Subiza J, Feliú A, Subiza J L, Uhlig J, Fernández-Caldas E
Centro de Asma y Alergia Subiza, Madrid, Spain.
Clin Exp Allergy. 2008 Jun;38(6):987-94. doi: 10.1111/j.1365-2222.2008.02995.x. Epub 2008 Apr 25.
Cluster immunotherapy is becoming increasingly used. It allows for a rapid build up phase and the administration of higher doses of allergen in a shorter period of time.
To evaluate the effect of short-term pre-seasonal immunotherapy using a glutaraldeyde-modified allergen vaccine in reducing specific nasal hyperreactivity in nasal challenge tests.
Thirty-three patients were selected. All patients had a positive history of allergic rhinitis and skin tests to grass pollen, although most of them (72.7%) were sensitized to other allergens as well. The study was conducted outside of the pollen season and the patients did not receive any pharmacological treatment during this period of time. Two randomized groups of patients were established; Group A: 22 patients (13 females and nine males) and Group B, 11 control patients (seven females and four males). Patients in Group A received immunotherapy with a vaccine containing 50% of the wild grasses Trisetum paniceum and Dactylis glomerata. All patients underwent titrated nasal provocation tests (NPT) before and after completion of the study (2.3 and 2.8 months for Groups A and B, respectively). The administration schedule consisted of 0.1 and 0.2 mL at day 1, followed by 0.3 and 0.5 mL at day 7, 0.5 mL after 2 weeks followed by 0.5 mL monthly. A single vial was used containing an allergen concentration of 10 000 TU/mL (105 microg of total protein and 24.6 microg of Group 1 plus 5 allergens/mL). A mean of 6.5 injections were administered to Group A patients between NPTs.
There were no significant differences between both groups at the beginning of the study (P=0.48). At the end, only Group A patients needed significant greater threshold concentrations for a positive NPT than at the beginning (P=0.002).
A short-term cluster pre-seasonal inmunotherapy with a modified vaccine containing a mixture of grass pollen is effective as determined by an objective measure after only a mean 2.3 months of treatment.
集群免疫疗法的应用越来越广泛。它能实现快速起效阶段，并在更短时间内给予更高剂量的变应原。
评估使用戊二醛修饰的变应原疫苗进行短期季节性前免疫疗法在鼻激发试验中降低特异性鼻高反应性的效果。
选取33例患者。所有患者均有过敏性鼻炎病史且对草花粉皮肤试验呈阳性，不过其中大多数患者（72.7%）也对其他变应原致敏。研究在花粉季节之外进行，在此期间患者未接受任何药物治疗。将患者随机分为两组；A组：22例患者（13例女性和9例男性），B组为11例对照患者（7例女性和4例男性）。A组患者接受含50%野生禾本科植物穗三毛和鸭茅的疫苗免疫治疗。所有患者在研究结束前（A组和B组分别为2.3个月和2.8个月）接受滴定鼻激发试验（NPT）。给药方案为第1天注射0.1和0.2 mL，随后第7天注射0.3和0.5 mL，2周后注射0.5 mL，之后每月注射0.5 mL。使用单个小瓶，变应原浓度为10000 TU/mL（总蛋白105μg，第1组加5种变应原/mL共24.6μg）。A组患者在两次NPT之间平均注射6.5次。
研究开始时两组之间无显著差异（P = 0.48）。结束时，只有A组患者在阳性NPT中所需的阈值浓度比开始时显著更高（P = 0.002）。
仅经过平均2.3个月的治疗，通过客观测量确定，使用含草花粉混合物的改良疫苗进行短期集群季节性前免疫疗法是有效的。
