title: Early Intervention Improves Clinical Responses to House Dust Mite Immunotherapy in Allergic Rhinitis Patients.
abstract: BACKGROUND
  Allergen immunotherapy (AIT) is the unique causal treatment for respiratory allergy. As AIT is expensive and of long duration, the availability of a marker predicting AIT responders is of crucial relevance.
  
  
  OBJECTIVE
  To investigate clinical parameters correlated with effective AIT in allergic rhinitis (AR) patients.
  
  
  METHODS
  This is a prospective, nonrandomized open study in which a total of 284 AR patients who had received house dust mite (HDM) subcutaneous AIT were enrolled from January 2011 to December 2015, and then followed up for 3 consecutive years. Demographic data, clinical history, laboratory tests (specific and total IgE levels), symptoms score, concomitant medication, and adverse reactions during AIT were collected. An AIT responder patient was defined when a visual analog score (assessing global symptoms) had decreased by >30% compared to baseline and concomitant medication was equal to or less than before AIT.
  
  
  RESULTS
  Thirty-three patients dropped out, so 251 patients were analyzed; 175 (69.7%) patients were responders. This group had a higher baseline symptom score than the AIT nonresponder group (7.5 vs. 6.9). A significant negative correlation was found between AR symptom duration and the clinical response to AIT. Local reactions (LRs) during AIT had a positive correlation. Other variables such as a family history of atopy, combined asthma history, and the levels of specific and total IgE had no correlations with effective AIT.
  
  
  CONCLUSIONS
  Early intervention with AIT helps to improve the efficacy of AR treatment. LRs might predict successful AIT. Highly symptomatic AR patients may develop increased clinical responses to AIT.
authors.affiliation: Department of Allergy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Qi
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.forename: Nan
authors.initials: N
authors.lastname: Huang
authors.forename: Wenjing
authors.initials: W
authors.lastname: Li
authors.forename: Guanghui
authors.initials: G
authors.lastname: Liu
authors.forename: Yin
authors.initials: Y
authors.lastname: Wang
authors.forename: Lintao
authors.initials: L
authors.lastname: Hu
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Rongfei
authors.initials: R
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003888:Desensitization, Immunologic; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D039981:Pyroglyphidae / Q000276:immunology*; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D012882:Skin Tests; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; D007073:Immunoglobulin E