Immunotherapy with the storage mite lepidoglyphus destructor.

We carried out a double-blind clinical trial of immunotherapy on 35 patients sensitized to the storage mite Lepidoglyphus destructor (Ld). Before and after 12 months of specific hyposensitization (Abelló Lab., Spain) we performed in vivo (skin tests with Ld, methacholine and challenge tests), and in vitro tests (specific IgE, IgG, IgG1 and IgG4 to Ld and specific IgE, IgG, IgG1 and IgG4 to their major allergen Lep dI). We also monitored the efficacy and safety of the immunotherapy with clinical and analytical controls (symptoms and medication score, detection of immune complexes). After therapy we found a significant decrease in specific skin reactivity, dose of positive challenge tests, and hyperresponsiveness to methacholine. Sputum eosinophilia decreased. Specific IgE to Ld was increased and we also observed an increase in specific IgG1 and IgG4 to Ld and Lep DI. The placebo group showed no changes in these variables. There were no severe secondary reactions after treatment with the extract. Patients-self-evaluation was favourable and their labour absence decreased. No development of circulating immune complexes was associated with this immunotherapy.

Immunotherapy with allergenic extracts in geriatric patients: evaluation of effectiveness and safety.

A study has been performed of the prevalence of allergic pathology in the geriatric population attending our department during a period of one year, showing that this type of clinical problem affects 10.4% of our patients 60 years or older. In spite of such considerable prevalence, immunotherapy is not normally used with this age group. This paper describes the results of hyposensitization in 22 of these patients, diagnosed as having extrinsic allergic illness by means of clinical, functional and analytical parameters. We found a significant decrease in cutaneous sensitivity, bronchial hyperreactivity and specific IgE in the patients treated with immunotherapy, as well as a subjective clinical improvement. We feel that immunotherapy can be very effective for the geriatric population, offering the advantages of not requiring self-administration by the older patients and avoiding the secondary effects already described with other kinds of antiallergic medications.