title: Mite-specific immunotherapy using allergen and/or bacterial extracts in atopic patients in Brazil.
abstract: 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.
authors.affiliation: Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlindia, Uberlândia, Minas Gerais, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Guimarães Junqueir de Queirós
authors.forename: D A
authors.initials: DA
authors.lastname: Oliveira Silva
authors.forename: R
authors.initials: R
authors.lastname: Alves
authors.forename: H
authors.initials: H
authors.lastname: Fukuhara Chiba
authors.forename: V B
authors.initials: VB
authors.lastname: Soares de Amaral
authors.forename: K C
authors.initials: KC
authors.lastname: de Almeida
authors.forename: L H
authors.initials: LH
authors.lastname: Ynoue
authors.forename: R
authors.initials: R
authors.lastname: de Oliveira Resende
authors.forename: M C
authors.initials: MC
authors.lastname: Camargo Sopelete
authors.forename: G
authors.initials: G
authors.lastname: Rodrigues Silva Segundo
authors.forename: P
authors.initials: P
authors.lastname: Ferreira de Sousa Moreira
authors.forename: S J
authors.initials: SJ
authors.lastname: Sung
authors.forename: E A
authors.initials: EA
authors.lastname: Taketomi
mesh_terms: 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*
chemical_list: D039741:Antigens, Dermatophagoides; D004338:Drug Combinations; D007136:Immunoglobulins