title: A Pilot Study of Intralymphatic Immunotherapy for House Dust Mite, Cat, and Dog Allergies.
abstract: Several recent clinical trials reported that intralymphatic immunotherapy (ILIT) for some allergens, such as cat dander and pollen, induce tolerance more rapidly than conventional subcutaneous or sublingual immunotherapy, have a comparable duration of effect after only 3 injections, and do not provoke serious local or systemic reactions. However, the efficacy and safety of ILIT are using Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dp), and dog, which are indoor allergens that are commonly found globally, need to be evaluated. Furthermore, use of multiple allergens in ILIT should be investigated. We assessed the clinical efficacy and adverse effects of ILIT using aqueous Df, Dp, dog, and cat allergens or mixtures thereof in patients with allergic rhinitis. A total of 11 subjects with AR sensitized to Df, Dp, cat, and/or dog allergens received 3 intralymphatic inguinal injections of sensitized allergen extract (HollisterStier, New Orleans, LA, USA). Clinical parameters were assessed before ILIT, and 4 months and 1 year after the first injection. Rhinitis symptoms were alleviated and quality of life was improved 4 months after ILIT (P=0.012 and P=0.007, respectively), and these improvements lasted for 1 year after ILIT (P=0.047 and P=0.009, respectively). However, we observed 2 cases of anaphylaxis, one case of a moderate-to-severe systemic hypersensitivity reaction and the other case of a severe local reaction at the injection site after ILIT. In conclusion, ILIT can rapidly improve allergy symptoms and quality of life, and this effect lasts for 1 year. In hypersensitized patients, however, ILIT can provoke severe systemic and/or local hypersensitivity reactions when performed using aqueous allergen extracts.
authors.affiliation: Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sang Pyo
authors.initials: SP
authors.lastname: Lee
authors.affiliation: Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul Medical Center, Seoul, Korea.
authors.forename: Eugene
authors.initials: E
authors.lastname: Joe
authors.affiliation: Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea. sangminlee77@naver.com.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Gachon University Graduate School of Medicine, Incheon, Korea.
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Lee
authors.affiliation: Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Shim
authors.affiliation: Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kyung
authors.affiliation: Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Jeong Woong
authors.initials: JW
authors.lastname: Park
authors.affiliation: Division of Pulmonology and Allergy, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Jeong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Jung
keywords: Allergen-specific immunotherapy; allergic rhinitis; intralymphatic immunotherapy