The effect of local nasal immunotherapy in allergic rhinitis: using strips of the allergen dermatophagoides pteronyssinus.
Local nasal immunotherapy (LNIT) has been reported to be effective for mite-induced allergic rhinitis. However, its compliance is poor due to persistent nasal reactions and difficult application. The main objective of this study was to develop a Dermatophagoides pteronyssinus (Der p)-coated strip for self-application and to evaluate its clinical efficacy. Randomized, double-blind, placebo-controlled trials were carried out to evaluate the efficacy and compliance of LNIT. A total of 35 patients with allergic rhinitis from the allergy clinic were recruited to receive four months of LNIT. Clinical efficacy was evaluated by the symptoms of sneezing, rhinorrhea and nasal stuffiness. Local and systemic effects were evaluated by measuring histamine and eosinophil cationic protein (ECP) in nasal discharge and allergen-specific IgG1, IgG4 and IgE in sera. LNIT with Der p-coated strips could reduce nasal symptoms and modulate the serum levels of Der p-specific IgG1, IgG4 and IgE. The secretion of both histamine and ECP was reduced within four months after treatment. When the symptomatic and immunological changes were compared between active treatment and placebo groups, the improvements were greater in the active treatment groups for all three symptom scores. There were no severe adverse events except nasal response persisting within the first month in some cases. LNIT with a steady dose of Der p-coated strips can be self-administered at home without any systemic reactions. Both local and systemic immune responses were observed after LNIT. This therapeutic modality may serve as a good alternative treatment for allergic rhinitis.
Tsai
Jaw-Ji
JJ
Department of Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan. jawji@vghtc.gov.tw
Liao
En-Chih
EC
Tsai
Fu-Hsu
FH
Hsieh
Ching-Chen
CC
Lee
Mey-Fan
MF
D000287:Administration, Topical; D000328:Adult; D039741:Antigens, Dermatophagoides / Q000008:administration & dosage / Q000276:immunology / Q000627:therapeutic use*; D060829:Arthropod Proteins; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D004311:Double-Blind Method; D047150:Eosinophil Cationic Protein / Q000378:metabolism; D005260:Female; D006632:Histamine / Q000378:metabolism; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D008297:Male; D009297:Nasal Mucosa / Q000378:metabolism; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D012646:Self Administration; D016896:Treatment Outcome
D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; C451163:Dermatophagoides pteronyssinus antigen p 2; D007074:Immunoglobulin G; D007073:Immunoglobulin E; D006632:Histamine; D047150:Eosinophil Cationic Protein; C479220:RNASE3 protein, human