Mite-specific immunotherapy using allergen and/or bacterial extracts in atopic patients in Brazil.
OBJECTIVE
This study aimed to evaluate the clinical efficacy and antibody response changes after specific immunotherapy (SIT) using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in Brazilian mite-atopic patients.


METHODS
One-hundred patients with allergic rhinitis were selected for a randomized double-blind, placebo-controlled trial and distributed into 4 groups: Dpt (Dpt allergen extract), Dpt+MRB (Dpt allergen plus mixed respiratory bacterial extracts), MRB (MRB extract only) and placebo. Rhinitis symptom and medication scores; skin prick test (SPT) to Dpt extract; and serum immunoglobulin (Ig) E, IgG4, and IgG1 levels to Dpt, Der p 1, and Der p 2 allergens were evaluated before and after a year of treatment.


RESULTS
After 1 year, the SPT response was reduced in the Dpt group (P=.03), whereas IgE levels to Der p 2 decreased only in the Dpt (P = .048) and Dpt+MRB (P = .005) groups. IgG4 and IgG1 levels to Dpt and Der p 1 increased in the Dpt group (P < .05), whereas in the Dpt + MRB group the IgG1 level only increased to Dpt (P=.001) and the IgG4 only increased to Der p 1 (P=.049). IgE levels to Dpt decreased only in the MRB (P= .005) and Dpt + MRB (P= .001) groups. Rhinitis symptom and medication scores fell in all groups, including the placebo group (P<.001).


CONCLUSIONS
SIT using Dpt extract alone was effective in reducing SPT response and IgE levels to Der p 2 allergen, while bacterial extracts induced decreases in IgE levels to whole Dpt extract. However, only groups receiving Dpt allergen had higher levels of IgG1 and IgG4 to Dpt and Der p 1 after a year of treatment.
Guimarães Junqueir de Queirós
M
M
Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlindia, Uberlândia, Minas Gerais, Brazil.
Oliveira Silva
D A
DA
Alves
R
R
Fukuhara Chiba
H
H
Soares de Amaral
V B
VB
de Almeida
K C
KC
Ynoue
L H
LH
de Oliveira Resende
R
R
Camargo Sopelete
M C
MC
Rodrigues Silva Segundo
G
G
Ferreira de Sousa Moreira
P
P
Sung
S J
SJ
Taketomi
E A
EA
D000293:Adolescent; D000328:Adult; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology* / Q000627:therapeutic use*; D001419:Bacteria / Q000166:cytology / Q000276:immunology*; D001938:Brazil; D002648:Child; D040002:Dermatophagoides pteronyssinus / Q000276:immunology*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood / Q000276:immunology; D007167:Immunotherapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012221:Rhinitis, Allergic, Perennial / Q000097:blood / Q000276:immunology / Q000628:therapy*
D039741:Antigens, Dermatophagoides; D004338:Drug Combinations; D007136:Immunoglobulins