ABSTRACT
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)
Subject(s)
Humans , Male , Female , Child , Adolescent , Interleukin-10/administration & dosage , Interleukin-10/immunology , Interleukin-10/therapeutic use , Dermatophagoides pteronyssinus , Dermatophagoides pteronyssinus/immunology , Antigens, Dermatophagoides , Antigens, Dermatophagoides/immunology , Antigens, Dermatophagoides/isolation & purification , Immunotherapy/methods , Immunotherapy , Interleukin-10/isolation & purification , Interleukin-10/metabolism , Immunotherapy/standards , Immunotherapy/trends , Prospective Studies , Treatment Outcome , Evaluation of the Efficacy-Effectiveness of InterventionsABSTRACT
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.
Subject(s)
Antigens, Dermatophagoides/therapeutic use , Arthropod Proteins/therapeutic use , Asthma/therapy , Cysteine Endopeptidases/therapeutic use , Dermatophagoides pteronyssinus/immunology , Desensitization, Immunologic/methods , Interleukin-10/immunology , Rhinitis, Allergic/therapy , Adolescent , Animals , Antigens, Dermatophagoides/immunology , Arthropod Proteins/immunology , Asthma/immunology , Child , Child, Preschool , Cysteine Endopeptidases/immunology , Female , Humans , Immunoglobulin E/blood , Immunoglobulin G/blood , Male , Prospective Studies , Rhinitis, Allergic/immunology , Spain , Visual Analog ScaleABSTRACT
Hypersensitivity reactions to hymenoptera venom are infrequent in paediatric patients. A study was made to determine the incidence of this pathology in children, based on an epidemiological survey targeted to all members of the SEICAP (Sociedad Española de Inmunología Clínica y Alergia Pediátrica/Spanish Society of Paediatric Clinical Immunology and Allergy), and designed to collect the data on patients under 17 years of age diagnosed with hymenoptera venom allergy. Results: The data corresponding to 175 patients (135 males) were collected. The mean age was 9.9±3.6 years. Seventeen percent (32 patients) were the offspring of beekeepers, and 68.9% had experienced previous stings. The causal insect was Apis melifera, implicated in 55 cases, followed by Polistes dominulus (33 cases). In 151 patients (83.9%) the condition consisted of a local reaction. The most frequent systemic response was urticaria and angio-oedema. Fourteen patients suffered anaphylactic shock. The diagnosis was based on skin test (intradermal and prick) and/or specific IgE testing. Three treatment categories were established: (a) prevention and educational measures; (b) symptomatic treatment with oral antihistamines as well as self-injectable adrenalin; and (c) immunotherapy. In this context, 135 patients underwent immunotherapy with a mean duration of 3.5±1.7 years (range 25 years) with excellent tolerance. The starting regimen was predominantly conventional (92 patients). Conclusions: The results of this survey show hypersensitivity reactions to hymenoptera venom to be infrequent in paediatrics, though with a strong impact upon patient quality of life
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Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Bee Venoms/adverse effects , Hypersensitivity, Immediate/epidemiology , Hymenoptera/pathogenicity , Health Surveys , Anaphylaxis/epidemiology , Desensitization, Immunologic , Epinephrine/therapeutic use , Histamine H1 Antagonists/therapeutic useABSTRACT
UNLABELLED: Hypersensitivity reactions to hymenoptera venom are infrequent in paediatric patients. A study was made to determine the incidence of this pathology in children, based on an epidemiological survey targeted to all members of the SEICAP (Sociedad Española de Inmunología Clínica y Alergia Pediátrica/Spanish Society of Paediatric Clinical Immunology and Allergy), and designed to collect the data on patients under 17 years of age diagnosed with hymenoptera venom allergy. RESULTS: The data corresponding to 175 patients (135 males) were collected. The mean age was 9.9 ± 3.6 years. Seventeen percent (32 patients) were the offspring of beekeepers, and 68.9% had experienced previous stings. The causal insect was Apis melifera, implicated in 55 cases, followed by Polistes dominulus (33 cases). In 151 patients (83.9%) the condition consisted of a local reaction. The most frequent systemic response was urticaria and angio-oedema. Fourteen patients suffered anaphylactic shock. The diagnosis was based on skin test (intradermal and prick) and/or specific IgE testing. Three treatment categories were established: (a) prevention and educational measures; (b) symptomatic treatment with oral antihistamines as well as self-injectable adrenalin; and (c) immunotherapy. In this context, 135 patients underwent immunotherapy with a mean duration of 3.5 ± 1.7 years (range 2-5 years) - with excellent tolerance. The starting regimen was predominantly conventional (92 patients). CONCLUSIONS: The results of this survey show hypersensitivity reactions to hymenoptera venom to be infrequent in paediatrics, though with a strong impact upon patient quality of life.
