Walker S M, Pajno G B, Lima M T, Wilson D R, Durham S R
Upper Respiratory Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, London, UK.
J Allergy Clin Immunol. 2001 Jan;107(1):87-93. doi: 10.1067/mai.2001.112027.
Grass pollen immunotherapy significantly reduces hay fever symptoms and medication requirements. Effects on seasonal asthma are less clear, and concerns over safety persist.
The goal of this study was to assess the effects of grass pollen immunotherapy on symptoms, bronchial hyperresponsiveness, and quality of life in seasonal rhinitis and asthma.
Forty-four patients with severe summer hay fever (of whom 36 reported seasonal chest symptoms and 28 had seasonal bronchial hyperresponsiveness) participated in a randomized, double-blind, placebo-controlled, parallel group study. After symptom monitoring for one summer, participants received injections of a depot grass pollen vaccine (n = 22) or matched placebo injections (n = 22) in a rapid updosing cluster regimen for 4 weeks, followed by monthly injections for 2 years. Outcome measures included hay fever symptoms and medication use, health-related quality of life, and measurements of nonspecific bronchial responsiveness.
Significant reductions were observed in the immunotherapy group compared with the placebo group in hay fever symptoms (49%, 15%; P =.01), medication scores (80%, 18%; P =.007), and seasonal chest symptoms (90%, 11%; P <.05). Impairment of overall quality of life (mean score of 7 domains) during the pollen season was less in the immunotherapy group than in the placebo group (median difference [95% CI], 0.8 [0.18-1.5]; P =.02). During the pollen season there was no change in airway methacholine PC(20) (provocation concentration producing a 20% fall in FEV(1)) in the immunotherapy-treated group (P =.5), compared with an almost 3 doubling-dose decrease in the placebo-treated group (P =.01, between-group difference). There were no significant local or systemic side effects during the study.
Grass pollen immunotherapy improves quality of life in seasonal allergic rhinitis and reduces seasonal asthma symptoms and bronchial hyperresponsiveness.
草花粉免疫疗法可显著减轻花粉症症状并减少药物需求。其对季节性哮喘的影响尚不清楚，且对安全性的担忧依然存在。
本研究旨在评估草花粉免疫疗法对季节性鼻炎和哮喘患者的症状、支气管高反应性及生活质量的影响。
44例重度夏季花粉症患者（其中36例有季节性胸部症状，28例有季节性支气管高反应性）参与了一项随机、双盲、安慰剂对照、平行组研究。在对症状进行一个夏季的监测后，参与者接受快速递增剂量的集群方案注射长效草花粉疫苗（n = 22）或匹配的安慰剂注射（n = 22），为期4周，随后每月注射，持续2年。观察指标包括花粉症症状和药物使用情况、健康相关生活质量以及非特异性支气管反应性测量。
与安慰剂组相比，免疫疗法组的花粉症症状（49%，15%；P =.01）、药物评分（80%，）和季节性胸部症状（90%，11%；P <.05）均有显著降低。花粉季节期间，免疫疗法组总体生活质量（7个领域的平均得分）的受损程度低于安慰剂组（中位数差异[95%CI]，0.8[0.18 - 1.5]；P =.02）。在花粉季节，免疫疗法治疗组的气道乙酰甲胆碱PC(20)（使FEV(1)下降20%的激发浓度）无变化（P =.5），而安慰剂治疗组下降了近3倍剂量（P =.01，组间差异）。研究期间未出现显著的局部或全身副作用。
草花粉免疫疗法可改善季节性过敏性鼻炎患者的生活质量，并减轻季节性哮喘症状和支气管高反应性。
