OBJECTIVETo compare the efficacy and safety of a 6-week cluster schedule of specific immunotherapy with that of a 14-week conventional schedule for the treatment of subjects with persistent allergic rhinitis (AR).

METHODSThe trial was a prospective and randomized study involving 80 patients with persistent AR, who were allergic to Dermatophagoides pteronyssinus. While 40 patients were randomly assigned to the cluster schedule reaching the maintenance dose within 6 weeks, the other 40 patients were randomly assigned to the conventional schedule reaching the maintenance dose within 14 weeks. Symptom scores and medication scores were used to evaluate the clinical efficacy. Serum specific IgG4 level was examined to mark immunologic change, adverse reactions were recorded during the treatment.

RESULTSCluster group achieved clinical efficacy (reducing symptom scores and medication score) and increasing serum specific IgG4 sooner (after 6 weeks treatment). During the incremental dose phase, there were 6 systemic adverse reactions (1.12% of all injection) in 3 patients in cluster group and there were 5 systemic adverse reactions (0.85% of all injection) in 3 patients in conventional group. No severe systemic reactions occurred in both group. There was no difference between the 2 groups in frequency or type of systemic reaction (χ(2) = 0.333, P > 0.05).

CONCLUSIONThe cluster schedule is a safe alternative to the conventional schedule with the advantage of achieving clinical efficacy sooner.

Adolescent ; Adult ; Allergens ; immunology ; Animals ; Dermatophagoides pteronyssinus ; immunology ; Drug Administration Schedule ; Female ; Humans ; Immunoglobulin G ; blood ; Immunotherapy ; methods ; Male ; Middle Aged ; Prospective Studies ; Rhinitis, Allergic, Perennial ; therapy ; Young Adult

OBJECTIVETo evaluate the efficacy and immunological changes of children receiving subcutaneous immunotherapy with Dermatophagoides pteronyssinus.

METHODSSixty-four children with allergic rhinitis to Dermatophagoides pteronyssinus (Der p) were randomly allocated to receive either specific immunotherapy (n = 32) or medical treatment (n = 32). Symptom and medication scores were assessed to evaluate the clinical efficacy in the baseline and after one year treatment. Total IgE, Der p-specific IgE, and specific IgG4 were measured.

RESULTSImmunotherapy reduced the symptom (the scores reduced from 10[9;11] to 4[3;6]) and medication score (the scores reduced from 0.76[0.61;0.90] to 0.35[0.30;0.43]) in children with allergic rhinitis significantly(Z value were -4.80 and -4.74, respectively, each P < 0.01). There was a significant difference in symptom and medication scores between both groups after one year treatment (U value were 155.00 and 139.50, respectively, each P < 0.01). There were no differences in levels of serum total IgE, specific IgE before and after one year treatment, but the level of serum specific IgG4 increased significantly after one year treatment.

CONCLUSIONSImmunotherapy with standardized extract is efficacious to treat children sensitive to Der p, allergen-specific IgG4 is significant as immunological marker to predict efficacy of immunotherapy.

Adolescent ; Allergens ; immunology ; pharmacology ; Animals ; Antigens, Dermatophagoides ; immunology ; pharmacology ; Child ; Desensitization, Immunologic ; Female ; Humans ; Immunoglobulin E ; blood ; Immunotherapy, Active ; Male ; Mites ; immunology ; Rhinitis, Allergic, Perennial ; immunology ; therapy ; Treatment Outcome

OBJECTIVETo evaluate the long-term efficacy of subcutaneous immunotherapy with Dermatophagoides pteronyssinus (DerP) in patients with allergic rhinitis.

METHODSNinety-two patients with allergic rhinitis to DerP were randomly allocated to receive either specific immunotherapy (n = 46) or medical treatment (n = 46). Symptom and medication scores and skin response to Derp were assessed to evaluate the clinical efficacy in the baseline and after three years treatment. DerP-specific IgE and IgG4 were measured.

RESULTSAfter 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 Derp (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 (χ(2) = 5.50, P < 0.05), and 15.0% of the initially DerP nonsensitized patients in immunotherapy group had developed new sensitization compared to 47.2% in the control group (χ(2) = 9.32, P < 0.05).

CONCLUSIONThree years immunotherapy improves allergic rhinitis symptoms, increases the level of serum specific IgG4, reduces the development of asthma and new sensitization.

Adolescent ; Adult ; Allergens ; immunology ; Animals ; Antigens, Dermatophagoides ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Desensitization, Immunologic ; Female ; Humans ; Immunoglobulin E ; blood ; Immunoglobulin G ; blood ; Male ; Middle Aged ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; therapy ; Treatment Outcome ; Young Adult

Schisandra chinensis, a traditional Chinese medicine (TCM), has been used to treat sleep disorders. Zebrafish sleep/wake behavioral profiling provides a high-throughput platform to screen chemicals, but has never been used to study extracts and components from TCM. In the present study, the ethanol extract of Schisandra chinensis and its two main lignin components, schisandrin and schisandrin B, were studied in zebrafish. We found that the ethanol extract had bidirectional improvement in rest and activity in zebrafish. Schisandrin and schisandrin B were both sedative and active components. We predicted that schisandrin was related to serotonin pathway and the enthanol extract of Schisandra chinensis was related to seoronin and domapine pathways using a database of zebrafish behaviors. These predictions were confirmed in experiments using Caenorhabditis elegans. In conclusion, zebrafish behavior profiling could be used as a high-throughput platform to screen neuroactive effects and predict molecular pathways of extracts and components from TCM.
Animals ; Behavior, Animal ; drug effects ; Caenorhabditis elegans ; Central Nervous System Agents ; chemistry ; isolation & purification ; pharmacology ; Cyclooctanes ; analysis ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Lignans ; analysis ; isolation & purification ; pharmacology ; Plant Extracts ; chemistry ; isolation & purification ; pharmacology ; Polycyclic Compounds ; analysis ; isolation & purification ; pharmacology ; Schisandra ; chemistry ; Zebrafish ; physiology