Analysis of the dynamics of clinical indicators in patients with allergic rhinitis with sensitization to pollen and household allergens using combined allergen-specific immunotherapy

The aim of this study was to evaluate the clinical efficacy of combined allergen-specific immunotherapy (ASIT) in patients with allergic rhinitis (AR) with combined sensitization to pollen and household allergens. To achieve this goal, 49 patients with AR of working age were examined – 35.5±1.5 years with clinical manifestations of seasonal rhinoconjunctival syndrome with a long period of 9.2±1.1 years, among which there were 25 (51.0%) males and 24 (49%) females. All patients were divided into 2 homogeneous groups by age, sex, duration of the disease, the average number of etiologically significant allergens: the main one – 31 patients who received combined ASIT with solutions of pollen and household allergens and a comparison group – 18 patients for whom only pollen allergens were used. Allergological examination included anamnesis, skin tests with pollen allergens (wormwood, ragweed, quinoa, corn, etc.) and household (house dust, mites, epidermal agents) and / or molecular research methods using the ALEX technology. The quantitative integral assessment of the intensity of AR clinical symptoms was calculated as a total score for the main symptoms. The maximum score for the severity of nasal symptoms – 12, eye - 6, total – 18. The results obtained and their analysis indicate that under the influence of ASIT pollen and household allergens in patients there is a significant and reliable decrease in the intensity of clinical manifestations of seasonal rhinoconjunctive syndrome: nasal manifestations – by 52,2%, conjunctival – by 60%, integral – by 54.3% and an increase of 2.2 times in the percentage of patients in the main group with the disappearance or minimization of clinical symptoms of the disease after treatment compared with patients from the comparison group, which convincingly proves and confirms high efficiency of the selected type of therapy in patients with AR in combination with sensitization to pollen and household allergens.

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Dynamics of basophil reactivity in the patients with allergic rhinitis on the background of allergen-specific immunotherapy

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja1410 ◽

2021 ◽

Vol 17 (4) ◽

pp. 75-84

Author(s):

Liudmila Yu. Barycheva ◽

Liudmila V Dushina ◽

Marina V. Golubeva ◽

Milana M. Minasyan ◽

Yulia N. Medvedenko

Keyword(s):

Allergic Rhinitis ◽

Specific Immunotherapy ◽

Clinical Symptoms ◽

Stimulation Index ◽

Basophil Activation Test ◽

Basophil Activation ◽

House Dust Mites ◽

Allergen Specific Immunotherapy ◽

Activation Test ◽

Positive Treatment

BACKGROUND: Allergen-specific immunotherapy (ASIT) helps to reduce spontaneous and to induce basophil reactivity, which is one of the major mechanisms of its effectiveness. A number of studies, though, have not confirmed the informative value of the basophil activation test (BAT), in case of ASIT, with house dust mites, meadow grass pollen, and wasp venom. BAT outcomes are likely to be influenced by the properties of the sensitizing allergen, the duration of ASIT, and the BAT markers that are used. AIMS: To evaluate the basophils reactivity in the patients sensitized to weed pollen and treated with allergen-specific therapy. MATERIALS AND METHODS: The study involved 60 patients (aged 1655) with allergic rhinitis sensitized to weed pollen. The diagnosis was based on the skin test outcomes as well as on identifying specific antibodies to major allergens of ragweed, wormwood, timothy, and birch. The pre-seasonal ASIT involved water-salted extracts of pollen allergens during 2 years. Clinical symptoms and the immunotherapy effectiveness were evaluated 6 and 18 months after the ASIT started. BATs were made before the treatment, after the first and second courses of pre-seasonal ASIT, which corresponded to zero, the 3rd and the 15th months of the treatment. The activated basophils were identified based on the CRTH2pos CD203brightCD3neg phenotype. RESULTS: The first treatment course was completed by 52 patients, while the second one by 43 patients. A statistically significant decrease in spontaneous basophil reactivity was detected only after the second course of ASIT. The decrease in the allergen-induced basophil activation was identified in 67.4% of the samples obtained after the first ASIT course, and in 67.6% of samples taken after the second immunotherapy course. A decrease in the BAT stimulation index (BAT SI) was identified mainly in the patients featuring positive treatment outcomes. CONCLUSIONS: ASIT influences on the basophil reactivity indicators in the patients sensitized to weed pollen. The basophil activation test may be considered as a potential predictor of ASIT effectiveness.

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Dynamics of class E and G immunoglobulins under the influence of combined allergen-specific immunotherapy in patients with allergic rhinitis with combined sensitization to pollen and household allergens

OTORHINOLARYNGOLOGY 2-3(2) 2019 - OTORHINOLARYNGOLOGY ◽

10.37219/2528-8253-2020-6-42 ◽

2020 ◽

pp. 42-48

Author(s):

E.М Dityatkovska ◽

S.V. Biletska

Keyword(s):

Allergic Rhinitis ◽

Specific Immunotherapy ◽

Immunoglobulin E ◽

Skin Tests ◽

Total Serum ◽

Combination Immunotherapy ◽

Pollen Allergens ◽

Allergen Specific Immunotherapy ◽

Prick Test ◽

Specific Combination

The aim of this study is to assess the dynamics of immunoglobulin E and G under the influence of combined allergen-specific immunotherapy (ASIT) in patients with allergic rhinitis with combined sensitization to pollen and household allergens. Materials and methods: The study involved 49 patients, residents of Dnipro city, of working age (35,5±1,5 years), of whom 24 (49,0%) - women and 25 (51,0%) - men. All patients were diagnosed with allergic rhinitis with average disease duration of 9,2 ±1,1 year, who underwent allergy examination - skin tests - prick test with pollen and household allergens and/or methods of allergy component diagnosis ALEX. The number of pollen allergens in one patient was 4,6±0,4 on average. All patients received one course of pre-season ASIT allergen according to the express scheme. Patients in the main group (31 patients) received a combined ASIT with solutions of pollen and household allergens. 18 patients in the comparison group received ASIT only with pollen allergens. Clinical groups were homogeneous in age, sex, duration of the disease, as well as the average number of pollen allergens. Results: The obtained results and their analysis show that the use of allergen-specific combination immunotherapy in patients with allergic rhinitis with combined sensitization to pollen allergens causes a more significant effect on the activation of the immune response, which was revealed by reduced relative to baseline lgE production by 41,9% (p<0,001) and an increase in lgG by 7,5% (p<0,05). The production of total serum in patients with allergic rhinitis before treatment and under the influence of ASIT was the opposite to the dynamics of lgG production. The positive results of immunological studies convincingly prove the benefits and effectiveness of allergen-specific combination immunotherapy in the treatment of patients with allergic rhinitis with combined sensitization to pollen and household allergens.

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Clinical and allergological characteristic of children with allergic rhinitis receiving allergen-specific immunotherapy in Altai region

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja468 ◽

2015 ◽

Vol 12 (2) ◽

pp. 64-67

Author(s):

N V Shakhova ◽

V V Gordeev ◽

U F Lobanov ◽

T S Ardatova ◽

M V Surcova

Keyword(s):

Allergic Rhinitis ◽

Medical Record ◽

Allergic Conjunctivitis ◽

Specific Immunotherapy ◽

Primary Diagnosis ◽

House Dust Mites ◽

Allergen Specific Immunotherapy ◽

Altai Region ◽

Persistent Allergic Rhinitis ◽

Record Card

The purpose of this study. To investigate clinical characteristics of the allergic rhinitis in children receiving allergen-specific immunotherapy. Methods. The epidemiologic observational multicenter study was conducted with the allergists of Altai region. The participating allergists filled out the specially designed medical record card on children with allergic rhinitis receiving ASIT. The study lasted from October 2013 to March 2014. Results. Allergists have filled out medical record cards of 165 children with allergic rhinitis receiving ASIT. The average age of children was 10,5±2,3 years, with the average of 4,8±2,5 years of allergic rhinitis prior to the start of ASIT. 159 (96,2%) children had moderate/severe allergic rhinitis, and 121 (73,3%) children had persistent allergic rhinitis. In 123 (74,5%) children rhinitis was accompanied by allergic conjunctivitis, and in 70 (42,2%) children - by bronchial asthma. 69 (41,8%) children receiving ASIT were mono-sensitized, 96 (58,2%) children were polysensitized. 48,5% of children were sensitized to house dust mites, 63,6% to tree pollen, 48,5% to meadow grass pollen, 30,9% to weed pollen, and in 21,8% sensitization to epidermal allergens was found. Conclusion. The findings of the study showed that in most cases (96,2%), children with allergic rhinitis receiving ASIT had moderate/severe rhinitis and in 73,3% symptoms were persistent. In 74,5% of cases, allergic rhinitis was accompanied by allergic conjunctivitis. Most part of children receiving ASIT had multiple sensitization (58,2%). Also a delayed beginning of ASIT was observed - 4,8±2,5 year from primary diagnosis to ASIT initiation.

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CONFIRMATION OF ETIOLOGIC DIAGNOSIS IN CHILDREN WITH HOUSE DUST MITE ALLERGY AS AN ESSENTIAL STAGE BEFORE ALLERGEN SPECIFIC IMMUNOTHERAPY. A REVIEW

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja287 ◽

2017 ◽

Vol 14 (6) ◽

pp. 98-106

Author(s):

O V Trusova ◽

A V Kamaev ◽

N L Lyashenko ◽

I V Makarova

Keyword(s):

Allergic Rhinitis ◽

House Dust ◽

House Dust Mite ◽

House Dust Mites ◽

Skin Tests ◽

Allergen Specific Immunotherapy ◽

House Dust Mite Allergy ◽

Mite Allergy ◽

Dust Mite

House dust mites are important cause for allergic rhinitis, and almost half of allergic rhinitis patients is sensitized to them. In patients with house dust mite allergy evidence of sensitivity can not be strictly achieved with medical history and patients complaints, since the cause-effect relationships are not obvious. At the same time incomplete allergological examination can lead to an incorrect definition of the main relevant allergens, and expensive treatment may not give the desired result in this cases. The estimation of the allergens for allergenspecific immunotherapy should be based on the disease history, detection of offending allergens by means of allergological examination in vivo with skin tests, nasal or conjunctival provocational tests, and component diagnostics if necessary. This approach based on use of provocational tests as a part of allergological examination is considered to be one of the ways to personalized therapy.

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Dynamics of clinical symptoms and immunity local parametres during allergen - specific immunotherapy in patents with pollinosis and combined forms of sensibilization

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja873 ◽

2009 ◽

Vol 7 (3) ◽

pp. 14-18

Author(s):

E V Bezrukova ◽

B A Molotilov

Keyword(s):

Czech Republic ◽

Oral Cavity ◽

Specific Immunotherapy ◽

Sublingual Immunotherapy ◽

Clinical Symptoms ◽

Pollen Allergens ◽

Local Immunity ◽

Allergen Specific Immunotherapy ◽

Made In

Background. To evaluate clinical and immunological efficiency of immunotherapy of pollinosis patients with combined forms of sensitization with «Sevapharma» allergens, Czech Republic. Materials and methods. 189 patients with pollinosis (age 18-55 years old) were examined during this study. Out of these 189 patients three groups were chosen to be treated with pollen allergens made in Czech Republic and domestic allergens from Russia. During the study slgA in saliva was examined and the efficiency of different AS IT methods with combined forms of sensitization was tested. Results. Patients with pollinosis had disruption in local immunity. slASIT increases slgA production in saliva. Treatment with interfacing allergens is most effective in combined forms of sensitization. Conclusion. The sensibilization to different kinds of pollen allergens was observed in 10- 15% of cases. Combined forms of sensitization are much more common. Moreover, combined forms of sensitization to pollen and domestic allergens predominate. Besides that, the study showed pollinosis patients have disruption of local immunity that appeared in slgA deficit in oral cavity. Sublingual immunotherapy is the most effective method of treatment. In case of combined forms of sensitization treatment with interfacing allergens is the most efficient.

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Dynamic Changes, Correlation of Basophils, and the Therapeutic Effect in Patients With Allergic Rhinitis During Allergen-specific Immunotherapy

American Journal of Rhinology and Allergy ◽

10.1177/19458924211027073 ◽

2021 ◽

pp. 194589242110270

Author(s):

Meixu Huo ◽

Susu Tang ◽

Daihua Wang ◽

Xiaoqing Liu ◽

Qianxu Liu

Keyword(s):

Allergic Rhinitis ◽

Therapeutic Effect ◽

House Dust ◽

Peripheral Blood ◽

Specific Immunotherapy ◽

House Dust Mites ◽

Dust Mites ◽

Allergen Specific Immunotherapy ◽

Time Points ◽

Activation Rate

Background The role of basophils in allergic rhinitis (AR) has been studied extensively; however, there are very few reports on changes in basophils after allergen-specific immunotherapy (SIT). Objective To examine the changes and correlation of peripheral blood basophils and the therapeutic effect in patients with AR during allergen-SIT. Methods A total of 77 patients with AR who were allergic only to house dust mites received allergen-SIT. At 3 time points, patients underwent testing for the percentage and activation rate of basophils in peripheral blood, skin index (SI) measurement, visual analog scale (VAS) assessment, and rhinoconjunctivitis quality of life questionnaire (RQLQ) evaluation. The results were compared to a control group with congenital preauricular fistula. Results (1) Before treatment, the percentage and activation rate of basophils in patients with AR were significantly higher than those in controls. There was no significant difference in the percentages and activation rates of basophils at the 3 time points. (2) The SIs, VAS, and RQLQ scores of the patients immediately after treatment and 2 years posttreatment decreased significantly compared to those before treatment; the SI, VAS, and RQLQ scores of the patients 2 years posttreatment increased significantly compared with those immediately after treatment. (3) There was no correlation between the patients’ basophil activation rate and percentage and the SI, VAS, and RQLQ scores at all time points. Conclusion The percentage and activation rate of basophils were higher in patients with AR than in controls. The values did not change significantly after allergen-SIT and showed no correlation with treatment effectiveness. Therefore, the frequency and activation rate of basophils cannot be used as criteria for assessing the effectiveness of allergen-SIT for house dust mites. Allergen-SIT is effective for the management of AR, but the effect declines after the completion of therapy.

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Planning and approach to allergen-specific immunotherapy in polyallergic patients

Immunotherapy ◽

10.2217/imt-2019-0182 ◽

2020 ◽

Vol 12 (8) ◽

pp. 577-585

Author(s):

Nerin N Bahceciler ◽

Ozel Yuruker

Keyword(s):

Clinical Management ◽

Respiratory Diseases ◽

Specific Immunotherapy ◽

Clinical Symptoms ◽

Allergen Specific Immunotherapy ◽

Stepwise Approach ◽

Future Studies ◽

Disease Modifying ◽

Management Recommendations ◽

Disease Modifying Treatment

Allergy immunotherapy (AIT) is currently the only disease-modifying treatment for allergic-respiratory diseases. Polysensitization may increase the severity of current disease resulting in subsequent asthma development in patients with allergic rhinitis. Due to the absence of general recommendations for the practical approach to polysensitized patients, clinical management is not standardized. The correlation between sensitizations and clinical symptoms, elimination of possible pollen cross-reactivities and principles of homologous allergen groups will guide the allergists to deduce the most relevant allergens for AIT. In the highlight of the previously proposed approach strategies to polyallergic patients, hereby we propose a revised practical stepwise approach based on the current European Medicine Agency (EMA) guidelines. However, more supporting data from well-designed, controlled, future studies are needed to improve clinical management recommendations for AIT in polyallergic patients.

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The use of interferon inducers in the comprehensive treatment for the prevention of tick-borne viral encephalitis

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40937 ◽

2016 ◽

Vol 21 (6) ◽

pp. 329-334

Author(s):

Sergey L. Kazakovtsev ◽

T. V Sologub ◽

V. V Tsvetkov

Keyword(s):

Viral Encephalitis ◽

High Efficiency ◽

Clinical Symptoms ◽

Standard Dose ◽

Clinical Manifestations ◽

Post Exposure Prophylaxis ◽

Comprehensive Treatment ◽

Post Exposure ◽

Immunoglobulin Preparations ◽

Exposure Prophylaxis

The use of immunoglobulin preparations for the postexposure prevention of tick-borne encephalitis as the main therapeutic and prophylactic agent fails to have enough high efficiency. For the postexposure prevention and treatment of tick-borne viral encephalitis the use of preparation tioloroin seems to be appropriate. Objective. To determine the expedience of the use of the preparation tiloron for the emergency prevention of tick-borne viral encephalitis and to evaluate its effectiveness in the treatment of patients with febrile and meningeal forms of this infection. Materials and Methods. The evaluation ofpost-exposure prophylaxis of tick-borne was carried out in two groups of individuals (each group was consisted of 100 cases), suffered from the suction of ticks infected by encephalitis virus. Both groups sought for medical help in the first 48 hours after the moment of the tick suction. None of the victims has not been vaccinated against the disease and had no serological markers of infection. According to existing regulations, patients in both groups received post-exposure prophylaxis antiviral tick immunoglobulin in the standard dose. Patients of the second group additionally received an interferon inducer drug tiloron. For the evaluation of the therapeutic efficacy of the drug tiloron there was executed the analysis of clinical and laboratory picture of verified tick-borne viral encephalitis in 40 patients treated at "Republican Hospital for Infectious Diseases" of the city of Syktyvkar in the period from 2010 to 2015. There were studied the dynamics of clinical symptoms, haematological and biochemical markers, CSF, certain immunological indices: CD4, CD8, CD4/CD8, IgM and IgG. For the comparative assessment of the effectiveness of treatment, all the examined patients were divided into 4 groups depending on the clinical diagnosis and ongoing taken causal treatment. Results. Among the patients received post-exposure prophylaxis with inclusion of the preparation tiloron, the disease developed significantly less often, without the formation offocal forms. The use of tiloron in combination therapy reduced the duration of main clinical manifestations in patients with febrile and meningeal forms of the disease, contributed to a more rapid rehabilitation of cerebrospinal fluid, recovery of subpopulations of T-lymphocytes. Conclusions. Immunomodulating inductor tiloron is effective in complex treatment and prevention of tick-borne viral encephalitis.

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Nasal Nitric Oxide and Nasal Cytology as Predictive Markers of Short-Term Sublingual Allergen-Specific Immunotherapy Efficacy in Children with Allergic Rhinitis

American Journal of Rhinology and Allergy ◽

10.1177/19458924211060592 ◽

2021 ◽

pp. 194589242110605

Author(s):

Giuseppe Fabio Parisi ◽

Sara Manti ◽

Maria Papale ◽

Melania Amato ◽

Amelia Licari ◽

...

Keyword(s):

Nitric Oxide ◽

Allergic Rhinitis ◽

Conventional Therapy ◽

House Dust Mites ◽

Dust Mites ◽

Short Term ◽

Allergen Specific Immunotherapy ◽

Nasal Nitric Oxide ◽

Nasal Cytology ◽

Term Response

Background Few studies have been conducted on the short-term response to sublingual immunotherapy (SLIT). Objective The purpose of our experimental trial was to evaluate if two markers such as nasal nitric oxide (nNO) and nasal cytology could be useful to identify a precocious clinical efficacy of SLIT treatment. Methods We enrolled 34 children aged 6 to 14 years old with diagnosis of allergic rhinitis (AR) and documented sensitization towards house dust mites. We started allergoid-monomeric tablets immunotherapy along with any conventional therapy for AR and we evaluated at baseline (T0), after one (T1), two (T2), three (T3), and six months (T6) the effects of the treatment through the study of: i) a visual analogue scale (VAS 1-10); ii) measurement of nNO; iii) measurement of FeNO; iv) nasal cytology; v) spirometry; and vi) evaluation of any conventional therapy. Results We observed an improvement in symptoms evaluated by global VAS (T0 vs. T6: 47.13 vs. 17.57; p < .05) and a statistically significant reduction of nNO (1035.2 ± 956.08 vs. 139.2 ± 59.01; p < .05). In this case, significance was reached when the patients completed the 6 months of treatment. Cytological evaluation revealed significant reduction in nasal eosinophils (T0 vs. T6: 87% vs. 16%; p < .01). Moreover, at T0, 56% of patients had also neutrophils that were reduced up to the 8% at T6 (p < .05). Conclusions Our data confirm the effectiveness of SLIT treatment from a clinical perspective and identifies two biomarkers, such as nNO and nasal cytology, as predictive of treatment efficacy in the short term.

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