Specific allergen immunotherapy: effect on immunologic markers and clinical parameters in asthmatic children.
BACKGROUND
Specific allergen immunotherapy (SIT) is the main treatment modality for achieving long-term symptom relief in perennial allergic diseases.


OBJECTIVE
The aim of this study was to evaluate the effect of 1 year of house dust mite immunotherapy on the concentrations of 3 immunologic markers: eosinophil cationic protein (ECP), nitric oxide (NO), and monocyte chemoattractant protein 1 (MCP-1). We also compared the effect on asthma symptoms and medication scores, allergen-specific bronchial challenge test, and the skin prick test.


METHODS
A total of 31 mite-allergic, asthmatic children (age range, 6-16 years) were enrolled; 19 were treated with SIT and 12 controls who had refused SIT received only drug treatment. Efficacy was evaluated using serum NO, ECP, and MCP-1 levels, and asthma symptom and medication scores, allergen-specific bronchial challenge test, and skin-prick test. The results of the tests were compared at baseline and after 1 year of treatment.


RESULTS
Serum NO and ECP levels decreased significantly in the SIT group (P = .01 and P = .018) compared to baseline, whereas control group values remained similar. The serum MCP-1 level decreased significantly in both the SIT and control groups (P = .009 and P = .041, respectively). The SIT group experienced significant improvement in asthma symptoms (P = .001) and medication scores (P = .001) and skin reactivity to Dermatophagoides pteronyssinus (P = .020), whereas the control group did not. The results of bronchial challenge to D pteronyssinus showed a similar pattern at baseline and after 1 year of treatment in both groups. The tolerated allergen concentration increased in both groups (P < .05). Lung function tests, total immunoglobulin (Ig) E and specific IgE to D pteronyssinus and Dermatophagoides farinae did not change after a year of treatment in either group.


CONCLUSIONS
SIT with D pteronyssinus improves immunological and clinical parameters in mite-allergic asthmatic children after 1 year of treatment. The skin prick test may be used as a marker of efficacy of therapy.
Cevit
O
O
Division of Allergy, Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey. ocevit@cumhuriyet.edu.tr
Kendirli
S G
SG
Yilmaz
M
M
Altintas
D U
DU
Karakoc
G B
GB
D000293:Adolescent; D039741:Antigens, Dermatophagoides / Q000276:immunology*; D001249:Asthma / Q000175:diagnosis / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D001985:Bronchial Provocation Tests; D018932:Chemokine CCL2 / Q000097:blood*; D002648:Child; D003888:Desensitization, Immunologic; D047150:Eosinophil Cationic Protein / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000097:blood*; D016896:Treatment Outcome
D039741:Antigens, Dermatophagoides; D015415:Biomarkers; D018932:Chemokine CCL2; D009569:Nitric Oxide; D047150:Eosinophil Cationic Protein