Specific immunotherapy with a standardized Dermatophagoides pteronyssinus extract. II. Prediction of efficacy of immunotherapy.
House dust mites of the species Dermatophagoides pteronyssinus (Dpt) represent one of the major allergens inducing asthma. However, a strict allergy to Dpt is not always observed in Dpt-allergic patients, since nonallergic and other allergic triggering factors often coexist. It was suggested that specific immunotherapy with house dust-mite extracts is more effective in children than in adults. A controlled study was undertaken in 215 Dpt-allergic patients with asthma ranging in age from 3 to 72 years (mean +/- SD, 28.2 +/- 10.9 years) to investigate parameters that might predict the efficacy of specific immunotherapy before it is started; 171 patients received a rush immunotherapy protocol with a standardized Dpt extract and, subsequently, maintenance injections with 3000 BU of this extract, and 44 patients served as a control group. Before immunotherapy, all patients had a complete evaluation of the severity of asthma by symptom-medication scores and a pulmonary function test, as well as a study of other triggering factors by checking on seasonal and perennial allergens, sinusitis, and other possible causes, such as aspirin intolerance; 196 patients were investigated between 9 and 12 months after the onset of the survey by means of pulmonary function tests and symptom-medication scores. Medications were adapted according to peak flow rates. It was observed that patients with chronic sinusitis, and/or aspirin intolerance, and/or other perennial allergies did not benefit from specific immunotherapy; therefore, the treatment of a major etiologic factor did not demonstrate improvement in the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Bousquet
J
J
Clinique des Maladies Respiratoires, Centre Hospitalier Universitaire, Montpellier, France.
Hejjaoui
A
A
Clauzel
A M
AM
Guérin
B
B
Dhivert
H
H
Skassa-Brociek
W
W
Michel
F B
FB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000008:administration & dosage* / Q000592:standards; D000818:Animals; D039741:Antigens, Dermatophagoides; D001241:Aspirin / Q000009:adverse effects; D001249:Asthma / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D004342:Drug Hypersensitivity / Q000209:etiology / Q000628:therapy; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D008925:Mites / Q000276:immunology*; D011237:Predictive Value of Tests; D006255:Rhinitis, Allergic, Seasonal / Q000628:therapy; D012852:Sinusitis / Q000628:therapy
D000485:Allergens; D039741:Antigens, Dermatophagoides; D007074:Immunoglobulin G; D007073:Immunoglobulin E; D001241:Aspirin