title: Modulation of mucosal/systemic antibody response after sublingual immunotherapy in mite-allergic children.
abstract: BACKGROUND
  There have been no data on sublingual immunotherapy (SLIT) in Brazilian patients sensitized to house dust mites. This study aimed to evaluate the mucosal/systemic antibody response changes and clinical efficacy after SLIT using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in mite-allergic Brazilian children.
  
  
  METHODS
  Patients with allergic rhinitis and asthma were selected for a double-blind, placebo-controlled trial randomized to three groups: DPT (Dpt extract, n = 34), DPT+MRB (Dpt plus mixed respiratory bacterial extracts, n = 36), and Placebo (n = 32). Total symptom and medication scores for rhinitis/asthma, skin prick test (SPT) to Dpt, and measurements of Dpt-, Der p 1-, Der p 2-specific serum IgE, IgG4, IgG1, and specific salivary IgA were evaluated at baseline and after 12 and 18 months of treatment.
  
  
  RESULTS
  A significant long-term decline in total symptom/medication scores was observed only in active groups (DTP and DPT+MRB). There was no significant change in SPT results in all groups. SLIT using Dpt allergen alone induced increased levels of serum IgG4 to Dpt, Der p 1, and Der p 2, serum IgG1 and salivary IgA to Dpt and Der p 1. SLIT with Dpt plus bacterial extracts was able to decrease IgE levels, particularly to Der p 2, to increase salivary IgA levels to Der p 1, but had no changes on specific IgG4 and IgG1 levels.
  
  
  CONCLUSIONS
  All children undergoing SLIT showed clinical improvement, but a long-term reduction in symptom/medication scores with modulation of mucosal/systemic antibody responses were seen only in active groups (DPT and DPT+MRB).
authors.affiliation: Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil; Public Health System, Itumbiara, Brazil.
authors.forename: Meimei G J
authors.initials: MG
authors.lastname: Queirós
authors.forename: Deise A O
authors.initials: DA
authors.lastname: Silva
authors.forename: Isabella L
authors.initials: IL
authors.lastname: Siman
authors.forename: Leandro H
authors.initials: LH
authors.lastname: Ynoue
authors.forename: Núbia S
authors.initials: NS
authors.lastname: Araújo
authors.forename: Fernando L
authors.initials: FL
authors.lastname: Pereira
authors.forename: Karine C
authors.initials: KC
authors.lastname: Almeida
authors.forename: Juliana S
authors.initials: JS
authors.lastname: Miranda
authors.forename: Janethe D O
authors.initials: JD
authors.lastname: Pena
authors.forename: Jair P
authors.initials: JP
authors.lastname: Cunha-Junior
authors.forename: Ernesto A
authors.initials: EA
authors.lastname: Taketomi
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000818:Animals; D000942:Antigens, Bacterial / Q000008:administration & dosage; D039741:Antigens, Dermatophagoides / Q000276:immunology; D060829:Arthropod Proteins / Q000276:immunology; D001938:Brazil; D002648:Child; D003546:Cysteine Endopeptidases / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology / Q000628:therapy*; D007136:Immunoglobulins / Q000097:blood; D008297:Male; D009092:Mucous Membrane / Q000276:immunology*; D039981:Pyroglyphidae / Q000276:immunology; D012882:Skin Tests
chemical_list: D000942:Antigens, Bacterial; D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; C451163:Dermatophagoides pteronyssinus antigen p 2; D007136:Immunoglobulins; D003546:Cysteine Endopeptidases; C451162:Dermatophagoides pteronyssinus antigen p 1
keywords: Dermatophagoides pteronyssinus; IgE antibody; IgG1/IgG4 subclasses; salivary IgA antibody; sublingual immunotherapy