scholarly journals Patient dropouts from sublingual allergen specific immunotherapy with house dust mites. Solving a problem.

2020 ◽  
Vol 17 (2) ◽  
pp. 53-60
Author(s):  
Olga V. Trusova ◽  
Andrey V. Kamaev ◽  
Irina V. Makarova
Keyword(s):  
House Dust ◽  
Patient Management ◽  
Specific Immunotherapy ◽  
Low Frequency ◽  
Management Plan ◽  
Drop Out ◽  
House Dust Mites ◽  
Treatment Withdrawal ◽  
Dust Mites ◽  
Allergen Specific Immunotherapy

Relevance. The insufficient effect of sublingual allergen-specific immunotherapy (SLIT) is caused, first of all, by non-compliance with the treatment regimen and premature treatment termination. Purpose of the study. Determining the frequency of patient drop-out rate during SLIT with house dust mites (HDM) allergens in children with allergic rhinitis (AR) or AR in combination with bronchial asthma (BA), with an analysis of the drop-out reasons, and approbation of the developed visit-to-visit patient management plan (Plan). Materials and methods. We analyzed 274 cases of treatment with HDM SLIT in children. 218 patients: 67.4% (147) boys, median age 11.33 years [7.26; 15.46], the proportion of patients with BA 43.1% (94 children) received HDM SLIT in 20132020. 56 patients: 71.4% (40) boys, median age 9.29 years [6.13; 15.93], the proportion of patients with BA 78.6% (44 children) received treatment in accordance with the Plan. Results. A relatively low frequency of treatment withdrawal was noted in the first 2 years of therapy (2 years after the start of treatment, 72.47% patients continue it). However, only 52.29% complete 3 years of therapy, and 14.67% complete 4 years of therapy. Implementation of the Plan increased patient retention in treatment at the 3rd year of treatment to 69.64% (p=0.031). Conclusions. Only half of the patients receive the required three-year minimum of treatment. The daily plan optimizes the patient management schedule for HDM ASIT; reduces patient dropout from treatment and can be recommended for practical healthcare.

scholarly journals 96 Sublingual allergen-specific immunotherapy in pediatric patients: biomarkers and molecular allergy diagnostics as predictors of therapeutic success

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e40-e40
Author(s):  
Lala Allahverdiyeva ◽  
G E Agaragimova ◽  
Veronica Mugarab Samedi
Keyword(s):  
House Dust ◽  
Pediatric Patients ◽  
Specific Immunotherapy ◽  
Dermatophagoides Pteronyssinus ◽  
House Dust Mites ◽  
Healthy Children ◽  
Dust Mites ◽  
Dermatophagoides Farinae ◽  
Allergen Specific Immunotherapy ◽  
Molecular Allergy

Abstract Background Efficacy of allergen-specific immunotherapy (ASIT) in patients with asthma could be significantly enhanced when physicians have an opportunity to identify those who are most likely to respond, determine when to stop treatment, and predict relapse. Thus, molecular allergy diagnostic is an effective tool that could help to individualize the diagnosis and treatment of asthma by accurate detection of the causative and cross-reactive allergens in pediatric patients. Cytokines are known as reliable diagnostic and prognostic biomarkers for asthma and can be used to evaluate the therapeutic effect. Objectives To evaluate the roles of molecular allergy diagnostic and biomarkers (L-10, IFNγ и TGFβ) as predictors of ASIT efficacy in pediatric patients with asthma. Design/Methods Eighty children aged 5 to 18 years with mild and moderate atopic bronchial asthma were included in the study. Sixty-eight out of 80 (85%) were found to have sensitization to house dust mites Dermatophagoides Pteronyssinus and/or Dermatophagoides Farinae. All these patients underwent molecular diagnostics using ImmunoCAP (Phadia 100) to determine the major (r Der p1, r Der p 2) and minor allergens (r Der p10) of the house dust mites. Twenty-eight patients with mild and moderate asthma were found to have a high sensitivity to these allergens and received SLIT with a mixture of house dust mites (Dermatophagoides Pteronyssinus and/or Dermatophagoides Farinae). To compare the efficacy of SLIT, we evaluated the severity of asthma clinical symptoms on a point scale from 0 to 3, and biomarker levels (IL-10, IFNγ и TGFβ) before and 6 months after SLIT. Twelve healthy children were included in the study as a reference group. Results At the beginning of the study, the average daily score in the SLIT group of 2.5 ± 0.7, and after 6 months of treatment, it decreased to 0.5 ± 0.2. The levels of biomarkers were markedly decreased prior to the treatment, especially TGFβ levels, and normalized at the end of treatment (Tab.1). Conclusion These findings support the efficacy of molecular diagnosis to determine the efficacy of allergen-specific immunotherapy in patients with asthma.

scholarly journals THE CLINICAL EFFICACY OF SUBLINGUAL ALLERGEN-SPECIFIC IMMUNOTHERAPY IN CHILDREN AGED 3-5 YEARS

2016 ◽  
Vol 6 ◽  
pp. 3-9
Author(s):  
Elena Sharikadze ◽  
Elena Okhotnikova ◽  
Serhii Yuriev
Keyword(s):  
House Dust ◽  
Specific Immunotherapy ◽  
Dermatophagoides Pteronyssinus ◽  
Information Value ◽  
House Dust Mites ◽  
In Vitro Tests ◽  
Dust Mites ◽  
Allergen Specific Immunotherapy

The aim of this study was to determine the efficacy of sublingual allergen–specific immunotherapy (SLIT) in Ukrainian children younger than 5 years old with allergic rhinitis and bronchial asthma sensitized to house dust mite allergens. Material and methods: Four hundred and fifty children aged 28 months up to 5 years with rhinitis or asthma were examined. One hundred and twenty five children sensitized to house dust mites Dermatophagoides pteronyssinus and/or Dermatophagoides farina were included. In vivo and in vitro tests were made with a standard inhalant allergens panel. Results: The high information value of molecular diagnostics methods applied prior to prescription of the given therapy in children is analyzed. It has been found that in children under 5 sensitized to allergens of house dust mites Dermatophagoides pteronyssinus and/or Dermatophagoides farinae the application of sublingual allergen–specific immunotherapy therapy allows gaining control over the symptoms of the disease during the first 6 months. Conclusion: The high safety of SLIT in children has been proven. Comparative analysis in the group of patients not receiving SLIT shows a high frequency of symptoms of the disease after “free-of-symptoms interval” against full or partial baseline therapy denial.

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

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.

scholarly journals Immunoglobulin G1 subclass responses can be used to detect specific allergy to the house dust mites Dermatophagoides farinae and Dermatophagoides pteronyssinus in atopic dogs

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
N. Khantavee ◽  
C. Chanthick ◽  
A. Tungtrongchitr ◽  
N. Techakriengkrai ◽  
S. Suradhat ◽  
...  
Keyword(s):  
House Dust ◽  
Characteristic Curve ◽  
False Positive Rate ◽  
Specific Ige ◽  
House Dust Mites ◽  
Dust Mites ◽  
Dermatophagoides Farinae ◽  
Allergen Specific Immunotherapy ◽  
Intradermal Testing ◽  
Positive Rate

Abstract Background In dogs with atopic dermatitis, intradermal testing (IDT) or allergen specific IgE serological testing are routinely employed to identify causative allergens. These allergens can then be used for allergen-specific immunotherapy and allergy management. The clinical relevance of this testing is affected by the source of allergen, and other biomarkers that are more related to specific allergens still need to be identified. The aim of this study was to investigate levels of specific IgE, total IgG, and IgG1 and IgG2 subclasses against the local house dust mites (HDM) Dermatophagoides farinae (DF) and D. pteronyssinus (DP) as biomarkers by using in-house ELISAs in healthy (n = 33) and atopic dogs (AD) (n = 44) that were either positive or negative by IDT to HDM. Results Being over 3 years of age was a risk factor for AD (Odds Ratio (OD) = 4.10, 95% Confidence interval (CI) 1.57–10.75, p = 0.0049), but there was no relation to IDT outcomes (OR = 0.9091, 95% CI 0.22–3.74, p = 1.00). High levels of all antibody isotypes (IgE, IgG, IgG1 and IgG2) against HDM were found in aged healthy dogs (> 3 years old). In AD, HDM-IgE and IgG1 levels were higher in dogs that were IDT positive to HDM than in IDT negative animals. Levels of IgE and IgG1 could be used to distinguish the specific allergens, whereas total IgG and IgG2 levels were not different between IDT-positive and IDT-negative AD. By the receiver operating characteristic curve at a false-positive rate = 0.10, both IgE and IgG1 showed better sensitivity than IgG and IgG2. Similar to IgE, serum IgG1 concentration was also relevant to IDT outcomes. Conclusions Our in-house ELISAs coated with local HDM were useful for evaluating antibody levels, and we propose use of the HDM-specific IgG1 subclass as a biomarker to detect HDM specific allergens in AD, potentially together with an IgE based platform.

scholarly journals Comparing the results of intradermal skin tests for four dust mite allergens in dogs with atopic dermatitis in Thailand

2020 ◽  
Vol 13 (11) ◽  
pp. 2381-2387
Author(s):  
Suttiwee Chermprapai ◽  
Pojnicha Chuayjuljit Anukkul ◽  
Teerawat Kritsadasima ◽  
Pudcharaporn Kromkhun ◽  
Naris Thengchaisri
Keyword(s):  
Atopic Dermatitis ◽  
House Dust ◽  
House Dust Mites ◽  
Intradermal Test ◽  
Skin Tests ◽  
Dust Mites ◽  
Skin Reactions ◽  
Allergen Specific Immunotherapy ◽  
Exact Test ◽  
Significant Difference

Background and Aim: Hypersensitivity to house dust mites is a common cause of atopic dermatitis in dogs. The intradermal test (IDT) identifies allergens to be included in allergen-specific immunotherapy. Common mite allergens used for IDT include single source extracts obtained from Dermatophagoides farinae or Dermatophagoides pteronyssinus or multisource extracts from multimite species (mixed mites), as well as a combination of multimite species and proteins from feces and shed skin (house dust). The objectives of the present study were to evaluate the prevalence of mite sensitivity in dogs diagnosed with atopic dermatitis in different Thailand provinces and to determine if positive test results to mite allergens aligned. Materials and Methods: Eighty-two dogs (median age [range]: 5 years [11 months-11 years]; 51 males and 31 females) diagnosed with atopic dermatitis underwent IDTs with four different mite-related allergens (D. farinae, D. pteronyssinus, mixed mites, and house dust). The skin reactions were reported on a scale of 0-4 and the reactions 2+ were considered clinically relevant. The relationship between IDT results from different allergens was determined using Pearson's correlation coefficient (r). Fisher's exact test was used to compare IDT results for different mite allergens as well as for dogs residing in Bangkok versus other provinces in Thailand. Results: The prevalence (95% confidence interval [CI]) of positive IDT results for D. farinae, D. pteronyssinus, mixed mites, and house dust in dogs with atopic dermatitis was 64.63% (52.30-74.88), 58.54% (47.12-69.32), 47.56% (36.41-58.89), and 35.37% (25.12-46.70), respectively. A moderate correlation was found in IDT results between D. pteronyssinus and house dust (r=0.514), between D. pteronyssinus and D. farinae (r=0.426), and between D. farinae and mixed mites (r=0.423). The prevalence of dogs with positive IDT results for mite allergens with mono-sensitization, bi-sensitization, tri-sensitization, and quadru-sensitization did not differ significantly between dogs residing in Bangkok (11.63%, 18.60%, 25.58%, and 16.28%) and dogs residing in other provinces (12.82%, 30.77%, 35.90%, and 10.26%). The overall sensitivity (95% CI) and specificity (95% CI) of the mixed mites test associated with atopic dermatitis in dogs were 60.32% (47.20-72.40%) and 94.70% (74.00-99.90%), respectively. The overall sensitivity (95% CI) and specificity (95% CI) of the house dust test associated with atopic dermatitis in dogs were 42.90% (30.50-56.00%) and 89.50% (66.90-98.70%), respectively. Conclusion: House dust mites are an important source of allergens for dogs with atopic dermatitis. In the present study, no significant difference in the prevalence of atopic dermatitis was found in dogs living in the urban area compared with dogs living in the countryside. Application of multisource extracts from mites for IDT revealed a higher reaction to mixed mites than that of house dust.

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