Laboratory of Allergy and Clinical Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil; Public Health System, Itumbiara, Brazil.
Pediatr Allergy Immunol. 2013 Dec;24(8):752-61. doi: 10.1111/pai.12163. Epub 2013 Dec 2.
There have been no data on sublingual immunotherapy (SLIT) in Brazilian patients sensitized to house dust mites. This study aimed to evaluate the mucosal/systemic antibody response changes and clinical efficacy after SLIT using Dermatophagoides pteronyssinus (Dpt) allergens with or without bacterial extracts in mite-allergic Brazilian children.
Patients with allergic rhinitis and asthma were selected for a double-blind, placebo-controlled trial randomized to three groups: DPT (Dpt extract, n = 34), DPT+MRB (Dpt plus mixed respiratory bacterial extracts, n = 36), and Placebo (n = 32). Total symptom and medication scores for rhinitis/asthma, skin prick test (SPT) to Dpt, and measurements of Dpt-, Der p 1-, Der p 2-specific serum IgE, IgG4, IgG1, and specific salivary IgA were evaluated at baseline and after 12 and 18 months of treatment.
A significant long-term decline in total symptom/medication scores was observed only in active groups (DTP and DPT+MRB). There was no significant change in SPT results in all groups. SLIT using Dpt allergen alone induced increased levels of serum IgG4 to Dpt, Der p 1, and Der p 2, serum IgG1 and salivary IgA to Dpt and Der p 1. SLIT with Dpt plus bacterial extracts was able to decrease IgE levels, particularly to Der p 2, to increase salivary IgA levels to Der p 1, but had no changes on specific IgG4 and IgG1 levels.
All children undergoing SLIT showed clinical improvement, but a long-term reduction in symptom/medication scores with modulation of mucosal/systemic antibody responses were seen only in active groups (DPT and DPT+MRB).
巴西尘螨过敏患者的舌下免疫疗法（SLIT）数据尚属空白。本研究旨在评估巴西尘螨过敏儿童接受含有或不含有细菌提取物的屋尘螨变应原舌下免疫治疗（SLIT）后黏膜/系统抗体反应变化和临床疗效。
选择过敏性鼻炎和哮喘患者进行双盲、安慰剂对照随机分组试验，分为三组：DPT（屋尘螨提取物，n=34）、DPT+MRB（屋尘螨加混合呼吸道细菌提取物，n=36）和安慰剂（n=32）。在基线和治疗 12 个月和 18 个月时评估鼻炎/哮喘总症状和药物评分、屋尘螨皮肤点刺试验（SPT）和屋尘螨、Der p 1、Der p 2 特异性血清 IgE、IgG4、IgG1 和特异性唾液 IgA 的测定。
仅在活跃组（DPT 和 DPT+MRB）观察到总症状/药物评分的长期显著下降。所有组的 SPT 结果均无显著变化。单独使用屋尘螨变应原进行 SLIT 可诱导血清 IgG4 对屋尘螨、Der p 1 和 Der p 2、血清 IgG1 和唾液 IgA 对屋尘螨和 Der p 1 的水平升高。使用屋尘螨加细菌提取物进行 SLIT 可降低 IgE 水平，特别是对 Der p 2，增加唾液 IgA 水平对 Der p 1，但对特异性 IgG4 和 IgG1 水平无变化。
所有接受 SLIT 的儿童均表现出临床改善，但仅在活跃组（DPT 和 DPT+MRB）观察到症状/药物评分的长期降低，同时伴有黏膜/系统抗体反应的调节。
