scholarly journals Allergen Immunotherapy in Asthma

Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1406
Author(s):  
Kazuyuki Nakagome ◽  
Makoto Nagata
Keyword(s):  
Allergic Rhinitis ◽  
Allergen Immunotherapy ◽  
Sublingual Immunotherapy ◽  
Clinical Symptoms ◽  
Remission Rate ◽  
Specific Treatment ◽  
Allergic Diseases ◽  
Subcutaneous Immunotherapy ◽  
Dust Mite ◽  
Medication Dose

Allergen immunotherapy (AIT) is a specific treatment involving the administration of relevant allergens to allergic patients, with subtypes including subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). In asthma, AIT using the house dust mite (HDM) alleviates clinical symptoms and decreases airway hyper responsiveness and medication dose. In addition, AIT can improve the natural course of asthma. For example, the effects of AIT can be preserved for at least a few years, even after ending treatment. AIT may increase the remission rate of asthma in children and suppress sensitization to new allergens. If AIT is introduced in pollinosis, AIT may prevent the development of asthma. Moreover, AIT can control other allergic diseases complicated by asthma, such as allergic rhinitis, which also improves the control of asthma. The indication of HDM-SCIT for asthma is mild-to-moderate HDM-sensitized allergic asthma in a patient with normal respiratory function. To date, HDM-SLIT is applicable in Japan for allergic rhinitis, not for asthma. However, the effect of SLIT on asthma has been confirmed internationally, and SLIT is available for asthma in Japan if allergic rhinitis is present as a complication.

scholarly journals Role of Allergen Immunotherapy in Asthma Treatment and Asthma Development

Allergies ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 33-45
Author(s):  
Kazuyuki Nakagome ◽  
Makoto Nagata
Keyword(s):  
Allergic Rhinitis ◽  
Allergen Immunotherapy ◽  
Clinical Symptoms ◽  
Remission Rate ◽  
Allergic Diseases ◽  
Natural Course ◽  
Atopic Asthma ◽  
Subcutaneous Immunotherapy ◽  
Conventional Drug ◽  
Moderate Disease

Allergen immunotherapy may modify the natural course of allergic diseases and induce remission. It includes subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). For asthma, allergen immunotherapy using house dust mite (HDM) improves clinical symptoms and airway hyperresponsiveness and decreases drug requirements. Furthermore, it has been suggested that allergen immunotherapy also has the following effects: (1) the effect can be maintained for more than a year even if the treatment is terminated, (2) the remission rate of childhood asthma can be increased, (3) new allergen sensitization can be suppressed, and (4) asthma development can be prevented if allergen immunotherapy was performed in the case of pollinosis. Allergen immunotherapy differs from conventional drug therapy, in particular the effect of modifying the natural course of allergic diseases and the effect of controlling complicated allergic diseases such as rhinoconjunctivitis. The general indication for HDM-SCIT in asthma is HDM-sensitized atopic asthma with mild-to-moderate disease and normal respiratory function. HDM allergens should be involved in the pathogenesis of asthma, and a duration of illness of less than 10 years is desirable. HDM-SLIT is available for allergic rhinitis but not for asthma in Japan. However, as the efficacy of SLIT for asthma has been fully proven internationally, SLIT is also applied in asthmatics with complicated allergic rhinitis in Japan.

scholarly journals Dropouts From Sublingual Immunotherapy and the Transition to Subcutaneous Immunotherapy in House Dust Mite-Sensitized Allergic Rhinitis Patients

2022 ◽  
Vol 2 ◽  
Author(s):  
Huan Chen ◽  
Guo-qing Gong ◽  
Mei Ding ◽  
Xiang Dong ◽  
Yuan-li Sun ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Allergic Asthma ◽  
House Dust ◽  
House Dust Mite ◽  
Sublingual Immunotherapy ◽  
Dropout Rates ◽  
Subcutaneous Immunotherapy ◽  
Transition Rates ◽  
Dust Mite

Purpose: Both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are effective in reducing symptoms and medication scores and inducing long-term efficacy in patients with allergic rhinitis (AR). However, SLIT has been associated with poor patient adherence. This study investigates the factors impacting dropout rates from SLIT in house dust mite (HDM)-sensitized AR patients.Methods: A retrospective study was performed to analyze dropout rates and reasons in AR patients receiving Dermatophagoides farinae (Der f) SLIT with a follow-up period of 2 years.Results: A total of 719 HDM-sensitized AR patients received Der f-SLIT. Dropout rates increased with time and most occurred after 1 year of SLIT. By month 24, 654 (91%) patients had discontinued SLIT. The dropout rates by month 24 were 100, 90.1, and 91.1% in children <5 years old, children aged 5–18 years old, and adults ≥ 18 years old, respectively. Combination with allergic asthma and mono- or multi-sensitization to other aeroallergens did not affect the dropout rates. The most common self-reported reasons for dropouts were refusal of continuation, dissatisfaction with the efficacy, transition to SCIT, and adverse effects. Refusal of continuation increased with age, whereas transition to SCIT decreased with age. Ninety-seven cases transitioned from SLIT to SCIT, and the transition rates increased with time. Comorbid allergic asthma did not affect the transition rates. However, multi-sensitization was associated with a slightly higher rate of transition to SCIT. The most common reason for the transition was dissatisfaction with the efficacy (54.6%), which was only reported by patients older than 5 years. For children who began SLIT at younger than 5 years old, the most common reason (81.2%) for transition was age reaching 5 years.Conclusions: HDM-SLIT has a very high dropout rate, which is mainly due to refusal of continuation and dissatisfaction with the efficacy. Transitioning from SLIT to SCIT may help keep these patients on AIT and thus increase adherence and long-term efficacy.

scholarly journals Satisfaction of allergic patients treated with house dust mite sublingual immunotherapy

2021 ◽  
Vol 35 ◽  
pp. 205873842110155
Author(s):  
Matheus Fonseca Aarestrup ◽  
Paula Fonseca Aarestrup ◽  
Mariana Senff de Andrade ◽  
Beatriz Julião V Aarestrup ◽  
Akinori Cardozo Nagato ◽  
...  
Keyword(s):  
House Dust ◽  
House Dust Mite ◽  
Allergen Immunotherapy ◽  
Treatment Effectiveness ◽  
Sublingual Immunotherapy ◽  
Cost Benefit ◽  
Allergic Diseases ◽  
Satisfaction Scale ◽  
Dust Mite ◽  
Validated Instrument

Sublingual immunotherapy (SLIT) has been used for more than three decades as a therapeutic strategy for the treatment of allergic diseases. Studies have demonstrated its efficacy and safety, and numerous clinical trials have evaluated these parameters. In the present study, through patient perception, we investigated the patient satisfaction with the use of house dust mite SLIT treatment. “Satisfaction Scale for Patients Receiving Allergen Immunotherapy” (ESPIA) questionnaire, a standardized and validated instrument for clinical studies evaluating allergen immunotherapy, was applied to allergic patients ( N = 136). Children and adults of both sexes who received SLIT for Dermatophagoides pteronyssinus and/or Blomia tropicalis, according to the results of an immediate reading puncture test, were included. Data analysis showed that the perception of treatment effectiveness was 92%, performance improvement in the daily activities was 91%, a satisfactory cost-benefit balance was 84%, and the perception of general satisfaction was 97%. The results showed a high perception of satisfaction in allergic patients undergoing house dust mite SLIT.

scholarly journals The EVALUATION OF 3-YEARS COURSE OF SUBLINGUAL IMMUNOTHERAPY WITH EXTRACTS OF CAT EPITHELIUM IN PRE-SCHOOL CHILDREN

2019 ◽  
Vol 6 (4) ◽  
pp. 216-220
Author(s):  
O. Sharikadze
Keyword(s):  
Allergic Rhinitis ◽  
Preschool Children ◽  
Bronchial Asthma ◽  
School Children ◽  
Allergen Immunotherapy ◽  
Sublingual Immunotherapy ◽  
Clinical Symptoms ◽  
Fel D 1 ◽  
Direct Indication ◽  
Definition Of

EVALUATION OF 3-YEARS COURSE OF SUBLINGUAL IMMUNOTHERAPY WITH EXTRACTS OF CAT EPITHELIUM IN PRE-SCHOOL CHILDREN. Sharikadze O. The article presents the results of a 3-year course of sublingual allergen immunotherapy with a lyophilized extract of cat epidermal allergens in preschool children with allergic rhinitis, rhino-conjunctivitis and bronchial asthma. New possibilities of component diagnostics were found, and in particular, the definition of the major Fel d 1 molecule as a direct indication for the start of therapy and use to assess the achievement of tolerance to the causative allergen. It was found that a 3-year course of sublingual allergen immunotherapy with lyophilized epidermal cat allergens for children with allergic rhinitis and/or bronchial asthma was characterized by a significant improvement in the clinical symptoms of the disease and a decrease in the level of Fel d1. A comparative analysis of the results of observing children with SLIT and without therapy proved that SLIT in children with allergic pathology associated with sensitization to cat epidermal allergens reduces the number of exacerbations and prevents the development of symptoms of bronchial asthma in preschool children. In addition, once again, high safety allergen immunotherapy efficacy in children has been proven. Keywords: preschool children, sublingual allergen immunotherapy, prevention, asthma, major allergens Fel d 1.   Абстракт. ОЦІНКА 3-РІЧНОГО КУРСУ СУБЛІНГВАЛЬНОЇ ІМУНОТЕРАПІЇ ЕКСТРАКТАМИКОТЯЧОГО ЕПІТЕЛІЮ У ДІТЕЙ ДОШКІЛЬНОГО ВІКУ. Шарікадзе О. У статті представлені результати 3-х річного курсу сублингвальной алерген-імунотерапіїліофілізованим екстрактом епідермальних алергенів кота у дітей дошкільного віку з алергічнимринітом, рино-кон'юнктивітом і бронхіальну астму. Виявлено нові можливості компонентної діагностики і зокрема, визначення мажорній молекули Fel d 1 як прямого показання до початку терапії і використання для оцінки досягнення толерантності до причинному алергену. Встановлено, що проведення 3-х річного курсу сублингвальной алерген-імунотерапії ліофілізованими епідермальними алергенами кота дітям з алергічним ринітом та / або бронхіальною астмою характеризувалося достовірним поліпшенням клінічних симптомів захворювання і зменшенням рівня Fel d1. Порівняльний аналіз результатів спостереження дітей на тлі злити і без терапії довів, що злитися у дітей з алергічною патологією, пов'язаною з сенсибілізацією до епідермальних алергенів кота зменшує кількість загострень і попереджає розвиток симптомів бронхіальної астми у дітей дошкільного віку. Крім того, в черговий раз була доведена висока безпека алерген-імунотерапія ефективність у дітей.  Ключові слова: діти дошкільного віку, сублінгвальна алерген-імунотерапія, профілактика, бронхіальна астма, мажорні алергени Fel d 1.   Абстракт. ОЦЕНКА 3-ЛЕТНЕГО КУРСА СУБЛИНГВАЛЬНОЙ ИММУНОТЕРАПИИ С ИСПОЛЬЗОВАНИЕМ ЭКСТРАКТОВ КОШАЧЬЕГО ЭПИТЕЛИЯ У ДЕТЕЙ ДОШКОЛЬНОГО ВОЗРАСТА. Шарикадзе Е. В статье представлены результаты 3-х летнего курса сублингвальной аллерген-иммунотерапии лиофилизированным экстрактом эпидермальных аллергенов кота у детей дошкольного возраста с аллергическим ринитом, рино-конъюнктивитом и бронхиальной астмой. Обнаружены новые возможности компонентной диагностики и в частности, определения мажорной молекулы Fel d 1 как прямого показания к началу терапии и использования для оценки достижения толерантности к причинному аллергену. Установлено, что проведение 3-х летнего курса сублингвальной аллерген-иммунотерапии лиофилизированными эпидермальными аллергенами кота детям с аллергическим ринитом и / или бронхиальной астмой характеризовалось достоверным улучшением клинических симптомов заболевания и уменьшением уровня Fel d1. Сравнительный анализ результатов наблюдения детей на фоне СЛИТ и без терапии доказал, что  СЛИТ у детей с аллергической патологией, связанной с сенсибилизацией к эпидермальным аллергенам кота уменьшает количество обострений и предупреждает развитие симптомов бронхиальной астмы у детей дошкольного возраста. Кроме того, в очередной раз была доказана высокая безопасность аллерген-иммунотерапия эффективность у детей.  Ключевые слова:  дети дошкольного возраста, сублингвальная аллерген-иммунотерапия, профилактика, бронхиальная астма, мажорные аллергены Fel d 1.

scholarly journals Dose dependence of efficacy but not of safety in sublingual immunotherapy

2016 ◽  
Vol 65 (1) ◽  
Author(s):  
F. Frati ◽  
C. Incorvaia ◽  
F. Marcucci ◽  
L. Sensi ◽  
G. Di Cara ◽  
...  
Keyword(s):  
Sublingual Immunotherapy ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Dose Dependence ◽  
Subcutaneous Immunotherapy ◽  
High Dose ◽  
Systemic Reactions ◽  
Significant Difference

Sublingual immunotherapy (SLIT) currently represents, as indicated by meta-analysis of its efficacy and safety, a valid option to the generally used traditional subcutaneous immunotherapy (SCIT) for treating respiratory allergy. Regarding efficacy, recent studies demonstrated that, similar to what has already been observed in SCIT as well as in experimental and clinical studies about the magnitudo of allergen exposure, the effectiveness on both clinical symptoms and immunologic changes depends on the amount of allergen administered during treatment. In addition, in vitro studies addressed with the role of dendritic cells, currently considered to be of pivotal importance in orienting toward tolerance the immune response to allergens, showed that the internalisation of allergen molecules, which is followed by tolerogenic presentation to T cells, depends on the amount of allergen. However, such dose dependence is not apparent concerning the safety. In fact, the comparison of studies respectively conducted with high and low allergen doses did not show differences in the rate of systemic reactions, which in any case never had the presentation of anaphylaxis, and instead a significant difference in the rate of local reactions, following the oral and gastrointestinal contact with the allergen extract, in favour of high dose studies.

scholarly journals Immunotherapy in Allergic Rhinitis: It’s Effect on the Immune System and Clinical Symptoms

2018 ◽  
Vol 6 (7) ◽  
pp. 1248-1252 ◽  
Author(s):  
Samaneh Kouzegaran ◽  
Mohammad Ali Zamani ◽  
Reza Faridhosseini ◽  
Houshang Rafatpanah ◽  
Abdolrahim Rezaee ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Symptoms ◽  
Nasal Congestion ◽  
Subcutaneous Immunotherapy ◽  
Positive Skin Prick Test ◽  
Tgf Beta ◽  
Positive Skin ◽  
Ifn Gamma ◽  
Clinical Criteria ◽  
Prick Test

BACKGROUND: Allergic rhinitis is one of the most common allergic diseases and characterised by sneezing, rhinorrhea, nasal congestion and nasopharyngeal itching. Subcutaneous immunotherapy (SCIT) for specific allergens is an effective treatment and induces the inhibitory effect of T regulatory lymphocytes and decreases clinical symptoms in allergic rhinitis.AIM: In this study effect of subcutaneous immunotherapy with specific allergens on clinical symptoms and T regulatory and T Helper cells cytokines, in patients with allergic rhinitis are evaluated.METHODS: In this study, 30 patients with moderate to severe allergic rhinitis according to clinical criteria and positive skin prick test for aeroallergens were selected and treated by SCIT. Clinical symptoms and T cells cytokines IL4, IL17, IFN gamma, TGF beta, GITR, FOXP3 and IL-10 (by RT-PCR) were evaluated before and one year after initiation of treatment.RESULTS: Thirty (30) patients with allergic rhinitis at age range 15-45 years old were treated by SCIT, and 23 (14 female, 9 male) patients continued the study, and 7 patients did not continue treatment. After immunotherapy, clinical symptoms decreased significantly. The specific cytokines TGF beta and IL10 levels increased and changes were statistically significant. (Respectively P = 0.013 and P = 0.05) The IL17 level was also increased, but not statistically significant. (P = 0.8) IFN gamma, IL4, GITR, FOXP3, all decreased, but the changes were not statistically significant (P > 0.05).CONCLUSION: Subcutaneous Immunotherapy for specific allergens decreases clinical symptoms in patients with allergic rhinitis and induces tolerance in T lymphocytes, especially by increasing T regulatory cells cytokines, TGF beta and IL10.

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