The role of house dust mite immunotherapy in Indonesian children with chronic rhinosinusitis allergy: A randomized control trial

Abstract

Background Chronic rhinosinusitis allergy (CRA) is a disease that is commonly found in children and is mostly caused by allergy to house dust mites (HDM). The use of HDM immunotherapy can be considered in children with allergies. Objectives Analyzing the impact of mite immunotherapy on disease burden in Indonesian children with CRA. Methods A randomized control trial study was conducted to participants in 2 groups, namely the immunotherapy group (n = 25) and the non-immunotherapy group (n = 25). Participants were given HDM immunotherapy for 14 weeks, which was given once per week. Participants during therapy were evaluated for rhinosinusitis symptoms and measured their immunity status (specific IgE), sleep quality (SDSC), quality of life (SN5), and family coping (F-COPES) pre-post therapy. Statistical analysis used in this study included paired t-test, Wilcoxon test, independent t-test, or Mann Whitney test with p < 0.05. Results The value of specific IgE in the immunotherapy group was 4.12 ± 7.75 kU/l (pre-test) and 1.52 ± 2.42 kU/l (post-test; p < 0.001), while in the non-immunotherapy group was 1.47 ± 3.28 kU/l (pre-test) and 1.18 ± 2.81 kU/l (post-test; p = 0.317). The SDSC value in the immunotherapy group was 42.16 ± 2.75 (pre-test) and 30.32 ± 3.22 (post-test; p < 0.001), while in the non-immunotherapy group was 41.92 ± 2.75 (pre-test) and 41.84 ± 2.87 (post-test; p = 0.987). The F-COPES value in the immunotherapy group was 101.56 ± 5.78 (pre-test) and 105.20 ± 4.31 (post-test; p = 0.015), while in the non-immunotherapy group was 100.36 ± 9.63 (pre-test) and 99.96 ± 9.98 (post-test; p = 0.224). The SN-5 value in the immunotherapy group was 30.04 ± 2.78 (pre-test) and 11.00 ± 2.33 (post-test; p < 0.001), while in the non-immunotherapy group was 30.04 ± 2.78 (pre-test) and 30.04 ± 2.78 (post-test; p = 0.767). There was a significant comparison between the immunotherapy group and the non-immunotherapy group on the specific IgE ( p = 0.013), SDSC ( p < 0.001), and SN-5 ( p < 0.001) values. Meanwhile, there was no significant difference in the F-COPES value ( p = 0.129). Conclusions The administration of HDM immunotherapy can improve the participant's immunity, quality of life, and sleep disorder.

Correlation between Skin Prick Test and Specific IgE of Local Mites Allergen in Atopic Dermatitis Patients: an Indonesian Study

“…House dust mites SPT allergen extract used for this study was extracted from Dermatophagoides pteronyssinus. Standard SPT allergen extract was produced by Astromed® dan local SPT allergen extract was produced by Teaching Industry Allergen by Dr.Soetomo Hospital-Universitas Airlangga, Surabaya, Indonesia (Putera et al, 2021). The production of local SPT has 9 steps of manufacturing an allergen extract including comminution, defatting, extraction, clarification, dialysis, concentration, sterilization, standardization, and quality control.…”

“…They can cause several allergic diseases such as atopic dermatitis, asthma, and allergic rhinitis, which can not only affect the quality of life, but can also cause morbidity and mortality (Taha et al, 2018;Miller, 2019). The most common species of mites found in Indonesia are Dermatophagoides farinae which is commonly found in sofas and Dermatophagoides pteronyssinus which can be found in dust and many stuff such as mattresses, bedding, and stuffed animal (Anggraeni et al, 2021;Huang et al, 2017;Putera et al, 2021). Avoiding exposure to dust mites is recommended by many clinicians for the prevention and treatment of patients with AD (Bumbacea et al, 2020).…”

Indonesia-Based Study of the Clinical and Cost-Saving Benefits of Subcutaneous Allergen Immunotherapy for Children with Allergic Rhinitis in Private Practice

“…A systemic reaction was defined as a life-threatening range from mild to very severe anaphylaxis [ 20 ]. The house dust mite allergen immunotherapy (Teaching Industry Allergen by Dr. Soetomo Hospital-Airlangga University, Surabaya, Indonesia) used was an extract of Dermatophagoides pteronyssinus with 11.3–26.6 ng/mL via subcutaneous injection [ 21 , 22 , 23 ]. The dose of immunotherapy used every week varies: 0.1 cc (first week), 0.15 cc (second week), 0.22 cc (third week), 0.32 cc (fourth week), 0.48 cc (week fifth), 0.72 cc (sixth week), 1 cc (seventh week), 0.1 cc (eighth week), 0.15 cc (ninth week), 0.22 cc (tenth week), 0.32 cc (eleventh week), 0.48 cc (twelfth week), 0.72 cc (thirteenth week), and 1 cc (fourteenth week) [ 22 ].…”

“…The house dust mite allergen immunotherapy (Teaching Industry Allergen by Dr. Soetomo Hospital-Airlangga University, Surabaya, Indonesia) used was an extract of Dermatophagoides pteronyssinus with 11.3–26.6 ng/mL via subcutaneous injection [ 21 , 22 , 23 ]. The dose of immunotherapy used every week varies: 0.1 cc (first week), 0.15 cc (second week), 0.22 cc (third week), 0.32 cc (fourth week), 0.48 cc (week fifth), 0.72 cc (sixth week), 1 cc (seventh week), 0.1 cc (eighth week), 0.15 cc (ninth week), 0.22 cc (tenth week), 0.32 cc (eleventh week), 0.48 cc (twelfth week), 0.72 cc (thirteenth week), and 1 cc (fourteenth week) [ 22 ]. The use of HDM immunotherapy is based on previous studies in Indonesia that stated that the most common types of HDM were Dermatophagoides pteronyssinus (87%), Dermatophagoides farinae (7%), and Bromia tropicalis (6%) [ 24 ].…”

Indonesia-based Study of the Clinical and Cost-saving Benefits of Subcutaneous Allergen Immunotherapy for Children with Allergic Rhinitis in Private Practice

“…A systemic reaction was defined as a lifethreatening range from mild to very severe anaphylaxis [20]. The house dust mite allergen immunotherapy (Teaching Industry Allergen by Dr. Soetomo Hospital-Airlangga University, Surabaya, Indonesia) used was an extract of Dermatophagoides pteronyssinus with 11.3-26.6 ng / mL via subcutaneous injection [21,22,23]. The dose of immunotherapy used every week varies: 0.1 cc (first week), 0.15 cc (second week), 0.22 cc (third week), 0.32 cc (fourth week), 0.48 cc (week fifth), 0.72 cc (sixth week), 1 cc (seventh week), 0.1 cc (eighth week), 0.15 cc (ninth week), 0.22 cc (tenth week), 0.32 cc (eleventh week), 0.48 cc (twelfth week), 0.72 cc (thirteenth week), and 1 cc (fourteenth week) [12].…”