Three years of specific immunotherapy with house-dust-mite extracts in patients with rhinitis and asthma: significant improvement of allergen-specific parameters and of nonspecific bronchial hyperreactivity.
Twenty-seven patients with allergy to house-dust mite and the clinical symptoms of perennial rhinitis and/or mild asthma were treated with specific immunotherapy (SIT) with standardized extracts of house-dust mite for 3 years. The success of therapy was evaluated in yearly intervals by 1) subjective rhinitis and asthma scores. 2) allergen-specific skin and conjunctival tests. 3) nonspecific bronchial hyperreactivity to methacholine. 4) medication scores of rhinitis and asthma. SIT induced a significant improvement of all parameters already after 1 year, with further improvement in the follow-up measurements at 2 and 3 years. We found a constant improvement of the rhinitis and asthma symptom scores, a reduced reactivity in the skin prick and conjunctival provocation tests, and a constantly increasing reduction of bronchial hyperreactivity to methacholine. Concomitantly, the use of medication (topical corticosteroids, beta2-mimetics, and antihistamines) was reduced. Our data support the concept that SIT with standardized extracts of house-dust mite results in an improvement of allergen-specific parameters in patients with perennial rhinitis and intermittent asthma. This beneficial effect of SIT on allergen-specific immune parameters seems to induce also a diminution of nonspecific bronchial hyperreactivity and enables reduction of symptomatic treatment.
Pichler
C E
CE
Division of Allergology, Clinic for Rheumatology and Clinical Immunology/Allergology, University Hospital, Bern, Switzerland.
Helbling
A
A
Pichler
W J
WJ
D000328:Adult; D000818:Animals; D001249:Asthma / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*; D016535:Bronchial Hyperreactivity / Q000276:immunology / Q000628:therapy; D003888:Desensitization, Immunologic; D004311:Double-Blind Method; D004391:Dust / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology / Q000628:therapy; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D016210:Methacholine Chloride / Q000627:therapeutic use; D008875:Middle Aged; D008925:Mites / Q000276:immunology*; D012220:Rhinitis / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*
D004391:Dust; D016210:Methacholine Chloride; D007073:Immunoglobulin E