Long-term efficacy of Dermatophagoides pteronyssinus immunotherapy in patients with allergic rhinitis: a 3-year prospective study
10.3760/cma.j.issn.1673-0860.2012.10.003
- VernacularTitle:变应性鼻炎屋尘螨变应原皮下免疫治疗的远期疗效研究
- Author:
Cheng-Shuo WANG
1
;
Xiang-Dong WANG
;
Wei ZHANG
;
Wen-Yu SHE
;
Lin XI
;
Yu-Hui OUYANG
;
Yan ZHAO
;
Luo ZHANG
Author Information
1. 首都医科大学附属北京同仁医院
- Keywords:
Rhinitis,allergic,perennial;
Desensitization,imunologic;
Antigens,dermatophagoides;
Treatment outcome
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2012;47(10):804-808
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the long-term efficacy of subcutaneous immunotherapy with Dermatophagoides pteronyssinu (Der P) in patients with allergic rhinitis.Methods Ninety-two patients with allergic rhinitis to Der P were randomly allocated to receive either specific immunotherapy ( n =46 ) or medical treatment (n =46).Symptom and medication scores and skin response to Der p were assessed to evaluate the clinical efficacy in the baseline and after three years treatment. Der P-specific IgE and IgG4 were measured.Results After three years treatment,the immunotherapy group showed sustained reductions in symptom scores ( before treatment 9.20 [ 7.50 ; 11.13 ],after treatment 3.32 [ 2.49 ;5.12 ],Z =- 5.13,P ＜ 0.05 ),medication scores ( before treatment 0.72 [ 0.47 ; 0.83 ],after treatment 0.31 [ 0.28 ; 0.45 ],Z=-5.78,P＜0.05) and specific skin response to Der p (t =6.37,P＜0.05) when compared with control group. There were no differences in the level of serum specific IgE before and after three-year treatment ( before treatment 16.32 [ 4.34 ; 38.65 ] kU/L,after treatment 15.85 [ 4.93 ;46.27 ] kU/L,Z =- 0.84,P ＞ 0.05 ),but the level of serum specific IgG4 increased significantly after one year treatment in immunotherapy group ( before treatment 486 [ 319 ; 1439 ] AU/L,after treatment 8387 [ 7732 ; 16 634 ] AU/L,Z =- 2.81,P ＜ 0.05 ).After three-year treatment,7.5％ (3/40) of patients had asthma in immunotherapy group compared to 27.8％ (10/36) in the control group ( x2 =5.50,P ＜ 0.05 ),and 15.0％ of the initially Der P monosensitized patients in immunotherapy group had developed new sensitization compared to 47.2％in the control group ( x2 =9.32,P ＜ 0.05 ). Conclusion Three years immunotherapy improves allergic rhinitis symptoms,increases the level of serum specific IgG4,reduces the development of asthma and new sensitization.
