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Original Article

 

Specific Allergen Immunotherapy: Effect on Immunologic Markers and Clinical Parameters in Asthmatic Children

 

O Cevit,1 SG Kendirli,2 M Yılmaz,2 DU Altıntas,2 GB Karakoc3

1 Division of Allergy, Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
2 Division of Allergy, Department of Pediatrics, Cukurova University Faculty of Medicine, Adana, Turkey

J Investig Allergol Clin Immunol 2007; Vol. 17 (5): 286-291

 

 Abstract


Background: Specific allergen immunotherapy (SIT) is the main treatment modality for achieving long-term symptom relief in perennial allergic diseases.

Objective: The aim of this study was to evaluate the effect of 1 year of house dust mite immunotherapy on the concentrations of 3 immunologic markers: eosinophil cationic protein (ECP), nitric oxide (NO), and monocyte chemoattractant protein 1 (MCP-1). We also compared theeffect on asthma symptoms and medication scores, allergen-specific bronchial challenge test, and the skin prick test.

Methods: A total of 31 mite-allergic, asthmatic children (age range, 6-16 years) were enrolled; 19 were treated with SIT and 12 controls who had refused SIT received only drug treatment. Effi cacy was evaluated using serum NO, ECP, and MCP-1 levels, and asthma symptom and medication scores, allergen-specific bronchial challenge test, and skin-prick test. The results of the tests were compared at baseline and after 1 year of treatment.

Results: Serum NO and ECP levels decreased signifi cantly in the SIT group (P = .01 and P = .018) compared to baseline, whereas control group values remained similar. The serum MCP-1 level decreased signifi cantly in both the SIT and control groups (P = .009 and P = .041, respectively). The SIT group experienced signifi cant improvement in asthma symptoms (P = .001) and medication scores (P = .001) and skin reactivity to Dermatophagoides pteronyssinus (P = .020), whereas the control group did not. The results of bronchial challenge to D pteronyssinus showed a similar pattern at baseline and after 1 year of treatment in both groups. The tolerated allergen concentration
increased in both groups (P < .05). Lung function tests, total immunoglobulin (Ig) E and specific IgE to D pteronyssinus and Dermatophagoides farinae did not change after a year of treatment in either group.

Conclusion: SIT with D pteronyssinus improves immunological and clinical parameters in mite-allergic asthmatic children after 1 year of treatment. The skin prick test may be used as a marker of effi cacy of therapy.

Key words: Specific allergen immunotherapy. Asthma. House dust mite. Childhood.