Guimarães Junqueir de Queirós M, Oliveira Silva D A, Alves R, Fukuhara Chiba H, Soares de Amaral V B, de Almeida K C, Ynoue L H, de Oliveira Resende R, Camargo Sopelete M C, Rodrigues Silva Segundo G, Ferreira de Sousa Moreira P, Sung S J, Taketomi E A
Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlindia, Uberlândia, Minas Gerais, Brazil.
J Investig Allergol Clin Immunol. 2008;18(2):84-92.
This study aimed to evaluate the clinical efficacy and antibody response changes after specific immunotherapy (SIT) using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in Brazilian mite-atopic patients.
One-hundred patients with allergic rhinitis were selected for a randomized double-blind, placebo-controlled trial and distributed into 4 groups: Dpt (Dpt allergen extract), Dpt+MRB (Dpt allergen plus mixed respiratory bacterial extracts), MRB (MRB extract only) and placebo. Rhinitis symptom and medication scores; skin prick test (SPT) to Dpt extract; and serum immunoglobulin (Ig) E, IgG4, and IgG1 levels to Dpt, Der p 1, and Der p 2 allergens were evaluated before and after a year of treatment.
After 1 year, the SPT response was reduced in the Dpt group (P=.03), whereas IgE levels to Der p 2 decreased only in the Dpt (P = .048) and Dpt+MRB (P = .005) groups. IgG4 and IgG1 levels to Dpt and Der p 1 increased in the Dpt group (P < .05), whereas in the Dpt + MRB group the IgG1 level only increased to Dpt (P=.001) and the IgG4 only increased to Der p 1 (P=.049). IgE levels to Dpt decreased only in the MRB (P= .005) and Dpt + MRB (P= .001) groups. Rhinitis symptom and medication scores fell in all groups, including the placebo group (P<.001).
SIT using Dpt extract alone was effective in reducing SPT response and IgE levels to Der p 2 allergen, while bacterial extracts induced decreases in IgE levels to whole Dpt extract. However, only groups receiving Dpt allergen had higher levels of IgG1 and IgG4 to Dpt and Der p 1 after a year of treatment.
本研究旨在评估在巴西螨性特应性患者中，使用户尘螨（Dpt）变应原加或不加细菌提取物进行特异性免疫治疗（SIT）后的临床疗效及抗体反应变化。
选取100例变应性鼻炎患者进行随机双盲、安慰剂对照试验，分为4组：Dpt组（Dpt变应原提取物）、Dpt+MRB组（Dpt变应原加混合呼吸道细菌提取物）、MRB组（仅MRB提取物）和安慰剂组。在治疗1年前后评估鼻炎症状和用药评分；对Dpt提取物进行皮肤点刺试验（SPT）；以及血清免疫球蛋白（Ig）E、IgG4和IgG1针对Dpt、Der p 1和Der p 2变应原的水平。
1年后，Dpt组的SPT反应降低（P = 0.03），而仅Dpt组（P = 0.048）和Dpt+MRB组（P = 0.005）中针对Der p 2的IgE水平下降。Dpt组中针对Dpt和Der p 1的IgG4和IgG1水平升高（P < 0.05），而在Dpt + MRB组中，仅针对Dpt的IgG1水平升高（P = 0.001），仅针对Der p 1的IgG4水平升高（P = 0.049）。仅MRB组（P = 0.005）和Dpt + MRB组（P = 0.001）中针对Dpt的IgE水平下降。所有组，包括安慰剂组，鼻炎症状和用药评分均下降（P < 0.001）。
单独使用Dpt提取物进行SIT可有效降低SPT反应及针对Der p 2变应原的IgE水平，而细菌提取物可使针对整个Dpt提取物的IgE水平降低。然而，治疗1年后，仅接受Dpt变应原的组中针对Dpt和Der p 1的IgG1和IgG4水平较高。
