Siemund Ingrid, Hindsén Monica, Netterlid Eva, Güner Nuray, Bruze Magnus
Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02 Malmö, Department of Dermatology and Venereology, Skåne University Hospital, Lund University, S-221 85 Lund.
Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, S-205 02 Malmö
Eur J Dermatol. 2016 Jun 1;26(3):271-80. doi: 10.1684/ejd.2016.2765.
Type I sensitizations and atopic dermatitis (AD) often appear in the same patient. Beneficial effects of allergen-specific immunotherapy (ASIT) in patients with both AD and type I allergies have been reported. The predisposing role of AD to the development of type IV sensitization is discussed. Whether ASIT for type I allergy also influences type IV allergies is unknown. To compare the number of contact allergies between patients with and without AD, before and after one year's treatment with ASIT. A controlled, single-blind multicentre study of children/adults with allergic asthma and/or rhinoconjunctivitis, treated or untreated with ASIT, was performed. The history of AD was collected using questionnaires. The number of contact allergies was assessed by patch testing with a baseline series. 205 individuals completed the study; 133 treated with ASIT (exposed) and 72 before starting ASIT (unexposed). For participants with AD, significantly more contact allergies were found in the groups of all children (p = 0.002), all exposed children (p<0.001), and all exposed study persons (p = 0.013). Independent of AD, significantly more contact allergies were noted in the groups of all unexposed adults (p = 0.004) and all unexposed study persons (p = 0.004). The higher number of contact allergies in patients with AD indicates that AD may be a risk factor for type IV sensitization in those with allergic asthma and/or rhinoconjunctivitis. The lower number of contact allergies in patients exposed to ASIT suggests an immunomodulatory effect on type IV sensitization.
I型超敏反应和特应性皮炎（AD）常出现在同一患者身上。已有报道称变应原特异性免疫疗法（ASIT）对同时患有AD和I型过敏的患者有有益作用。本文讨论了AD在IV型超敏反应发生中的易感作用。I型过敏的ASIT是否也会影响IV型过敏尚不清楚。为了比较AD患者和非AD患者在接受ASIT治疗一年前后接触性过敏的数量。我们对患有过敏性哮喘和/或鼻结膜炎且接受或未接受ASIT治疗的儿童/成人进行了一项对照、单盲多中心研究。通过问卷调查收集AD病史。使用基线系列进行斑贴试验评估接触性过敏的数量。205名个体完成了研究；133名接受ASIT治疗（暴露组），72名在开始ASIT治疗前（未暴露组）。对于患有AD的参与者，在所有儿童组（p = 0.002）、所有暴露儿童组（p<0.001）和所有暴露研究对象组（p = 0.013）中发现的接触性过敏显著更多。与AD无关，在所有未暴露成人组（p = 0.004）和所有未暴露研究对象组（p = 0.004）中也发现接触性过敏显著更多。AD患者中接触性过敏数量较多表明AD可能是过敏性哮喘和/或鼻结膜炎患者IV型超敏反应的一个危险因素。接受ASIT治疗的患者接触性过敏数量较少表明对IV型超敏反应有免疫调节作用。
