RESUMO
Background: Allergen-specific immunotherapy (SIT) is a long-term treatment of respiratory allergy. Objective: To look for early predictors of the effectiveness of Dermatophagoides pteronyssinus SIT. Methods: A prospective multi-centre study was carried out in Spain. Children with D. pteronyssinus rhinitis or asthma were invited to participate. The study was divided into times: T0 (recruitment); T1 (inclusion); T2 a-f (immunotherapy times) and T3 (the end of study). Efficacy of SIT was assessed by clinical scores, visual analogue scales (VAS) and lung function tests. We performed D. pteronyssinus skin tests at T1 and T3, and determined specific serum IgE, IgG4 and IL-10 at T1, T2f and T3.Data were analysed using MannWhitney and KruskalWallis tests, compared using Wilcoxon and Chi-square tests, and correlated to Spearman test. All tests had a significance level of 0.05. Results: Thirty-eight children completed the study. At T1 all had rhinitis and 34 also had asthma. At T3, 30 patients had improved, six experienced no changes and two worsened. Improvement was associated to FEV1/FVC and VAS improvement; to a reduction in D. pteronyssinus skin prick test; to a progressive increase in serum levels of D. pteronyssinus IgE, and D. pteronyssinus, Der p1 and Der p2 IgG4. IL-10 levels showed an early increase at T2f (the end of initial build-up immunotherapy phase), and then a reduction at T3 (the end of a year of immunotherapy).Improvement associated to an early increase in IL-10 and was correlated with VAS and specific IgG4 evolution(AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Interleucina-10/administração & dosagem , Interleucina-10/imunologia , Interleucina-10/uso terapêutico , Dermatophagoides pteronyssinus , Dermatophagoides pteronyssinus/imunologia , Antígenos de Dermatophagoides , Antígenos de Dermatophagoides/imunologia , Antígenos de Dermatophagoides/isolamento & purificação , Imunoterapia/métodos , Imunoterapia , Interleucina-10/isolamento & purificação , Interleucina-10/metabolismo , Imunoterapia/normas , Imunoterapia/tendências , Estudos Prospectivos , Resultado do Tratamento , Avaliação de Eficácia-Efetividade de IntervençõesRESUMO
BACKGROUND: Allergen-specific immunotherapy (SIT) is a long-term treatment of respiratory allergy. OBJECTIVE: To look for early predictors of the effectiveness of Dermatophagoides pteronyssinus SIT. METHODS: A prospective multi-centre study was carried out in Spain. Children with D. pteronyssinus rhinitis or asthma were invited to participate. The study was divided into times: T0 (recruitment); T1 (inclusion); T2 a-f (immunotherapy times) and T3 (the end of study). Efficacy of SIT was assessed by clinical scores, visual analogue scales (VAS) and lung function tests. We performed D. pteronyssinus skin tests at T1 and T3, and determined specific serum IgE, IgG4 and IL-10 at T1, T2f and T3. Data were analysed using Mann-Whitney and Kruskal-Wallis tests, compared using Wilcoxon and Chi-square tests, and correlated to Spearman test. All tests had a significance level of 0.05. RESULTS: Thirty-eight children completed the study. At T1 all had rhinitis and 34 also had asthma. At T3, 30 patients had improved, six experienced no changes and two worsened. Improvement was associated to FEV1/FVC and VAS improvement; to a reduction in D. pteronyssinus skin prick test; to a progressive increase in serum levels of D. pteronyssinus IgE, and D. pteronyssinus, Der p1 and Der p2 IgG4. IL-10 levels showed an early increase at T2f (the end of initial build-up immunotherapy phase), and then a reduction at T3 (the end of a year of immunotherapy). Improvement associated to an early increase in IL-10 and was correlated with VAS and specific IgG4 evolution.
Assuntos
Antígenos de Dermatophagoides/uso terapêutico , Proteínas de Artrópodes/uso terapêutico , Asma/terapia , Cisteína Endopeptidases/uso terapêutico , Dermatophagoides pteronyssinus/imunologia , Dessensibilização Imunológica/métodos , Interleucina-10/imunologia , Rinite Alérgica/terapia , Adolescente , Animais , Antígenos de Dermatophagoides/imunologia , Proteínas de Artrópodes/imunologia , Asma/imunologia , Criança , Pré-Escolar , Cisteína Endopeptidases/imunologia , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Masculino , Estudos Prospectivos , Rinite Alérgica/imunologia , Espanha , Escala Visual AnalógicaRESUMO
No disponible
Assuntos
Feminino , Pré-Escolar , Humanos , Temperatura Baixa/efeitos adversos , Anafilaxia/etiologia , Urticária/etiologia , Angioedema/etiologia , Alérgenos , Testes Cutâneos/métodosRESUMO
No disponible
