1.The efficacy and safety evaluation of three-year specific immunotherapy to allergic rhinitis in children
Weiwei SONG ; Xiaoping LIN ; Ruonan CHAI
Chinese Journal of Postgraduates of Medicine 2013;36(21):26-28
Objective To evaluate the efficacy and safety of specific immunotherapy (SIT) to allergic rhinitis in children.Methods Sixty-four patients with mite allergy allergic rhinitis in children,were divided into two groups by random digits table:treatment group and control group,each group with 32 cases.Treatment group was given SIT with standardized allergen vaccine for 3 years on the basis of symptomatic therapy,control group only received symptomatic therapy.Observation indexs included rhinitis symptoms score,drug score,skin index (SI),serum specificity IgE (sIgE),peripheral eosinophil (Eos) counting,development of asthma and the new sensitization.Results The Eos counting,SI after treatment 3 years in treatment group were significantly better than those before treatment and those in control group after treatment 3 years[(0.14 ± 0.12) × 109/L vs.(0.74 ± 0.18) × 109/L,(0.78 ± 0.36) × 109/L and 1.03 ± 0.13 vs.1.51 ± 0.32,1.51 ± 0.37] (P < 0.01).There was no statistically significant difference in sIgE between two groups (P >0.05).The rhinitis symptoms score,drug score in two groups after treatment 1,2,3 years were significantly better than those before treatment (P < 0.01).The rhinitis symptoms score,drug score in treatment group after treatment 1,2,3 years were significantly better than those in control group(P < 0.01).The rate of new sensitization in treatment group was significantly lower than that in control group [3.1% (1/32)vs.34.4% (11/32),P < 0.01].Conclusion Keeping long-term SIT is effective and safe for children's allergic rhinitis induced by mite,it also prevents new allergen appeared and allergic rhinitis development for asthma.
2.Efficacy evaluation of standardized dust mite allergen specific immunotherapy to patients of allergic rhinitis.
Weiwei SONG ; Xiaoping LIN ; Ruonan CHAI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(5):300-302
OBJECTIVE:
To evaluate the efficacy of mite allergen specific immunotherapy (SIT) to patients of allergic rhinitis.
METHOD:
A total of 102 patients with mite allergy were recruited into the study. They were randomly divided into two groups: SIT group (n = 51) and ST (symptomatic therapy) group (n = 51). They were given SIT with standardized allergen vaccine for 3 years or only symptomatic therapy respectively. Observation items include: rhinitis symptom scores, drug score, skin prick test result, serum specificity IgE (sIgE), peripheral eosinophil counting. The development of asthma and new allergens sensitization was also assessed.
RESULT:
The blood eosinophil numbers, skin test index, rhinitis symptom scores and drug scores were all decreased significantly after the treatment with SIT for 3 years compared to that of ST group (P < 0.01). Although the level of serum slgE was decreased, no statistic diferences were found. No patients developed asthma in SIT group, and only 2.1% of patients had new allergen sensitization; 17.4% of those in ST group developed asthma, 32.6% had new sensitization. No severe adverse events occurred.
CONCLUSION
Keeping long-term SIT is effective and safe for patients with allergic rhinitis induced by mite, which can also prevent new allergen sensitization and development for asthma.
Adolescent
;
Adult
;
Antigens, Dermatophagoides
;
administration & dosage
;
Child
;
Desensitization, Immunologic
;
Female
;
Follow-Up Studies
;
Humans
;
Male
;
Middle Aged
;
Rhinitis, Allergic
;
therapy
;
Treatment Outcome
;
Young Adult
3.Evaluation of the efficacy and safety of standardized dust mite allergen specific immunotherapy to children with allergic asthma.
Weiwei SONG ; Xiaoping LIN ; Hua XIE ; Ruonan CHAI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2013;27(21):1193-1196
OBJECTIVE:
To evaluate the efficacy and safety of mite allergen specific immunotherapy (SIT) in treating children with allergic asthma.
METHOD:
A total of 136 patients with mite allergy were recruited into the study. They were randomly divided into two groups: SIT group (n = 66) and ST (symptomatic therapy) group (n = 70). They were investigated of SIT with standardized allergen vaccine or no SIT only symptomatic therapy respectively. Therapeutic evaluation index includes: asthma symptoms score, drug score, skin prick test, pulmonary function, serum specificity IgE (sIgE) and the new sensitization was also assessed. Local and systemic adverse reactions were used to evaluate the clinical safety.
RESULT:
Clinical symptom scores, drug scores, Lung function, and skin test result all improved significantly after the treatment with SIT compared to ST group (P < 0.01). SIT groups do not have new sensitization and no fatal systemic reactions occurred.
CONCLUSION
The standardized dust mite allergen specific immunotherapy is efficacious and safe to Children with allergic asthma . SIT can reduce house dust mites skin sensitivity and prevent new allergen appeared.
Adolescent
;
Allergens
;
therapeutic use
;
Animals
;
Antigens, Dermatophagoides
;
therapeutic use
;
Asthma
;
immunology
;
therapy
;
Child
;
Dust
;
Female
;
Humans
;
Hypersensitivity
;
immunology
;
therapy
;
Immunotherapy
;
methods
;
Male
;
Pyroglyphidae
;
immunology
;
Safety
;
Sensitivity and Specificity
;
Skin Tests
;
Vaccines
;
therapeutic use
4.Effect evaluation of allergen specific immunotherapy in patients with allergic rhinitis and asthma.
Weiwei SONG ; Hua XIE ; Ruonan CHAI ; Xiaoping LIN ; Lingling SONG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(7):629-632
OBJECTIVE:
To evaluate the effect of allergen specific immunotherapy (SIT) in patients with allergic rhinitis and asthma. METHOD A total of 68 patients with allergic rhinitis and asthma sensitized to dust mite were recruited into the study. They were randomly divided into two groups: SIT group n = 34 and symptomatic therapy (ST) group: n = 34. Patients in ST group received medication to treat, the symptoms, patients in SIT group received medication and 3 years of standardized allergen vaccine therapy. Evaluation index of therapy includes: rhinitis symptoms score, asthma symptoms score, drug score, skin prick test, serum specificity IgE (sIgE) , peripheral eosinophil (Eos) counting, lung function. The new sensitinogen rate was also assessed.
RESULT:
Clinical symptom scores, drug scores, lung function, blood eosinophil numbers and skin test result were all improved significantly after 3-year treatment in SIT group compared to those in ST group (P < 0.01). Although the level of serum slgE was decreased,there exited no statistic diferences between two groups. Only 8.8% patients have the new sensitization in SIT group, and 52.9% in ST group. There were no serious adverse reactions in treatment process.
CONCLUSION
SIT for patients with AR and asthma can obtain excellent clinical efficacy.
Animals
;
Asthma
;
drug therapy
;
Desensitization, Immunologic
;
Eosinophils
;
Humans
;
Immunoglobulin E
;
blood
;
Leukocyte Count
;
Pyroglyphidae
;
Rhinitis, Allergic
;
drug therapy
;
Sensitivity and Specificity
;
Skin Tests
5.Roles of type 2 innate lymphoid cells in the pathogenesis of bronchial asthma
Dandan WANG ; Ruonan CHAI ; Feifei QI ; Song BAI ; Beixing LIU
Chinese Journal of Microbiology and Immunology 2016;36(8):634-638
Type 2 innate lymphoid cells ( ILC2s) are recently identified members of the innate lymphoid cell ( ILC) family. These cells are capable of producing Th2-type cytokines such as IL-5 and IL-13 in response to epithelial cell-derived cytokines IL-25 and IL-33 and play critical roles in allergic diseases such as bronchial asthma. Further investigations on ILC2s will enhance the better understanding of type 2 immune responses and may provide new strategies for the treatment of allergic asthma. In this review, we fo-cus on the origin, location and biological function of ILC2s as well as their possible roles in the pathogenesis of bronchial asthma.
6.CD4+T cells mediate respiratory syncytial virus(RSV)-induced airway inflammation through secre-ting Th2 cytokines
Song BAI ; Yulin CUI ; Ruonan CHAI ; Yue FAN ; Beixing LIU
Chinese Journal of Microbiology and Immunology 2017;37(10):747-752
Objective To investigate the role of CD4+T cells in airway inflammation induced by respiratory syncytial virus (RSV) infection. Methods Animal models of acute RSV infection were estab-lished. Lung tissues were stained with hematoxylin and eosin (HE) to observe histopathological changes. Total number of CD4+T cells and the number of CD4+T cells secreting Th1/Th2 cytokines (IFN-γ, IL-4, IL-5 and IL-13) in spleen were detected by flow cytometry. Adoptive transfer of CD4+T cells was performed to identify the role of CD4+T cells in RSV-induced airway inflammation. Results RSV infection increased the total number of splenic CD4+T cells,particularly Th2-type CD4+T cells. The absolute numbers of IL-4/IL-5/IL-13-secreting CD4+T cells were increased significantly after RSV infection. Furthermore, adoptive transfer of CD4+T cells into BALB/c mice not only promoted the infiltration of mononuclear cells in lung,but also enhanced the secretion of Th2 cytokines during RSV infection. Conclusion CD4+T cells are involved in RSV-induced airway inflammation through secreting Th2 cytokines.
7.Efficacy comparison and safety analysis of subcutaneous specific immunotherapy with standardized house dust mite allergen in patients with single and multiple allergic rhinitis
Hehua HUANG ; Chong XU ; Lu LIU ; Ruonan CHAI
Chinese Journal of Preventive Medicine 2022;56(6):774-783
Objective:To investigate the efficacy and safety of house dust mite (HDM) allergen subcutaneous specific immunotherapy (SCIT) in patients with allergic rhinitis (AR) with single dust mite allergy and multiple allergen allergy.Methods:A retrospective study was conducted. A total of 372 patients with allergic rhinitis induced by house dust mite were diagnosed in the allergy clinic of General Hospital of North Theater Command from January 2013 to January 2018.They were treated with house dust mite allergen preparation for standardized SCIT for 3 years or more, and had complete follow-up data. The age ranged from 5 to 55 years, the median age was 13 years, and the average age was (19.4±14.7) years; 216 males and 156 females. According to their age, they were divided into the older group (age >14 years) and younger group (age ≤ 14 years). According to the number of allergens, they were divided into single group (only HDM group allergic to house dust mites) and multi recombination (including 2 or more allergens including house dust mites). The multi recombination was further divided into HDM+1 group, HDM+2 group, HDM+3 group, HDM+4 and above group. Before treatment (T0), 1 year (T1) and 3 years (T2) after SCIT treatment, the patients in each group established files, analyzed and compared the average total nasal symptoms score (TNSS), total non nasal symptoms score (TNNSS), visual analogue scale (VAS), total medicine score (TMS) and rhinoconjunctivitis quality of life questionnaire (RQLQ), and evaluated the clinical efficacy of the treatment and the comparison of various scores in the efficacy of SCIT with different allergens and ages. Record the occurrence of local and systemic adverse reactions of all patients during treatment, and evaluate the safety of SCIT. All scores are measurement data that do not conform to normal distribution. Mann-Whitney U and Kruskai-Wallis test of independent samples are used for inter group comparison, and Bonferroni correction is used for further pairwise comparison; Chi square test and continuity correction method were used for the comparison between count data groups such as the incidence of adverse reactions and the effective rate of TNSS, and a-division method was used for further pairwise comparison. Results:After SCIT treatment, the scores of TNSS, TNNSS, TMS, VAS and RQLQ in T1 and T2 were significantly lower than those in T0, and the scores in T2 were significantly lower than those in T1 ( Z=-11.168, -4.786, -6.639, -13.012, -10.652 in T0 vs T1; Z=-13.527, -8.746, -13.397, -14.477, -11.833 in T0 vs T2; Z=-4.721, -4.607, -10.020, -7.180, -5.721 in T1 vs T2; P<0.05). In T1 and T2, compared with the older group, the scores of TNSS, TNNSS, TMS, VAS and RQLQ in younger group were lower, and the differences of various indexes were statistically significant(the median scores of T1: Myounger=3.0, 1.0, 2.0, 4.0, 2.6, Molder=5.0, 2.0, 3.0, 5.0, 3.2; the median scores of T2: Myounger=3.0, 1.0, 0, 2.0, 1.3, Molder=4.0, 1.0, 1.5, 3.0, 2.3; ZT1=-4.525, -5.830, -4.061, -3.608, -2.785; ZT2=-3.847, -4.055, -2.820, -2.998, -3.418; P<0.05). In T1 and T2, the scores of TNSS, VAS and RQLQ in a single group after SCIT treatment were lower than those in multiple recombination(the median scores of T1: Msingle=4.0, 4.0, 2.6, Mmultiple=5.0, 5.0, 3.2; the median scores of T2: Msingle=3.0, 2.0, 1.4, Mmultiple=4.0, 3.0, 2.1), and the difference was statistically significant ( ZT1=-3.002, -2.092, -1.977; ZT2=-3.354, -2.469, -2.116; P<0.05). There was no significant difference in TMS (the median score during T1 period: Msingle=2.0, Mmultiple=3.0, ZT1=-1.130; the median score during T2 period: Msingle=1.0, Mmultiple=1.0, ZT2=-1.544; P>0.05). Further comparison within the group showed that there was no significant difference in the improvement rate of TNSS during T2 period among HDM group, HDM+1 group, HDM+2 group and HDM+3 group (HDM vs HDM+1 group χ 2=0.277, HDM vs HDM+2 group χ 2=0.78, HDM vs HDM+3 group χ 2=0.075, HDM+1 vs HDM+2 group χ 2=0.057, HDM+1 vs HDM+3 group χ 2=0.019, HDM+2 vs HDM+3 group χ 2=0.003; P>0.005), the improvement rates were 92.5%, 90.3%, 89.1% and 89.5%. Respectively in HDM group,HDM+1 group, HDM+2 group, HDM+3 group, compared with HDM+4 and above group, the difference was statistically significant (χ 2=26.144, 13.254, 15.144, 8.808; P<0.005). The improvement rate of TNSS in HDM+4 and above group was 60.9%. 122 patients had local adverse reactions during the treatment of SCIT, accounting for 32.8%. The local adverse reactions were 759 injections (15 336 injections in total), accounting for 4.95%. Most of them were swelling, dizziness, induration and pruritus at the injection site, which could be relieved by oral antihistamines or within 2 hours. There were 2 cases of local urticaria, once for each case. The symptoms were relieved within 1 week after oral antihistamine. No serious systemic adverse reactions occurred. Conclusion:Standardized SCIT may be a safe and effective treatment for AR patients, and the type of allergen may be one of the important factors affecting the efficacy of SCIT. The efficacy of SCIT was significant in AR patients with three or less allergens other than house dust mite.
8.Efficacy comparison and safety analysis of subcutaneous specific immunotherapy with standardized house dust mite allergen in patients with single and multiple allergic rhinitis
Hehua HUANG ; Chong XU ; Lu LIU ; Ruonan CHAI
Chinese Journal of Preventive Medicine 2022;56(6):774-783
Objective:To investigate the efficacy and safety of house dust mite (HDM) allergen subcutaneous specific immunotherapy (SCIT) in patients with allergic rhinitis (AR) with single dust mite allergy and multiple allergen allergy.Methods:A retrospective study was conducted. A total of 372 patients with allergic rhinitis induced by house dust mite were diagnosed in the allergy clinic of General Hospital of North Theater Command from January 2013 to January 2018.They were treated with house dust mite allergen preparation for standardized SCIT for 3 years or more, and had complete follow-up data. The age ranged from 5 to 55 years, the median age was 13 years, and the average age was (19.4±14.7) years; 216 males and 156 females. According to their age, they were divided into the older group (age >14 years) and younger group (age ≤ 14 years). According to the number of allergens, they were divided into single group (only HDM group allergic to house dust mites) and multi recombination (including 2 or more allergens including house dust mites). The multi recombination was further divided into HDM+1 group, HDM+2 group, HDM+3 group, HDM+4 and above group. Before treatment (T0), 1 year (T1) and 3 years (T2) after SCIT treatment, the patients in each group established files, analyzed and compared the average total nasal symptoms score (TNSS), total non nasal symptoms score (TNNSS), visual analogue scale (VAS), total medicine score (TMS) and rhinoconjunctivitis quality of life questionnaire (RQLQ), and evaluated the clinical efficacy of the treatment and the comparison of various scores in the efficacy of SCIT with different allergens and ages. Record the occurrence of local and systemic adverse reactions of all patients during treatment, and evaluate the safety of SCIT. All scores are measurement data that do not conform to normal distribution. Mann-Whitney U and Kruskai-Wallis test of independent samples are used for inter group comparison, and Bonferroni correction is used for further pairwise comparison; Chi square test and continuity correction method were used for the comparison between count data groups such as the incidence of adverse reactions and the effective rate of TNSS, and a-division method was used for further pairwise comparison. Results:After SCIT treatment, the scores of TNSS, TNNSS, TMS, VAS and RQLQ in T1 and T2 were significantly lower than those in T0, and the scores in T2 were significantly lower than those in T1 ( Z=-11.168, -4.786, -6.639, -13.012, -10.652 in T0 vs T1; Z=-13.527, -8.746, -13.397, -14.477, -11.833 in T0 vs T2; Z=-4.721, -4.607, -10.020, -7.180, -5.721 in T1 vs T2; P<0.05). In T1 and T2, compared with the older group, the scores of TNSS, TNNSS, TMS, VAS and RQLQ in younger group were lower, and the differences of various indexes were statistically significant(the median scores of T1: Myounger=3.0, 1.0, 2.0, 4.0, 2.6, Molder=5.0, 2.0, 3.0, 5.0, 3.2; the median scores of T2: Myounger=3.0, 1.0, 0, 2.0, 1.3, Molder=4.0, 1.0, 1.5, 3.0, 2.3; ZT1=-4.525, -5.830, -4.061, -3.608, -2.785; ZT2=-3.847, -4.055, -2.820, -2.998, -3.418; P<0.05). In T1 and T2, the scores of TNSS, VAS and RQLQ in a single group after SCIT treatment were lower than those in multiple recombination(the median scores of T1: Msingle=4.0, 4.0, 2.6, Mmultiple=5.0, 5.0, 3.2; the median scores of T2: Msingle=3.0, 2.0, 1.4, Mmultiple=4.0, 3.0, 2.1), and the difference was statistically significant ( ZT1=-3.002, -2.092, -1.977; ZT2=-3.354, -2.469, -2.116; P<0.05). There was no significant difference in TMS (the median score during T1 period: Msingle=2.0, Mmultiple=3.0, ZT1=-1.130; the median score during T2 period: Msingle=1.0, Mmultiple=1.0, ZT2=-1.544; P>0.05). Further comparison within the group showed that there was no significant difference in the improvement rate of TNSS during T2 period among HDM group, HDM+1 group, HDM+2 group and HDM+3 group (HDM vs HDM+1 group χ 2=0.277, HDM vs HDM+2 group χ 2=0.78, HDM vs HDM+3 group χ 2=0.075, HDM+1 vs HDM+2 group χ 2=0.057, HDM+1 vs HDM+3 group χ 2=0.019, HDM+2 vs HDM+3 group χ 2=0.003; P>0.005), the improvement rates were 92.5%, 90.3%, 89.1% and 89.5%. Respectively in HDM group,HDM+1 group, HDM+2 group, HDM+3 group, compared with HDM+4 and above group, the difference was statistically significant (χ 2=26.144, 13.254, 15.144, 8.808; P<0.005). The improvement rate of TNSS in HDM+4 and above group was 60.9%. 122 patients had local adverse reactions during the treatment of SCIT, accounting for 32.8%. The local adverse reactions were 759 injections (15 336 injections in total), accounting for 4.95%. Most of them were swelling, dizziness, induration and pruritus at the injection site, which could be relieved by oral antihistamines or within 2 hours. There were 2 cases of local urticaria, once for each case. The symptoms were relieved within 1 week after oral antihistamine. No serious systemic adverse reactions occurred. Conclusion:Standardized SCIT may be a safe and effective treatment for AR patients, and the type of allergen may be one of the important factors affecting the efficacy of SCIT. The efficacy of SCIT was significant in AR patients with three or less allergens other than house dust mite.
9.Evaluation of long-term effect for house dust mite subcutaneous immunotherapy for patients with allergic rhinitis
Weiwei SONG ; Xiaoping LIN ; Ruonan CHAI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2015;50(8):632-635
Objective To evaluate the long-term effect of house dust mite subcutaneous immunotherapy (SCIT) in patients with allergic rhinitis (AR).Methods A total of 102 patients with allergic rhinitis (not associated asthma) were recruited into the study.These patients were randomly divided into two groups:SCIT group and ST (symptomatic therapy) group.The patients were investigated for SCIT with standardized allergen vaccine for 3 years or no SIT only symptomatic therapy respectively.After the termination of SCIT,these patients were followed-up continuously for another 2 years.The therapeutic evaluation index included:rhinitis symptoms score,drug score,skin prick test,serum specific IgE (sIgE),as well as the number of development of asthma and the new sensitization.SPSS 11.0 software was used to analyze the data.Results Clinical symptom scores,drug scores,and skin test result all improved significantly after the treatment with SCIT compared to SCIT before and ST group (P < 0.01).Two years after the termination of SCIT,the same parameters showed no significant difference compared to 3 years before (P > 0.05).No rhinitis patients in SCIT group developed to asthma,only 4.7% of patients had been found to have new allergen.In the meantime,22.0% of the patients with rhinitis in ST group developed asthma,and 41.5% patients were found to have new allergen.No severe adverse events occurred.Conclusions The symptoms of the patients with allergic rhinitis were obviously improved by SCIT and a long-term curative effect could be maintained.It should be early applicated,which could prevent allergic rhinitis developed to asthma.