Successful management of mite-allergic asthma with modified extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae in a double-blind, placebo-controlled study

García-Robaina, J C; Sanchez, Inmaculada Prior; Torre, Fernando De la; Fernández-Caldas, Enrique; Casanovas, Miguel

doi:10.1016/j.jaci.2006.07.043

Cited by 89 publications

(103 citation statements)

References 40 publications

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“…It inactivates the enzymatic activity of mite extracts and removes irrelevant material. Immunotherapy with this type of extract (depigmented), followed by a polymerization process, was shown to be clinically effective and safe [25]. In a previous study, we have also confirmed that these enzymatically inactive extracts retain their in vivo allergenicity [26].…”

Section: Introductionsupporting

confidence: 65%

Enzymatic Activity of <i>Dermatophagoides pteronyssinus</i> Extracts after Acidic Treatment

Fernández-Caldas¹,

Gallego²,

Carnés³

et al. 2007

Int Arch Allergy Immunol

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Background: Mite extracts contain potent enzymes. These enzymes, especially Der p 1, may affect the bronchial homeostasis and the amplification of the allergic response. The objectives of this study were to determine how depigmentation affects the enzymatic activity of allergen extracts of Dermatophagoides pteronyssinus and to verify if these depigmented extracts retain their in vitro allergenic properties. Methods: Four native extracts were manufactured from 4 different batches of raw material of D. pteronyssinus. Once extracted, native extracts were reconstituted and modified by adding increasing quantities of 2 M HCl to the solution and dialyzed against double-distilled water. The enzymatic activity of these 8 extracts (4 native and 4 depigmented) was evaluated using in vitro methods. The allergenic potency was evaluated by human specific IgE and IgG ELISA inhibition experiments. The major allergen content (Der p 1 and Der p 2) was measured with monoclonal antibodies. Results: Protease, phosphatase, lipase and glycosidase activity was detected in native extracts. After depigmentation, all the enzymatic activities showed a significant decrease. SDS-PAGE reveals the same protein profile in both types of extracts. The results of ELISA inhibition confirmed that depigmented extracts preserved their antigenic and allergenic capacity. Der p 2 levels increased in depigmented extracts, while the detection capacity of Der p 1 decreased. Conclusions: The depigmentation process significantly reduced the enzymatic activity of these mite extracts, while preserving their allergenicity and antigenicity. No significant differences were observed in the antigenic profile of native and depigmented extracts.

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Section: Introductionsupporting

confidence: 65%

Enzymatic Activity of <i>Dermatophagoides pteronyssinus</i> Extracts after Acidic Treatment

Fernández-Caldas¹,

Gallego²,

Carnés³

et al. 2007

Int Arch Allergy Immunol

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“…In regard to HDM, the classic studies performed in HDM-induced asthma in Navarra (Spain) [83][84][85][86] , demonstrated intense clinical and immunological changes in the group treated with SCIT (either with cluster or conventional schedule) that were sustained during a 5-year course of treatment. SCIT for HDM during one year consistently produced a reduction of symptoms and medication use compared with placebo treatment [87][88][89][90]. Longer SCIT duration was also associated to a clear immunomodulatory effect [91] and with significant reductions in rhinitis and asthma scores [92] in adults with HDM-allergic asthma.…”

Section: Subcutaneous Immunotherapymentioning

confidence: 94%

“…De Castro et al [174] Case-control study Cools et al [176] Cohort study (90) Grass pollen or HDM / pharmacotherapy 9 years after SLIT withdrawal Less frequent asthma symptoms (p<0.001)…”

Section: Ait In Severe Asthmamentioning

confidence: 99%

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

Domínguez‐Ortega

Delgado

Blanco

et al. 2017

J Investig Allergol Clin Immunol

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Asthma is frequently associated with atopy, characterized by the production of specific immunoglobulin E in response to environmental allergens. Currently, two types of allergen immunotherapy (AIT) are used in clinical practice: subcutaneous and sublingual immunotherapy, both accepted as key components of the therapeutic repertoire for allergic rhinitis and conjunctivitis. However, their role in asthma remains controversial. The present document is aimed at providing the clinicians with a review of the evidence on the use of AIT in asthma, focusing on the most relevant aspects of its mechanism of action, its efficacy, and existing data on safety, tolerability, and cost-effectivity, both in pediatric and adult populations. A systematic search of MEDLINE, Cochrane, and Clinical Trials databases from 2000 to April of 2016 was carried out by a panel of experts from the Spanish Allergy and Clinical Immunology Scientific Society. Relevant studies prior to the year 2000 included in ulterior systematic reviews were also considered. More than 4000 articles were identified during the search and 241 were selected to retrieve available evidence on AIT, which was graded according to the Oxford classification. All the group members reviewed the resulting text until the final version reached the consensual agreement. A summary of recommendations on the more relevant topics are proposed. The role of AIT as a valuable therapeutic strategy for prevention of exacerbation and progressive decline in lung function is highlighted. Future research should include specific tools for asthma evaluation when assessing AIT effectiveness in asthmatic patients. ResumenEl asma se asocia frecuentemente con alergia, entendida ésta como la producción de IgE específica frente a alérgenos ambientales. Actualmente, existen dos tipos de inmunoterapia específica con alérgenos (ITE) para la práctica clínica habitual: subcutánea y sublingual, ambas indicadas en el tratamiento de la rinitis y la conjuntivitis alérgicas. Sin embargo, su papel en el asma resulta todavía controvertido. Dominguez-Ortega J, et al.

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“…Ultimately, 19 studies were included in the analysis. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] A diagram of the search process is shown in Figure 1.…”

Section: Characteristics Of Individual Studiesmentioning

confidence: 99%

The Efficacy and Safety of Subcutaneous Immunotherapy in Mite-Sensitized Subjects With Asthma: A Meta-Analysis

Xia

et al. 2014

Respir Care

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BACKGROUND: Subcutaneous immunotherapy (SCIT) is widely used in the management of allergic diseases such as allergic asthma. We aimed to conduct a systematic review and metaanalysis to evaluate the efficacy and safety of SCIT in mite-sensitized subjects with asthma. METHODS: Literature from January 1990 to February 2013 on the efficacy and safety of SCIT for mite-sensitized asthma patients was searched in electronic databases, including the Cochrane Library, MEDLINE, Embase, PubMed, China Knowledge Resource Integrated Database, Wanfang, and Vendor Information Pages. Data were extracted from randomized controlled trials (RCTs) according to the selection criteria by 2 investigators independently. The quality of included trials was evaluated according to the Jadad scale standard. RESULTS: A total of 796 subjects from 19 different RCTs were included in this analysis. SCIT significantly reduced the asthma symptom scores (standardized mean difference of ؊0.94, 95% CI ؊1.58 to ؊0.29, P ‫؍‬ .004) and the asthma medication scores (standardized mean difference of ؊1.06, 95% CI ؊1.70 to ؊0.42, P ‫؍‬ .001) compared with the control group. However, there were no significant differences between subjects receiving SCIT and the control group in lung function (peak expiratory flow, percent-of-predicted FEV 1 , percent-of-predicted FVC) and specific antibody (allergen-specific immunoglobulin E) levels of blood serum (P > .05). In the studies containing data on safety, the incidences of systemic and local adverse reactions were 9.1% (8/88) and 17.2% (23/134), respectively, in subjects treated with SCIT, and no severe adverse events were reported. CONCLUSIONS: Our results suggest that SCIT is helpful in alleviating symptoms and reducing medication used in mite-sensitive asthma subjects, but with no improvement in lung function. The safety of SCIT is acceptable.

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Successful management of mite-allergic asthma with modified extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae in a double-blind, placebo-controlled study

Cited by 89 publications

References 40 publications

Enzymatic Activity of <i>Dermatophagoides pteronyssinus</i> Extracts after Acidic Treatment

Enzymatic Activity of <i>Dermatophagoides pteronyssinus</i> Extracts after Acidic Treatment

Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence

The Efficacy and Safety of Subcutaneous Immunotherapy in Mite-Sensitized Subjects With Asthma: A Meta-Analysis

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