Comparison of perennial and preseasonal allergoid immunotherapy in grass pollen allergic patients.

ABSTRACT

BACKGROUND: The clinical and immunological efficacy of preseasonal allergoid immunotherapy has been previously investigated, however, studies comparing the effectiveness of the two protocols are limited in the literature. OBJECTIVE: The aim of this study is to compare the clinical and immunological efficacy of pre-seasonal and perennial allergoid immunotherapy. METHODS: This is a prospective cross sectional two-arm study. During the season; symptom and medication scores were filled. Before and at the end of the season; RQLQ was applied, Phl p sIgE, sIgG4 and IL-10 levels were measured. RESULTS: In preseasonal group patients had better symptom control for most of the weeks, particularly during the peak pollen period (April w-2 & w-4, p = 0.04; May w-2, p = 0.02; June w-1, w-2, p = 0.02; w-3, w-5, p = 0.03; July w-2, p = 0.01; w-3, p = 0.02; w-4, p = 0.04). In the perennial group, sIgG4 [1st time point preseasonal 0.02 mgA/L vs perennial 0.13 mgA/L (p < 0.0001); 2nd time point preseasonal 0.52 mgA/L vs perennial 0.33 mgA/L; 3rd time point preseasonal 0.04 mgA/L vs perennial 0.12 mgA/L (p < 0.0001)] and IL-10 (1st time point preseasonal 1.45 pg/ml vs perennial 2.03 pg/ml; 2nd time point preseasonal 2.29 pg/ml vs perennial 2.19 pg/ml; 3rd time point preseasonal 2.32 pg/ml vs perennial 2.16 pg/ml) levels were higher and more stable. CONCLUSIONS: Preseasonal immunotherapy provided better control of symptoms throughout the pollen season. However, the blocking antibody response was stronger and more permanent in the perennial immunotherapy group.