.001 ), but no statistic difference was observed in the ineffective group ( P > 0.05 ). Receiver operating characteristic (ROC) curve showed promising accuracy for predicting clinical efficacy of SLIT in AR patients ( area under the curve = 0.839 , P < 0.001 ). Conclusion. Serum sST2 is a potential biomarker for assessing disease severity and may serve as a sensitive biomarker for predicting the therapeutic response of SLIT in HDM-induced AR patients.

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“…The results are reasonable since more frequent bed cleaning reduced HDM levels. Moreover, our data suggested that children spend more time in the bedroom during the epidemic of COVID-19 than normal condition, which may be contribute to longer night sleep and afternoon nap [ 17 ]. Therefore, frequent bed cleaning may play more important role during this special period.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Children during Coronavirus Disease 2019

Liu

¹

,

Zeng

²

,

Tang

³

et al. 2021

ORL

Self Cite

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Background: Sublingual immunotherapy (SLIT) had good effectiveness for children with allergic rhinitis (AR). However, no studies explored the effect of persistent allergen exposure on SLIT treatment. Coronavirus disease 2019 (COVID-19) restricts outdoor activities of children significantly. We aimed to evaluate the effectiveness of SLIT during this special period. Methods: A total of 335 AR children who sensitize to house dust mite (HDM) undergoing SLIT were recruited in this study. The clinical effectiveness and safety were evaluated at different time points using symptom and medication scores. The serum total IgE and specific IgE (sIgE) at different time points were detected by using the Unicap system. Results: The total nasal symptoms score (TNSS) and total medication score (TMS) during the epidemic of COVID-19 increased significantly compared with the same period last year (p < 0.05), despite that they were still significantly lower than baseline levels (p < 0.05). The occurrence of adverse reactions at different time points had no significant differences. We also found that the family of the good response group had more frequent bedding cleaning. Both the tIgE and sIgE levels had no significant changes during SLIT treatment. Conclusion: Our results suggest that continuous HDM exposure reduced the effectiveness of SLIT, whereas effective reduction of HDM levels by frequent bed cleaning will be helpful during the SLIT treatment.

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Predictors for Short-Term Efficacy of Allergen-Specific Sublingual Immunotherapy in Children with Allergic Rhinitis

Cited by 14 publications

References 16 publications

Helminth infection induces non-functional sensitization to house dust mites

Helminth infection induces non-functional sensitization to house dust mites

Serum Soluble ST2 Correlated with Symptom Severity and Clinical Response of Sublingual Immunotherapy for House Dust Mite-Induced Allergic Rhinitis Patients

Efficacy of Sublingual Immunotherapy in Allergic Rhinitis Children during Coronavirus Disease 2019

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