Purello-D'Ambrosio F, Gangemi S, Merendino R A, Isola S, Puccinelli P, Parmiani S, Ricciardi L
Department of Human Pathology, School of Allergy and Clinical Immunology, University of Messina, Viale Gazzi, Messina, Italy.
Clin Exp Allergy. 2001 Aug;31(8):1295-302. doi: 10.1046/j.1365-2222.2001.01027.x.
Specific immunotherapy is the only currently available allergen-orientated treatment able to modify the natural history of respiratory allergic diseases. Safety and clinical efficacy of this treatment are well documented, but evidence about the ability to reduce new sensitizations is still poor.
We report a retrospective study conducted in order to assess the prevention of new sensitizations in monosensitized subjects treated with specific immunotherapy vs. monosensitized patients treated with anti-allergic drugs.
8396 monosensitized patients with respiratory symptoms were selected according to an open, retrospective design. Group A included 7182 patients submitted to specific immunotherapy (and anti-allergic drugs when needed) for 4 years and then treated with drugs for at least 3 years. Group B included 1214 patients treated only with drugs for at least 7 years. All patients underwent prick test with a standard panel of allergens and total and specific IgE determination before and after 4 years of treatment and again 3 years later.
Groups were well balanced. Polysensitized subjects were 23.75% in Group A and 68.03% in Group B after 4 years (P < 0.0001) and 26.95% and 76.77%, respectively, after 7 years (P < 0.0001). Asthmatic subjects were more prone to develop polysensitization in comparison to subjects suffering only from rhinitis (32.14% instead of 27.29% after 4 years, 36.5% instead of 31.33% after 7 years; P < 0.0001). Specific IgE decreased by 24.11% in Group A and increased by 23.87% in Group B (P < 0.0001). Total IgE decreased by 17.53% in Group A and increased by 13.71% in Group B (P < 0.0001).
Specific immunotherapy was observed retrospectively to reduce new sensitizations in monosensitized subjects suffering from respiratory allergic diseases.
特异性免疫疗法是目前唯一可用的以变应原为导向的治疗方法,能够改变呼吸道过敏性疾病的自然病程。这种治疗方法的安全性和临床疗效已有充分记录,但关于其减少新致敏反应能力的证据仍然不足。
我们报告一项回顾性研究,旨在评估接受特异性免疫疗法治疗的单致敏患者与接受抗过敏药物治疗的单致敏患者预防新致敏反应的情况。
根据开放的回顾性设计,选择8396例有呼吸道症状的单致敏患者。A组包括7182例患者,接受特异性免疫疗法(必要时联合抗过敏药物)治疗4年,然后接受药物治疗至少3年。B组包括1214例患者,仅接受药物治疗至少7年。所有患者在治疗4年前和4年后以及3年后再次接受标准变应原面板的点刺试验以及总IgE和特异性IgE测定。
两组均衡性良好。4年后,A组多致敏患者占23.75%,B组占68.03%(P<0.0001);7年后,分别为26.95%和76.77%(P<0.0001)。与仅患鼻炎的患者相比,哮喘患者更容易发生多致敏(4年后分别为32.14%和27.29%,7年后分别为36.5%和31.33%;P<0.0001)。A组特异性IgE下降24.11%,B组上升23.87%(P<0.0001)。A组总IgE下降17.53%,B组上升13.71%(P<0.0001)。
回顾性观察发现,特异性免疫疗法可减少患有呼吸道过敏性疾病的单致敏患者的新致敏反应。