title: Clinico-immunologic study on immunotherapy with mixed and single insect allergens.
abstract: BACKGROUND
  Immunotherapy (IT) is practiced mainly with mixed and single allergen vaccines. But studies are rare with mixed allergen preparations.
  
  
  OBJECTIVE
  The objective of this study is to study mix and single insect allergen IT in patients of allergic rhinitis and asthma.
  
  
  METHODS
  We performed a double-blind placebo-controlled trial of mix and single allergen IT for 1 year in 99 patients of asthma or rhinitis or both. There were two groups, (1) active allergen IT (n = 61) with three subgroups single insect extract (cockroach, housefly, or mosquito) and mix allergen IT (two or three insect extracts) and (2) placebo (n = 38). Clinical (skin reactivity, airway reactivity, and symptom score) and immunological (IgE/IgG4 and IgG1/IgG4 ratio) parameters were assessed at baseline and after 1 year of IT.
  
  
  RESULTS
  Eighty-five patients completed 1 year of IT. The active allergen IT group patients showed a significant improvement compared to baseline values (p < 0.05) and placebo group patients (p < 0.05) with regard to symptom scores, FEV1 values, and immunological parameters (IgG4). No significant difference was found between mixed and single IT group patients for changes in clinical and immunological parameters. Positive correlation was observed between increase in IgG4 and clinical improvement. The changes in above parameters in placebo group were nonsignificant after 1 year of treatment.
  
  
  CONCLUSIONS
  IT with two to three mix extract from the same allergen group is effective for insect hypersensitivity.
authors.affiliation: Institute of Genomics and Integrative Biology, Delhi 110007, India.
authors.forename: Deepsikha
authors.initials: D
authors.lastname: Srivastava
authors.forename: Bhanu P
authors.initials: BP
authors.lastname: Singh
authors.forename: Naveen
authors.initials: N
authors.lastname: Arora
authors.forename: Shailendra Nath
authors.initials: SN
authors.lastname: Gaur
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D000818:Animals; D001249:Asthma / Q000097:blood / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D002457:Cell Extracts / Q000008:administration & dosage / Q000009:adverse effects; D003058:Cockroaches / Q000276:immunology; D045424:Complex Mixtures / Q000008:administration & dosage / Q000009:adverse effects; D009033:Culicidae / Q000276:immunology; D003888:Desensitization, Immunologic; D018450:Disease Progression; D005260:Female; D006793:Houseflies / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D019476:Insect Proteins / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012221:Rhinitis, Allergic, Perennial / Q000097:blood / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy
chemical_list: D000485:Allergens; D002457:Cell Extracts; D045424:Complex Mixtures; D007074:Immunoglobulin G; D019476:Insect Proteins