在巴西，针对特应性患者使用变应原和/或细菌提取物进行螨特异性免疫疗法。

Mite-specific immunotherapy using allergen and/or bacterial extracts in atopic patients in Brazil.

作者信息

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

机构信息

Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlindia, Uberlândia, Minas Gerais, Brazil.

出版信息

J Investig Allergol Clin Immunol. 2008;18(2):84-92.

PMID:18447136

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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）。