Ferreira M B, Santos M C, Pregal A L, Alonso E, Santos A S, Palma-Carlos M L, Palma-Carlos A G
Faculty of Medicine, CHIUL, Immunoallergology Unit, Hospital Santa Maria, Lisbon, Portugal.
Allerg Immunol (Paris). 2001 Oct;33(8):319-22.
To evaluate comparatively the effect on serum ICAM-1 and VCAM-1 values of specific immunotherapy versus loratadine in the treatment of allergic rhinitis.
65 patients with mild to moderate House Dust Mite allergic rhinitis.
Patients were divided into three groups, according to patients' preference: a control group with patients receiving only rescue therapy (antihistamines and/or nasal cromoglycate when needed); an antihistamine group with patients receiving daily loratadine 10 mg (and nasal cromoglycate as rescue therapy); an immunotherapy group with patients receiving subcutaneous house dust mite specific immunotherapy (and antihistamines or nasal cromoglycate when needed). In all groups we measured soluble ICAM-1 and VCAM-1 serum levels before the start of the study period and at the end of the study period. The duration of the study was one year for the control group and for the immunotherapy group. In patients taking daily antihistamines we measured serum adhesion molecules one month after the beginning of the therapy. We used Student's T test for statistical analysis.
Patients in the control group didn't have significant variations in serum ICAM-1 (p = 0.239) or VCAM-1 (p = 0.38) levels. Patients receiving loratadine showed significant decreases in serum VCAM-1 levels (p = 0.0012) but not in serum ICAM-1 levels (p = 0.224). Patients receiving immunotherapy also showed a similar pattern, with significant decreases in serum VCAM-1 levels (p = 0.012) but not in serum ICAM-1 levels (p = 0.254).
Specific house dust mite immunotherapy and regular daily loratadine therapy are able to lower significantly serum levels of soluble VCAM-1. However, this effect, which can be interpreted as an anti-inflammatory action, is not applied to soluble ICAM-1 levels, which raises the possibility of a differential action of these therapies on the mechanisms of allergic inflammation. Patients on rescue medication alone did not show any significant differences in these parameters.
比较特异性免疫疗法与氯雷他定治疗变应性鼻炎对血清细胞间黏附分子-1（ICAM-1）和血管细胞黏附分子-1（VCAM-1）水平的影响。
65例轻至中度屋尘螨变应性鼻炎患者。
根据患者意愿将患者分为三组：对照组，仅接受缓解治疗（必要时使用抗组胺药和/或色甘酸钠滴鼻剂）；抗组胺药组，患者每日服用10mg氯雷他定（并使用色甘酸钠滴鼻剂作为缓解治疗）；免疫疗法组，患者接受皮下注射屋尘螨特异性免疫疗法（必要时使用抗组胺药或色甘酸钠滴鼻剂）。在所有组中，于研究期开始前及结束时测量血清可溶性ICAM-1和VCAM-1水平。对照组和免疫疗法组的研究持续时间为1年。对于每日服用抗组胺药的患者，在治疗开始1个月后测量血清黏附分子水平。采用学生t检验进行统计学分析。
对照组患者血清ICAM-1水平（p = 0.239）和VCAM-1水平（p = 0.38）无显著变化。接受氯雷他定治疗的患者血清VCAM-1水平显著降低（p = 0.0012），但血清ICAM-1水平无显著变化（p = 0.224）。接受免疫疗法的患者也呈现类似模式，血清VCAM-1水平显著降低（p = 0.012），而血清ICAM-1水平无显著变化（p = 0.254）。
特异性屋尘螨免疫疗法和每日规律服用氯雷他定疗法均能显著降低血清可溶性VCAM-1水平。然而，这种可解释为抗炎作用的效果并未作用于可溶性ICAM-1水平，这增加了这些疗法在变应性炎症机制上存在差异作用的可能性。仅接受缓解药物治疗的患者在这些参数上未显示任何显著差异。
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