How molecular diagnosis may modify immunotherapy prescription in multi-sensitized pollen-allergic children
Río Camacho, G Del; Montes Arjona, AM; Fernández-Cantalejo Padial, J; Rodríguez Catalán, J.
Allergol. immunopatol;
46(6): 552-556, nov.-dic. 2018. tab, graf
Artículo
en Inglés
| IBECS (España) | ID: ibc-177894
INTRODUCTION:
Specific immunotherapy (SIT) is used to treat asthma and allergic rhinitis, and a dose-response relationship has been found for SIT efficacy, creating a need to accurately select the allergen used in therapy. This need is especially pronounced in poly-sensitized children living in areas where different pollen allergen sources coexist in the same season, as this circumstance complicates diagnostic efforts. In such cases, component-resolved diagnosis (CRD) can increase diagnostic accuracy and aid in SIT prescription. MATERIALS ANDMETHODS:
We hypothesized that CRD results would lead to modifications in classical immunotherapy prescription based on sources such as medical history, season of symptom presentation, and skin testing. We studied a sample of children indicated for immunotherapy in whom classical methods had not pointed out the most relevant allergen due to sensitization to more than two pollens. We used a small panel of recombinant allergens, analyzing the percentage of changes to prescription considering the findings of molecular studies.RESULTS:
Of the 70 children included, CRD led to modified immunotherapy prescription in 54.3%. Indications of single-allergen therapy increased from 18% to 51% when CRD was included. The decision to prescribe immunotherapy was reversed following CRD in 9.3% of cases.DISCUSSION:
CRD use alters the choice of specific immunotherapy in poly-sensitized children. A wide panel of recombinant allergens may not be necessary to improve immunotherapy indication using molecular techniques; rather, a smaller panel adapted to include those allergens prevalent in the geographical area in question appears to be sufficient for more effective immunotherapy, also leading to an improved cost-benefit ratio
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Asunto(s)
Humanos Masculino Femenino Niño Alérgenos/uso terapéutico Asma/diagnóstico Antígenos de Plantas/uso terapéutico Desensibilización Inmunológica Rinitis Alérgica Estacional/diagnóstico Alérgenos/inmunología Asma/inmunología Asma/terapia Antígenos de Plantas/inmunología Reacciones Cruzadas Prescripciones Rinitis Alérgica Estacional/inmunología Rinitis Alérgica Estacional/terapia Pruebas Cutáneas
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ES1.1
Ubicación: BNCS
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