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Introduction:
Dose-response skin
prick tests are an
important tool to
standardise allergen
extracts and to
evaluate changes in
skin test response
as a consequence of
allergen
modifications.
Objectives:
To evaluate in vivo
and in vitro
characteristics of 3
different types of
extracts of Phleum
pratense,
Oleaeuropaea,
Parietaria judaica
and Dermatophagoides
pteronyssinus.
Material and
methods: Three
types of extracts
were used: native
unmodified extracts
(N), depigmented
extracts (DP) (extracts
subjected to a mild
acid treatment under
controlled
conditions and
dialysis), and a
depigmented
glutaraldehyde
polymerised extract
(DPP). Adult
patients were skin
tested in duplicate
with the 3 types of
extracts. The dose-response
relationship between
the geometric mean
of the wheal areas
and the allergen
concentrations was
calculated for each
patient using
regression line
analysis. The amount
of freeze-dried
allergen preparation
needed to produce
the same wheal size
as histamine was
calculated in each
patient (individual
10 HEP) and for each
of the 3 types of
extracts. In vitro
analysis consisted
of major allergen
determinations and
specific IgE and IgG
inhibitions.
Results: The
respective 10 HEP
values for N, DP and
DPP preparations
were 0.20 mg, 0.15
and 2.11 for D.
pteronyssinus. For
P. pratense, these
values were 0.02 mg,
0.02 and 0.99; for
O. europaea 0.15,
0.44 and 4.9; and
for P. judaica 0.01,
0.008 and 1.78 mg.
Conclusions:
The polymerised
depigmented extracts
are significantly
less allergenic than
the corresponding
native and
depigmented extracts.
This could provide a
greater safety
margin for the
administration of
higher doses of
immunotherapy in a
shorter period of
time.
Key words: skin
tests, depigmented
allergen extracts,
glutaraldehyde
polymerized allergen
extracts, allergoids |