title: Subcutaneous immunotherapy with a depigmented polymerized birch pollen extract--a new therapeutic option for patients with atopic dermatitis.
abstract: BACKGROUND
  Birch pollen is an important outdoor allergen able to aggravate symptoms in atopic dermatitis (AD). Specific immunotherapy (SIT), an established procedure for allergic airway diseases, might also represent an attractive therapeutic option for the causal treatment of allergen-triggered cutaneous symptoms in these patients. Studies with house dust mite SIT have already shown beneficial effects in AD patients, whereas the safety and efficacy of SIT with birch pollen extract in AD patients have not been studied so far. The aim of this study was to evaluate for the first time the safety and efficacy of SIT with a depigmented polymerized birch pollen extract in AD patients.
  
  
  METHODS
  Fifty-five adult patients with moderate-to-severe AD and clinically relevant sensitization to birch pollen received SIT for 12 weeks. SIT was continued during birch pollen season. The assessment of safety, the total SCORAD value, and the Dermatology Life Quality Index (DLQI) were evaluated.
  
  
  RESULTS
  The median total SCORAD value was reduced by 34% (p < 0.001) during the course of treatment and the mean DLQI improved by 49% (p < 0.001) despite strong simultaneous birch pollen exposure. Eight patients (14.5%) developed systemic reactions and 19 patients (34.5%) developed local reactions which were of mild intensity in most cases. No patient discontinued the study prematurely due to adverse drug reactions. Coseasonal treatment was well tolerated.
  
  
  CONCLUSIONS
  SIT with a depigmented polymerized birch pollen extract leads to significant improvement of the SCORAD value and the DLQI in patients suffering from moderate-to-severe AD sensitized to birch pollen.
authors.affiliation: Department of Dermatology and Allergy, University of Bonn, Bonn, Germany. Natalija.Novak@ukb.uni-bonn.de
authors.forename: Natalija
authors.initials: N
authors.lastname: Novak
authors.forename: Diamant
authors.initials: D
authors.lastname: Thaci
authors.forename: Matthias
authors.initials: M
authors.lastname: Hoffmann
authors.forename: Regina
authors.initials: R
authors.lastname: Fölster-Holst
authors.forename: Thilo
authors.initials: T
authors.lastname: Biedermann
authors.forename: Bernhard
authors.initials: B
authors.lastname: Homey
authors.forename: Knut
authors.initials: K
authors.lastname: Schaekel
authors.forename: Josef A
authors.initials: JA
authors.lastname: Stefan
authors.forename: Thomas
authors.initials: T
authors.lastname: Werfel
authors.forename: Thomas
authors.initials: T
authors.lastname: Bieber
authors.forename: Angelika
authors.initials: A
authors.lastname: Sager
authors.forename: Torsten
authors.initials: T
authors.lastname: Zuberbier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D029662:Betula / Q000737:chemistry / Q000276:immunology*; D015331:Cohort Studies; D003876:Dermatitis, Atopic / Q000628:therapy*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010936:Plant Extracts / Q000737:chemistry / Q000276:immunology / Q000627:therapeutic use*; D011058:Pollen / Q000737:chemistry / Q000276:immunology*; D058105:Polymerization; D006255:Rhinitis, Allergic, Seasonal / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010936:Plant Extracts; D007073:Immunoglobulin E