A Three-year Follow-up of D.f- and D.p-Specific Conventional Immunotherapy in Asthmatic Children / 소아알레르기및호흡기학회지

PURPOSE: Immunotherapy (IT) with Dermatophagoides farinae (D.f) or Dermatophagoides pteronyssinus (D.p) has proven to be clinically effective treatment for patients with asthma, but the mechanism and prognostic index of IT are not completely understood. We evaluated the long-term effect of conventional IT with D.f or D.p, and also investigated whether IT could prevent new sensitizations to other new allergens. METHODS: The patient group included 23 asthmatic patients with D.f- and D.p-sensitivities who visited Asan Medical Center and were treated with conventional IT (Allergopharma, Germany). The control group contained 27 asthmatic patients with D.f- and D.p-sensitivities who were not treated with IT. We compared skin test reactivity, total IgE, specific IgE, total eosinophil counts, eosinophils fraction and bronchial hyperreactivity before and three years after IT. RESULTS: The skin test reactivity to D.p and total eosinophil counts were decreased significantly three years after IT. But total IgE, D.f- and D.p-specific IgE, and eosinophils fraction were not changed three years after IT. The bronchial hyperreactivity by methacholine was decreased in both groups after three years. In addition, development of sensitization to new allergens happened in 13.0 percent of the IT group and 22.2 percent of the control group, but did not reach statistical significance. CONCLUSION: The conventional IT with D.f and D.p could change the allergic responsiveness of the target organs, such as skin, but it could not prevent the development of new sensitizations in asthmatic children.

Influence of Conventional Immunotherapy with D.f and D.p on Eosinophil, Specific IgE, Skin Test Reactivity, and Airway Hyperreactivity in House Dust Mite Sensitive Asthmatic Children / 소아알레르기및호흡기학회지

PURPOSE: Immunotherapy (IT) with house dust mite may be effective to treat house dust mite allergic disease, but the mechanism and prognostic index of IT are not completely understood. Generally allergen specific-IgE antibody significantly initially increases, then gradually declines, but there is no consistent data about the changes of allergen-specific IgE. Also there is some controversies for skin test reactivity and bronchial hyperreactivity after IT. To understand the mechanism and find the prognostic index after conventional IT, we compared the clinical and laboratory parameters before and after IT between patients with IT and patients without IT. METHODS: The IT group included 24 patients with D.f and D.p-sensitized asthmatic children who had received conventional IT. The control group included 22 D.f and D.p-sensitized asthmatic children who had not received IT. The symptom scores of asthma, methacholine challenge test (PC20), skin reactivity to D.f and D.p (allergen/histamine ratio), total eosinophil counts, the changes of D.f- and D.p-specific IgE, were compared before, 4 and 9 month after IT in two groups. RESULTS: The symptom scores and the skin reactivity to D.p were decreased significantly 9 month after IT. The eosinophil count in peripheral blood was decreased 9 month after IT. But D.p-specific IgE level was not changed 9 month after IT in either two groups. The bronchial hyperreactivity was not changed 9 month after IT. CONCLUSION: These findings suggest that the changes of effector cells such as skin mast cell may be induced after the result of IT regardless of the changes of serum IgE and bronchial hyperreactivity.